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1997-61 ¡ . . THE ANNUAL CHARTER AGREEMENT BETWEEN: C fìY "F ûd!Að4 hf'-£ a--¡;r.. and the Name of organization 0 Pack I - I Troop Pi Post Number 0 Team h //121 j)--1 Council, BSA C e::NTØJL The Boy Scouts of America is an educational resource program. It charters community or religious organizations or groups to use Scouting as part of their service to their own members, as well as the community at large. The BSA local council provides the support service necessary to help the chartered organization succeed in their use of the program. The responsibilities of both the BSA local council and the chartered group are described below. The chartered organization agrees to . Conduct the Scouting program according to its own poficies and guidelines as weD as those of the Boy Scouts of America. . (ndude Scouting as part of its overall program for youth and fammes. . Appoint a chartered organization representative who is a member of the organization and will coordinate all unit operations within it He or she will represent the organization to the Scouting district and selVe as a voting member of the local counCIl. (the chartered organization head or chartered organization representative must approve all leader applications before submitting them to the local council.) . Seìect a unit committee of parents and members of the chartered organization (minimum of three) who will screen and select unit leaders who meet the organization's standards as well as the leadership standards of the BSA (the committee chairman must sign all leadership applications before submitting them to the chartered organization for approval.) . Provide adequate facilities for the Scouting unit(s) to meet on a regular schedule with time and place reselVed. . Encourage the unit to participate in outdoor experiences, which are vital elements of scouting. Signe~~~1/~ For the chartered organization '---- Date IllaJ1í f 1 The council agrees to . Respect the aims and objectives of the organization and offer the resources of Scouting to help in meeting those objectives. . Provide year.;ound training, service, and program resources to the organization and its unit(s). . Provide training and support for the chartered organization representative as the primary communication bnk between the organization and the BSA. . Provide techniques and methods for selecting quality unit leaders and then share in the approval process of those leaders. (The Scout executive or designee must approve all leader applications.) . Provide primary general liability insurance to cover the chartered organization, its board, officers, chartered organization representative, and employees against all personal Dability judgments. This insurance includes attorney's fees and court costs as well as the costs of any judgment brought against the individual or organization. Unit leaders are covered U\ excess of any personal coverage they might have, or, if there is no personal coverage, the BSA insurance immediately picks them up on a primary basis. . Provide camping facilities, a service center, and a full-time professional staff to assist the organization in every way possible. Signed For the Boy Scouts of America See other side for discussion gUIde. No 28-182J Goldenrod - Chartered organization; White - Council 8OM597 MAR 24 '94 14:35 F. TREASURY . PAGE.001 BOY SCOUTS OF AMERICA National Office 1325 west Walnut HiJlLAne P.O. Box 152079, Irving. Te¡¡,as 75015-2079 214-580-2000 September 8, 1993 SOBJE cr: PRIMARY GENERAL LIAB II..1JY 1NSURAN CE FOR CHARTERED ORGANI.ZATIONS From: Debra C. Griffith Director Insurance & Risk Management To: Scout Executives EffectÏve January 1, 1984, the Boy Scouts of America assumed. primary responsibility for general liability coverage of the chanered organization, but not for automobile liability. Some chartered