Accident & Sickness Insurance for Activities and Events Excluded under Plan 1 (non-duplication provision does not apply)
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**Allow three (3) business days for processing.**
- Cost is $0.70 per person, per day
- Covers members and non-members as participants.
- Sickness benefits when illness/symptoms occur while coverage is in place.
- Covers travel to and from the covered activity.
- Insurance must be ordered for the entire period of the event and for 100% of the participants.
- All claims are subject to review by Mutual of Omaha.
Minimum processed premium payment is $5.60. In order to meet the minimum, you may submit for more than 1 event on this form.