2017 Benefit Guide Hand Family

14 / 20

Voluntary Accident Benefit
Customer Service: (888)600-1600
Websites:
Group Number: 00478539
Coverage Details Benefit
Accident Emergency Room Treatment $150
Air Ambulance $500
Ambulance $100
Burns (2nd Degree/3rd Degree) Schedule up to $12,000
Burn—Skin Graft 50% of burn benefit
Child Organized Sport 20% increase to child benefit
Coma $7,500
Concussions $50
Dislocations Schedule up to $3,600
Eye Injury $200
Fracture Schedule up to $4,500
Hospital Admission $750
Hospital Confinement $175 a day up to 1 year
Hospital ICU Admission $1,500
Hospital ICU Confinement $350 a day up to 15 days
Joint Replacement (Hip/Knee/Shoulder) $1,500/$750/$750
Laceration Schedule up to $300
Surgery Schedule up to $1,000
This is only a partial list of covered benefits. Please see accident policy for a complete listing.
Employee Only $6.43
Employee and Spouse $9.92
Employee and Child(ren) $10.15
Family $13.64
Bi-Weekly Premium