org3Iri.z.atioDS IMY not be aware that we provid~ full general liability coverage for any liability arising out of their sponSorship of an official Scouting activity. Vehicles owned by the chartered organization and loaDed to the unit will be coveœd by us on an excess basis for the chartered organization's benefit. When you have a request ñ'om a chartered organization, a Certificate of Insurance can be issued by , Risk Management Service to the chanered organization,. It explains how our general liability coverdge is prlInary for them, or from the first dollar of a claim; in addition to primary coverage for the chartered orgcmiza.tion. it also extends to their boards, officers and employees. While our general liabIlity coverage has been extended on a primary basis to the chanered organizations, the coverage fur our volunteerS remains on an excess basis. Any insurance COVerage th3t a volunteer has, such as a þ.omeownèi" policy or coverage on his or her personal autOmobile, will still protect the volunteer on a primary basjs ~d o~ <::overage will cover hiIn or her above the limits that the Úldividual has. If , ',Uie -YQl~ Jags' no personal <~a, then our coverage will eXtend to cover him or her -lminediáte1<- ~ , , ,-. y '" , '. There is !:l9 'çoverage Jor intentional or crim4W act<;. A copy of ' the Chartered Organization Endorsement (to t4e insuÍ'ancc policy) is attached. This can be shared with the chartered organizations. If you or your chattered organizations should have any qu~ons ~c~g this extension of CQ'Vtrngc;,. pleás~ çontaa Rb¡k ManagcmCnt Service at the National office, 214-580-2228. jm cc: Regional DirectOrs A rea Dit"ccto~ - "'. A Sa OUTLINE OF THE INSUR.E PLANS CONTAINED IN THIS ADMINISTRATIVE GUIDE The following is an outline of the coverage contained in Master Policies issued to the Boy Scouts of America. All information given is subject to the terms and conditions of the Master Policies. Please refer to the sample brochures in this Guide for complete information about benefits, exclusions and limitations. All questions concerning these coverages should be referred to Alexander & Alexander Benefits Services, Inc., 1185 Avenue of the Americas, New York, NY 10036, phone (212) 575-8000. PURPOSE ELIGIBILITY COVERAGE 1989 PREMIUM RATES BENEFITS AND AMOUNTS For Accidental Death For Accidental Dismemberment For Paralysis Medical Expense Benefits for Accidents Nonduplicatìqn Medical Expens~ Benefits lor Sickness For Return T ransportatipn Expense For Air Ambulance Service For Surface Ambulance Service Unit Accident Insurance Plan Provides AcCident Insurance for injuries occurnng dunng any approved. supervised Boy Scout activity. All registered members within a Unit (adulls' are optronal). Participating in and traveling to and from an activity approved and supervised by BSA. All youth members within a Unit must be insured. Leaders cost the same as the Unit they represent. CubslTlger Cubs Scouts Explorers -$ .60 - 1.20 - 1.80 $7,000.00 Up to $14,000.00 Up 10 $14,000.00 Up to $6,000.00 for expenses Incurred within 52 weeks lrom date of Injury $150.00 $1.250.00 dentallimil for iniury to sound, naturaf teeth ~ ~ f\lOT INCLl}DED NOT INCLUDED Up 10 $1,500.00 il recom- mended by a legally qualllied physIcIan or senior represen- latlve 01 a ca'mp or áèlivity Up to $1,500.00 for use of a professional ambulance for transportalìoh to hospital Camper's Accident and Sickness Plan for Councils Provides Accident and SIckness Insurance for illness or injurIes occurring during approved. supervised Boy Scout events sponsored by Councils. All persons (including Seasonal ~g~~~t~I:~ ~~~2t:~I~~~ ~~?I~~~P for attendance at a National or Local Councircãmp or Event. For Injuries and Sickness: While participating 10 and travelîng as a member of a group to and from any activity approved/supervised by BSA. Traveling to and from home as a member of a group immediately belore and after the approved/ supervised activity. (Adult Volunteer Leaders, Explorers and Seasonal Volunteer Staff while traveling individually directly to and from their homes.) 