Benefit Highlights  
This policy is designed to pay cash benefits when an employee is hospitalized or receives other medical treatment covered under the policy and provides cash benefits with streamlined flexibility from day one.
• Supplements existing medical coverage by filling gaps created by rising:
• Deductibles
• Increasing co-payments
• Higher out-of- pocket maximums
• Benefits are paid directly to the employee or medical service provider and are not coordinated with any other form of insurance
• Use the cash benefits as needed to cover:
• Out-of-pocket medical expenses
• Everyday living expenses
• Unexpected expenses
POLICY BENEFITSLowHigh
First Day Hospital Confinement$5,000$5,000
Maximum Days Payable per Year1 Day1 Day
Daily Hospital Confinement (Day 2 Forward)$100$100
Maximum Days Payable per Year31 Days31 Days
First Day ICU Confinement $500
Maximum Days Payable per Year
Not Covered
1 Day
Daily ICU Confinement (Day 2 Forward)$100
Maximum Days Payable per Year31 Days
Emergency Room Treatment (Covered Accident)$150
Maximum Days Payable per Year3 Days
Emergency Room Treatment (Covered Sickness)$100
Maximum Days Payable per Year2 Days
Inpatient Surgery$1,000
Maximum Days Payable per Year1 Day
ADDITIONAL BENEFITSLowHigh
MaternityIncludedIncluded
Pre-existing Limitation6/66/6

THIS IS NOT MAJOR MEDICAL INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL INSURANCE. IT DOES NOT QUALIFY AS MINIMUM ESSENTIAL COVERAGE
(MEC) AS DEFINED BY THE FEDERAL AFFORDABLE CARE ACT (ACA).
This is not a complete disclosure of plan qualifications and limitations. Please review this information before applying for coverage. The amount of benefits provided depends
on the plan selected. Premiums vary according to the selection made.