Emergency medical services (EMS) accounts raise three coverage questions worth answering before renewal. Who on the crew is covered? Which ambulance-specific exposures do the benefits address? And does protection continue once a shift ends? Those answers show how first responder health insurance works for an agency and where it falls short.
What Makes EMS Risk Different From Fire Department Risk?
The National Institute for Occupational Safety and Health (NIOSH) estimates that U.S. hospital emergency departments treated 16,900 nonfatal injuries among EMS clinicians in 2020, counting both paid and volunteer EMS duties.
Sprains and strains were the most common injuries in the NIOSH data. The data illustrates the physical side of EMS work, which may include, for example, lifting a patient off a bathroom floor and carrying a stair chair down three flights.
The ambulance adds its own exposure. Paramedics and EMTs treat patients in the rear compartment while the vehicle is in motion. Emergency response driving increases the danger: according to the American Ambulance Association, crash risk rises by more than 50% when lights and sirens are on.
Calls can also involve contact with blood and bodily fluids, along with aggression from patients or bystanders. Agents should check whether a client’s program includes benefits tied to those exposures. The benefits section below covers which ones do.
How Does EMS Staffing Affect Benefit Eligibility?
National Registry research on the EMS workforce found that clinicians who needed more than one EMS job to make ends meet had higher odds of leaving the workforce within one year. For agents, the finding is a reminder that an EMS agency’s workforce may extend beyond a straightforward roster of full-time employees. When reviewing an account, agents should understand how the agency staffs its shifts and which workers are eligible for the benefits being offered.
Start with the schedule. Ask the agency who covers its shifts, whether full-time, part-time, per-diem, or volunteer, and how it classifies each group. Then compare that picture with the program’s eligibility terms. Provident’s 24-hour AD&D coverage, for example, applies to eligible members and employees, and the policy terms determine who qualifies.
Eligibility comes first because A&H and AD&D benefits pay only for people the policy covers. If the agency’s staffing and the program’s eligibility terms don’t clearly line up, bring the question to Provident before renewal.
Which First Responder Health Insurance Benefits Address Ambulance Crew Risks?
Provident’s A&H program includes a Total Disability due to Injury benefit, payable weekly for life. The benefit requires no Permanent Physical Impairment Rating to qualify, so the paramedic doesn’t need an Impairment Rating for the benefit to apply.
A family expense benefit reimburses expenses for a family member who helps care for an insured person in the hospital or during outpatient care, including the family member’s lost wages. The coverage also includes the First Responder Assistance Program, a confidential, non-insurance service with 24/7 resources and referrals for responders and their families. Because A&H benefits pay independently of workers’ comp, a claim under one doesn’t reduce a payment under the other.
Off-duty injuries call for a different product. 24-hour accidental death and dismemberment (AD&D) coverage applies to eligible members on and off duty, anywhere in the world, subject to policy limitations and exclusions. AD&D pays for covered losses the policy defines, rather than every injury.
Several AD&D benefits connect to the exposures above. Seatbelt and airbag benefits may apply following a vehicle accident. For occupational hepatitis exposure, Provident offers the Hepatitis Occupational or Assigned Duties Accident Benefit. For violence on scene, the Felonious Assault & Violent Crime Benefit is available as an additional benefit.
Agencies can also purchase line-of-duty occupational coverage. It pays 100% of the principal sum, the policy’s stated benefit amount, for loss of life, up to a maximum benefit of $50,000.
Start the Next EMS Coverage Review With the Roster
A current roster does double duty. It answers the eligibility question and provides what a quote requires. Provident’s quote process asks how many members and employees the organization wants to cover and which benefit limits it wants to set.
Bring a roster listing every class, including per diem, part-time, and volunteer crews, when you review first responder health insurance with an EMS client. Benefits depend on the plan selected. Coverage carries exclusions and limitations, and availability and plan design can vary by state.
FAQ on EMS Insurance Gaps
Do EMTs get benefits?
It depends on the employer and the EMT’s status with the agency. For per-diem, part-time, and volunteer EMTs, coverage under an agency program depends on the policy’s eligibility terms. Agents should confirm how those terms apply to each group the agency uses.
What is A&H insurance for first responders?
A&H insurance for first responders provides income replacement and additional benefits after a covered injury, and some benefits also extend to covered illness. In Provident’s A&H policy, the benefits pay independently of one another, and coverage is available for both paid and volunteer responders.
Does AD&D insurance cover off-duty accidents?
A 24-hour AD&D program, like the one offered by Provident, covers eligible members at work and off duty, subject to policy limitations and exclusions.
About Provident
Founded in 1902, our rich history involves the creation of custom firefighter insurance benefits in 1928. Today, Provident continues to be a pioneer in developing insurance programs for firefighters, EMS providers, municipal entities, and law enforcement. In addition, we provide Special Risks insurance for various volunteer and nonprofit groups. Give us a call today at (412) 963-1200 to speak with one of our representatives.