3h~ per person. per day $7,000.00 Up to $14,000.00 Up to $14,000.00 Up to $ß,OOO.OO for expenses incurred within 52 wèeks from date of injury $150.00 $1,250.00 dental limit for ifljury to sound. n.~~~ral teeth Up to $6,ÓOO.00 for expenses incurred within 52 weeks áJter first treatment Up 10 $1,500.QO il recommended by a legally qualified physIcian Up to $1,500.00 II recommended by a legally qualified physiclàn or senior represenlahve 01 a c.amp or activity Up to $1,500.00 for use of a professi9nal ambulance lor transportation to hospital Council Accident and Sickness Insurance Plan Combines the coverages provided under the UnIt Accident Plan and Camper's Accidenl and Sickness Plan under one program. All registered Youth, Seasonal Volunteer Siaff, Leaders and Volunteer Leaders of the CouncIl. (Leader coverage optional.) For Injuries: While participating In and traveling as a member of a group to and from any activity approved/supervised by BSA. For Sickness: While in attendance and while traveling as a member of a group to and from a Council overnfght event or camp. (Adult Volunleer Leaders, Explorers and Seasonal Volunteer Staff while traveling individually dIrectly 10 and Irom.) The cost is determined by multiplying the annual rate of 75e times the average membership figures for the previous 12 months. Premiums can be paid annually, semiannually or quarterly. $7,000.00 Up to $14,000.00 Up to $14.000.00 Up to $6,000.00 for expenses Incurred within 52 weeks from dale of injury $150.00 $1,250.00 dental limit for injury to sound, natural teeth Up 10 $6,000.00 lor expenses incurred within 52 weeks alter first treatment Up 10 $1,500.00 II recommended by a legally qualified phYSIcian Up to $1.50000 II recommended by a legally qualified physician or senIor representative of a camp or activity Up to $1,50000 for use of a professional ambulance for transportallon to hospital - .Plans are available on a first-dollar coverage basIs for Camper's and Council programs Contacl Alexander & Alexander Benehts Services, Inc., lor rates and further information. MtU<S-t 11.90 - 7 'MAR 24 '94 14:35 , .M TREASURY . PAGE.001 ~ ~ BOY SCOUTS OF AMERICA National Office 1315 West Walnut Hill LAne P.O. Box 152079, Irving. Texas 75015.2079 214-580-2000 September 8. 1993 SUBJEcr: PRIMARY GENERAL LIABIIIrY INSURANCE FOR CHARTERED 0 R G ANIZA 'II 0 NS From: Debra C. Griffith Director ~ance & Risk: Management To: Scout Executives EffectÏve January 1, 1984, the Boy Scouts of America assumed prim2ry responsibility for general liability coverage of the chartered organization. but not for automobile liability. Some chartered or~oDS may not be aware that we provid~ full genera1liability coverage for any liability arising out of their sponsorship of an official Scouring activity. Vehicles owned by the chanered organization and loaDed to the unit will be CQvered by us on an excess baSis for'the chartered organization's benefit. When you have a'request from a chartered organÏzarion, a CertifiC3!e of Insurance can be issued by Risk Management Service to the chartered organization. It explains bow our gene.m liability coverage is prlInary for them, ot" from the first: doUar of a claim; in addition to primary coverage for the chartered organiz3tion. it also extends to their boards. officers and eIl1ploy~. While our general liabIlity coverage has been extended on a primary basis to the chartered organizations, the coverage fur our vol~ remains on an ace:ss basis. Any i.ns\u:ance cove.ragc th& a volU11teer has, such as a homeowner policy or coverage On his or her personal automobile, will still protect the volunteer on a primary basis and au,! coverage will cov~ l;Üm or her above the limits that the individual has. If ,tþe volunteer bas no personaJ ~œ7 thin our èovérage will extend to cover him or her , ~<ijnînèâîat.