Additional Benefits
You have the option to purchase accident insurance, which helps to protect your finances after an accident. You are paid a lump sum if you have a covered injury and can use the money to help pay out-of-pocket medical costs or everyday expenses.
Accident Hospital Care |
Benefit |
|---|---|
Ambulance (Air) |
$1,500 |
Ambulance (Ground) |
$300 |
Emergency Room Benefit |
$300 |
Urgent Care Benefit |
$225 |
Surgery |
Schedule to $3,500 |
Event (Accident Care) |
Benefit |
|---|---|
Concussion |
$300 |
Dental Extraction |
$125 |
Dental Crown / Broken Tooth |
$300 |
Dislocations |
Schedule to $10,000 |
Dislocation (Partial) |
25% |
Eye Injury |
$400 |
Fractures |
Schedule to $9,000 |
Fractured Rib |
Schedule to $1,350 |
Fractured Toe |
Schedule to $400 |
Lacerations |
Schedule to $900 |
Sports Accident Benefit Percent |
Not Included |
Tendon, Ligament, Rotator Cuff |
Schedule to $1,000 |
Common Treatment |
Benefit |
|---|---|
Physicians Office Visit |
$100 |
Follow Up Treatment |
$150 for 6 visits |
Chiropractic Care |
$75 for 6 visits |
Physical Therapy |
$75 for 6 visits |
X-Ray |
$75 |
Wellness |
Benefit |
|---|---|
Wellness Benefit Amount |
$50 |
Wellness Benefit Frequency |
Insured/Per Calendar Year |
Routine Dental Exam |
Not Included |
Routine Vision Exam |
Not Included |
Lipid Panel (Blood Test) |
Included |
Immunizations |
Not Included |
Per Pay Period Cost |
|
|---|---|
Employee Only |
$4.27 |
Employee + Spouse |
$6.79 |
Employee + Children |
$9.38 |
Employee + Family |
$12.43 |
You have the option to purchase critical illness insurance, which provides a fixed, lump-sum benefit upon the diagnosis of a serious illness like heart attack, stroke, or cancer. Benefits are paid directly to you and may be used for any reason from deductibles and prescriptions to travel expenses, childcare or other everyday expenses.
Benefits |
First Occurence |
Second Occurence |
|---|---|---|
Cancer Benefits |
||
Invasive Cancer |
100% |
100% |
Carcinoma in Situ |
25% |
25% |
Skin Cancer |
$500 |
$500 |
Benign Brain Tumor |
100% |
100% |
Vascular Benefits |
||
Coronary Artery Disease |
25% |
25% |
Heart Attack |
100% |
100% |
Stroke |
100% |
100% |
Major Organ Benefits |
||
Kidney Failure |
100% |
0% |
Major Organ Failure |
100% |
100% |
Progressive Disease Benefits |
||
Advanced Alzheimer's |
100% |
100% |
Advanced Parkinson's |
100% |
100% |
ALS - Lou Gehrig's |
100% |
100% |
Multiple Sclerosis |
100% |
100% |
Wellness |
||
Wellness Benefit Amount |
$50 |
$50 |
Wellness Benefit Frequency |
Insured/Per Calendar Year |
Insured/Per Calendar Year |
Routine Dental Exam |
Included |
Included |
Routine Vision Exam |
Included |
Included |
Lipid Panel |
Included |
Included |
Immunizations |
Included |
Included |
Employee Maximum Election |
$20,000 |
Spouse Maximum Benefit |
$20,000 |
Child Benefit Amount |
Up to 50% of Employee, up to $5,000 |
Dependent Age Limit |
To Age 26 |
Guarantee Issue |
|
Employee |
Matches Maximum Benefit |
Spouse |
Matches Maximum Benefit |
Child |
Matches Maximum Benefit |
Monthly Rates by Age per $1,000 of Benefit |
|
|---|---|
Age |
EE & Spouse Rate |
Under Age 25 |
$0.350 |
25 - 29 |
$0.350 |
30 - 34 |
$0.610 |
35 - 39 |
$0.610 |
40 - 44 |
$1.320 |
45 - 49 |
$1.320 |
50 - 54 |
$2.800 |
55 - 59 |
$2.800 |
60 - 64 |
$6.070 |
65 - 69 |
$6.070 |
70 - 74 |
$12.070 |
75 - 79 |
$12.070 |
80+ |
$19.090 |
Child |
Built in Employee rate |
You have the option to purchase hospital indemnity insurance, which pays you benefits while you are confined to a hospital. This type of coverage is helpful because it covers your out-of-pocket expenses not covered by your medical plan.
Benefits |
|
|---|---|
Hospital Admission Benefit |
$1,000 |
Hospital Confinement Benefit |
$100 for 30 days |
Hours of Confinement Required |
18 Hours |
ICU Admission Benefit |
$2,000 |
ICU Confinement Benefit |
$200 for 30 days |
Newborn Confinement Benefit |
$75 per day for 2 days |
Rates Per Pay Period |
|
|---|---|
Employee Only |
$9.92 |
Employee + Spouse |
$21.83 |
Employee + Children |
$13.10 |
Employee + Family |
$26.20 |