Hospital Insurance

Services covered

Group Hospital Insurance helps covered employees and their families cope with the financial impacts of a
inpatient hospitalization. You can receive benefits when you’re admitted to the hospital for a covered accident, illness or childbirth.

Why is this coverage so valuable?

• The money is payable directly to you — not to a hospital or care provider. The money can also help you pay the out-of-pocket expenses your medical plan may not cover, such as co-insurance, co-pays and deductibles.
• You get accessible rates when you buy this coverage at work.
• The cost is conveniently deducted from your paycheck.
• You may take the coverage with you if you leave the company or retire. You’ll be billed directly.

Be Well benefit

Every year, each family member who has Hospital coverage can also receive $50 for getting a covered Be Well screening test, such as:

• Annual exams by a physician include sports physicals, wellchild visits, dental and vision exams
• Screenings for cancer, including pap smear, colonoscopy
• Cardiovascular function screenings
• Screenings for cholesterol and diabetes
• Imaging studies, including chest X-ray, mammography
• Immunizations including HPV, MMR, tetanus, influenza

Who can get coverage?

You:	If you’re actively at work.
Your spouse:	Can get coverage as long as you have purchased coverage for yourself.
Your children:	Dependent children newborn until their 26th birthday, regardless of marital or student status.

Employee must purchase coverage for themselves in order to purchase spouse or child coverage. Employees must be legally authorized to work in the United States and actively working at a U.S. location to receive coverage.

See disclosures for more information. If enrolling, and eligible for Medicare (age 65+; or disabled) the Guide to Health Insurance for People with Medicare is available at https://www.medicare.gov/

How much does it cost?

Your monthly premium	Option 1	Option 2
You	$15.05	$10.05
You and spouse/domestic partner	$30.20	$20.10
You and your children	$20.50	$14.17
Family	$35.65	$24.22

Hospital

Option 1 benefits

Hospital Admission	Payable for a maximum of 1 day per year	$1,000
Hospital Daily Stay	Payable per day up to 90 days	$100
ICU Daily Stay (additive to daily stay)	Payable per day up to 30 days	$100

Option 2 benefits

Hospital Admission	Payable for a maximum of 1 day per year	$500
Hospital Daily Stay	Payable per day up to 90 days	$100
ICU Daily Stay (additive to daily stay)	Payable per day up to 30 days	$100

Exclusions and Limitations

Hospital insurance filed policy name is Group Hospital Indemnity Insurance Policy. The definition of hospital does not include certain facilities. See your contract for details.

Active employment

You are considered in active employment if, on the day you apply for coverage, you work at least 20 hours per week and perform the essential duties of your job. Coverage will be delayed if you're not actively working due to injury, illness, layoff, or leave of absence when your insurance would otherwise start.

Childbirth

Unum will pay benefits due to Childbirth for any Insured after the Insured’s Coverage Effective Date. Childbirth or Complications of Pregnancy will be covered to the same extent as any other Covered Sickness.

Exclusions and limitations

Additionally, no benefits will be paid for a Covered Loss that occurs prior to the Coverage Effective Date.

THIS INSURANCE PROVIDES LIMITED BENEFITS

This coverage is a supplement to health insurance. It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law.

This information is not intended to be a complete description of the insurance coverage available.  The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to full policy.

Publications and policies

Publications

• View hospital insurance flyer

Policy

• G7.02-6.1.7 Voluntary Benefits