~ly'.- ~ '.: ~ . , There is ~o ~verage for intentional or ~ acts. . A copy of the Chartered Orgai1Ízarion Endorsement (to t:l!e iIlSUÍ'aDcc policy) is attached. This çan be shared wÏth the chartered. organizations. If ýou or your chartered organizations should have any qu~ons concerning this extension of ÇÖ'Vmgt:; pleas'c ÇQntact ~k ManagcmCnt Service at the National Office, 214-580-2228., jm cc: Regional Directors Af'e.a Din~cton: "". ~Q :t< ~ « ~~ ë; 4~~ ~ 6 '" --------------------, m~ - a. ~~ a:Uo, :curo m Cm Ìi5 ro ro -D m- E o>ro o>uc E ~g (ij ~g ~ 0 C æ g § ~ g~ ~ E ~ E E 0 0> U ~ ~ ..r::. 0> ... U ~ ro ~ .3 LO CO CD ~tfi tßl LOW .... U- N(/)- (l}f-...J ::>CI: (/)01:2 U CI:(/)(!) w>-Z CI:f-- O_z ...J(/)CI:-o- o..CI:«'=' X<X:uJ 5 W>...Jl 0000 ~ ~ 0> Q C J:J 0 E tj{3 ~ o>ro ~ ..r::. 0> :; Uo g, ~...... ( xtfi : ~ ~ Q m E ... '" C ( ~ '" ro .>< a. g u CO ~ -c LO~ .!!!~ .,..;g¡ ~(/)O(l}¿ rol'-: ::>(1} UI~ CI:(/)::> Wroo ~::>U f-U(/) 000 in ~lJ Õ Ìi5 -D E ~ z >. C ro a. E 0 ~ U u- 0> -c 0 cI:0> c W"Q..r::.ro :20_'- ....O§:~ ....« c lL"'='E-ro O§~jg~ ~ 0 e~ 11 =>::0..00> Oco>_z uO>oo - cn.sæ(ijjg >-O::;.3ro Ocm~E ~.., r "" r-o '=0> :::£ m,- E.E 0::: -0 Eñ> iij-D °-g u- c.~ ro- o>C 00 c~ ~2i. ~ u mo>o> C..r::. '- --~ -om 0 -.!; O>uo> 1§Æ-D -roo '€E:';; O>a>c " - - c.I .5 § !I~ !ð! ~ t .. ¡Æ~- ~~~§! J!! J .g .di ~5=;¡ö Q i' Q -- II) J!! ~ g: ~~ ~ ëiJ ~i~~'l '2 1: ]!!~~~ ;;¡ ~ ~ J!!:31 ð u è5 <::z ~ E " z '2 => ~ 0.. Ñ II) 19 en .8 E " z II) c: 0 % ;§ '" ~ ~ z ~ -6 ~ ~ u b'l ~ I ~ I ói I 'I I I I 'I 'I 'I I 'I I I I , I I fßl z' ::¡ ,I @I 1= ,I 81 ~I 91 ~ I ~ ,I ~,I °,1 I I I , I I I I I I I I I I 'I ~ I ~ I 0 I New Catastrophic Benefits 1 ~~7 ~nrl1 QQR Dear Scouter. This brochure descnbes the Unit Accident Insurance Policy, arranged for you by the Boy Scouts of Amenca through Mutual of Omaha Insurânce . Company, which we recommend Although Scouting programs are designed for safety, aCCIdents do happen This Insurance program IS . designed to help meet the costs of medical care, paralysIs, dismemberment and death. Claims involving surgical and hospital expenses are payable on a nonduplicatfon basis as described below. . Please reVIew Ìhis brochure carefully to leam all the facts about the plan, Including Its benefits and restnctions, the easy enrollment feature and simplified claim-handling procedure. Administration of the Master Policy WIll be handled by Alexander & Alexander Benefits SeMCeS, Inc, 1185 Avenue of the Amencas, New York, NY 10109-0821. BOY SCOUTS OF AMERICA WHO IS TO BE INSURED? All registered youth (liger Cub Group, Cub Pack, Scout Troop, Varsity Team Explorer Post or Leaming for life groups) must be Insured. Leaders and committeemen, as a group, may be Insured at their option. New Members, Nonscouts and Nonscouters New members added during the year are automatically covered under thiS plan until the renewal date without additional premium This includes leaders and committeemen, if Insured Nonscouts, nonscouters and guests attending scheduled actlvrtJes for the purpose of being encouraged to become registered leaders or Scouts are automabcally insured at no additional cost. Other guests are not covered. See question 8. WHAT DOES THIS INSURANCE COVER? The insurance provides benefits, while the coverage is in force, for injuries to an insured person, anywhere in the world, while: (a) participabng in any activity approved and supervised by the Boy Scouts of Amenca or Leamlng for life or (b) traveling directly to or from such activities (travel is not limited to "as a grouPÎ. WHAT WILL IT COST? The annual cost IS $.70 for each Tiger Cub and each parent, $.70 for each Cub, $1.58 for each Scout or Varsity Scout, $2.15 for each Explorer and $.65 for Leaming for life members (Leaders pay the same rate as the unit they represent) Premium for youth and leaders is to be calculated on the basis of 100% of the membership of the unit, using the appropriate rate from above. WHAT ARE THE BENEFITS? BENEFITS FOR ACCIDENTAL DEATH, DISMEMBERMENT AND PARALYSIS When InJunes to the Insured result In death or dismemberment within one year from the date of the covered accident, and from loss which IS independent of sickness and all other causes, the Company will pay as follows. $7,000 Accidental Death Benefit Up to $14,000 for Dismembennent and Loss of Sight Benefits For loss of a combination of any TWO - hands, feet or eyesight, the Company will pay the full benefit of $14,000 For loss of ONE - hand, f",,' M n..n thn "'n~n~n.. ...11 n~" ~') CNI CM Innn n' +h.._h M..I .-..1- " finger, $1,750 As defined In the policy, loss of hand or foot means complete severance Loss of sight means total, uncorrectable and Irrecoverable loss of sight. . Up to $14,000 for Paralysis When InJunes result In paraplegia, hemiplegia or quadnplegla com- mencing wrthln 60 days after the covered accident and conhnUing for one year, the Company will pay $7,000 for paraplegia or hemi- plegia and $14,000 for quadriplegia. "Paraplegia" means complete paralysis of the lower extremities of the body With involvement of both legs. "Hemiplegia" means complete loss of function of one side of the body with Involvement of the arm and leg. "Quadnplegla" means complete paralysis of both the upper and lower extremities of the body WIth Involvement of both anTIS and both legs In the event of multiple losses or death resulting from anyone aCCI- dent, only one benefit IS payable. . the largest amount applicable BENEFITS FOR MEDICAL EXPENSES, DENTAL TREATMENT AND AMBULANCE SERVICES Up to $6,000 for Medical Expense Benefits For each inJury, benefits in the aggregate of up to $6,000 are payable for medical or surgical treatment beginnIng WIthin 60 days from the date of the aCCIdent, prescripbon drugs or for hospltalizahon or the exclusive selVlces of a pnvate duty nurse (RN or LPN). . Benefits will be paid for expenses Incurred up to the usual, rea~ able charges nonnally made within the geographic area where tr ment IS performed. Payment of benefits is subject to the Nonduplication Provision explained below. Nonduplication Provision When surgical treatment or hospital care IS Involved, benefits In excess of the first $150 WIll be payable only for the expenses shown above which are not recoverable under any other insurance policy or selVlce contract If no other collectJble Insurance IS available, this Nondupllcatlon ProVIsion WIll not apply SPECIFIED INJURY BENEFITS The aCCIdent medical benefit will be Increased from $6,000 up to $25,000 for medically necessary treatment due to the following specified InJunes (a) loss of sight In both eyes; (b)dlsmembennent, (c) paralysIs, (d) Irreversible coma, (e) entire loss of speech, or (~ loss of heanng In both ears "Irreversible Coma" means' (a) state of unconsciousness In whICh there IS a cessation of activity In the central nervous system as demonstrated by an electroencephalogram (using cntena established by the Amencan Electroencephalography Society), and (b) a diagnosIs of brain death by the attending Legally Qualified Up to $1,250 for Dental Treatment Pays for dental,njunes, up to a total of $1,250 for treatment andlor replacement of sound, natural teeth If, within the 52-week pened followmg the date of the covered aCCIdent, the Insured's attending dentIst certifies that dental treatment andlor replacement must be deferred beyond such 52-week pened, the Company will pay the estimated cost of such treatment, however, benefits shall not exceed a total of $1 ,250. This benefit shall be paid 10 addition to any other benefit Ambulance Service Benefits Pays for air ambulance seMce up to $6,000 when, In the judgment of the duly authonzed medical authonty or the senior representatIVe of the camp or activity, such seMce IS needed to facilitate treatment of InJunes and no other ambulance service IS available Pays for professional ambulance seMce up to $6,000 for surface transportatIon to a hospital These benefits shall be in addition to any other benefit payable under the tenns of thiS plan. Benefits for medical expenses, dental treatment and ambulance ser- ViceS are payable for seMces or treatment performed and supplies fumlshed within 52 weeks of the date of the covered accident. Treatment must begin within 60 days of the date of the accident NOTE: When medical expenses, dental treatment or ambulance seMces are Incurred as a result of injunes receIVed while partrclpatlng In any Nabonal, Regional or Local Council sponsored camp or special event, Includmg travel to and from the camp or event, the Company will pay the benefits descnbed above, but only for such expense which IS not recoverable under any policy ISSUed to the Boy Scouts of Amenca or Leammg for life to proVIde coverage for such camp or event. EXCLUSIONS - The policy does not cover. (a) the cost of medical or surgical treatment or nursing seMce rendered by any person employed or retained by the Boy Scouts of America or Leamlng for Life, (b) suIcide or any attempted suIcide; (c) intentionally self.inflict. ed ,nJunes; (d) eye refracbons, replacement of eyeglasses or contact lenses or heanng aids, or the fitting thereof; (e) loss caused by an act of declared or undeclared war, (~ dental treatment or dental X-rays, except for InJunes to sound, natural teeth; (g) disease or bactenallnfectron (except pyogenic Infectron which occurs WIth and through an accidental cut or wound). Medical expense benefits are not payable for any Injunes covered under workers' compensation or employer's liability laws 1. O. What is an approved and supervised activity? A. An actIvity camed out by youths who are registered members, or Leamlng for lJIe partrclpants, under the approval and overall supeMslon of Unit leaders, In keeping WIth the policies and standards of the BSA or Leamlng for life participants 2. O. Must leaders and committeemen be covered? A. No. Coverage IS optIonal. If elected, all must be Insured, including Den Aides/Chiefs 3. O. What rate must leaders and committeemen pay for this insurance? A. The same rate which applies to the youth members applies to them (I e., Cubmasters - $ 70, Scout or Varsity Leaders- $1.58, Explorer Advisors - $2 15, Leammg for life Leaders - $.65). 4. O. Are covered medical expenses payable in addition to bene- fits received from other forms of insurance? A. For claims involvmg hospital and surgical expenses, the plan pays the first $150 for covered medical expenses, regardless of other benefits that may be available under other fonns of Insur- ance (except for the National, Regional or Local CounCIl spon- sored camps or speCIal event plans descnbed preVIously In thiS folder). After benefits exceed $150, benefits under thiS plan are payable, up to a maximum of $6,000, only for such expenses that exceed the limit of benefrts available under other forms of Insurance. If no other collectrble insurance IS available, the Nonduplicabon Provision will not appty. The proVISion applies only to the medical expense benefits. Benefits for accidental loss of life, limb, eye- sight, paraplegia or quadriplegia are payable regardless of other Insurance. 5. O. If new members join our unit after we have applied for the insurance, are they covered? A. Yes. New members are automatically covered until the renewal date of your Certificate of Insurance as soon as their applicatIons are processed. No addnional premium IS necessary 6, O. Are Tiger Cubs eligible for coverage? A. Yes. When a TIger Cub joms a pack which has coverage In force, both he and his parent are automatIcally covered. When a Cub Pack renews the Insurance, all TIger Cubs of the pack (including parents) must be Insured The rate IS $ 70 for each TIger Cub and $ 70 for each parent. 7. O. What happens if the Cub Pack they are affiliated with does not have this Insurance? A. TIger Cub grou~wlli stIlI be allowed to enroll In the Unit ACCIdent Insuranœ Program even though their Cub Pack IS not Insured All TIger Cubs and a parent for each must be Insured 8. O. Are guests covered? A. Only nonscouts, nonscouters or guests who are being encour- aged to become registered leaders or Scouts are automatIcally covered at no extra cost while In attendance at a meetIng or Unit activity or while traveling as a group to or from such an activ1ty Other guests are not covered. 9. O. Who applies for this insurance? A. The Unit leader or the unit leader's representabve should apply for this msurance Please refer to HOW TO ENROLL for detæls. 10. O. For what period of time does coverage remain In force? A. A Certrficate of Insurance IS ISSUed for one year from the date the property completed enrollment form and annual premium are received by Alexander & Alexander Benefits SeMces, Inc , or from the date requested, If It IS later. 11. O. Will we receive notice that our coverage will expire? A. Yes. ApproXImately one month prior to the expiratIon date However, you must notify Alexander & Alexander Benefits Services, Inc., of any change of leaders so that the renewal reminder will be mailed to the correct person. 12. O. What is my unit's MB number? A. The label attached to the Certificate of Insurance you receIVe WIll Include a number with prefix MB located to the nght of the expi- ratIon date. This IS your unit's Identification number to be referred to on all inquiries and clæms. CLAIM PROCEDURE Immediate notIce of claims and alllnqUines regarding claims should be directed to' Mutual of Omaha Insurance Company ATTN: Special Coverages Claims Services P.O. Box 31156 Omaha, Nebraska 68131-0156 Be sure your unJfs MB number IS entered on claim forms. ff ,claim forms are needed, call or wnte the administrator of thiS program: Alexander & Alexander Benefits Services, Inc., 1185 Avenue of the Amencas, New York, NY 10109-0821, phone 1-800-BSA-ACG1 or 1-800-272-2241 MC13509 8-96 PolICy Form S13Y ~'" .~ ENROLL ". ~~7~- . ~ ~ .. '. r-----------------~-- I' 1. Complete the enrollment form on the back of thiS panel. I' One enrollment form should be completed for each unit I' to be Insured. Please print leglbty In Ink. I' 2. Make your check or money order for the annual premium I' payment payable to Alexander & Alexander Benefits I Services, Inc. Do not send cash. I 3. Mall your completed enrollment form and annual preml- I um payment in the attached postage paid envelope at I' least two weeks prior to the desired effectIVe date. I' Coverage becomes effective on the date the enrollment I' form and annual premium payment are received by . I Alexander & Alexander Benefits Services, Inc., or at a I' date if requested. I' A Certificate of Insurance with an identifying MB number and I clæm forms will be mailed to the person whose name is on the I enrollment form following acceptance of the enrollment form I' NOTE: This brochure has been prepared by Mutual of I' Omaha Insurance Company. The information gIVen IS I a description of the coverage, benefits and exdusions I contained In the Master Policy issued to the National , Council of Boy Scouts of America ... and all informa- I bon gIVen IS subject to the terms and conditions of the I' Master Policy. I' BSA's program of Unit Accident Insurance is presented and I administered by I' I I' I' I' I' I I I, I I I I I I I I I 1 I I I I &J[e . BENEFITS SERVICES 1185 Avenue of the Americas New York, NY 10109-0821 () MlßUïlL~/ÜmïlHïI COmPilDleS Underwritten by Mutual of Omaha Insurance Company Home Office: Omaha, Nebraska