Page 10 - 2019 DLS Enrollment Guide
P. 10
2019 BENEFITS ENROLLMENT
ADDITIONAL VOLUNTARY COVERAGE
Regular expenses, big and small, Accident Monthly Premiums
can add up. Think about your ability Coverage Level You Pay
to pay for those expenses if you or Employee $9.07
your family member experienced Employee + Spouse $18.06
a covered accident, illness, or Employee + Child(ren) $18.66
hospitalization. MetLife’s accident Family $23.37
and critical illness coverage can Critical Illness Coverage
supplement your health plan and
provide you and your family with the There are a lot of expenses associated with a critical illness and a major
additional financial protection you medical plan usually won’t cover them all. Critical illness coverage, provided
may need. These plans pay benefits by MetLife, helps you focus on recuperation instead of being distracted by the
directly to you and you decide how extra expenses you may be facing. Similar to life insurance which pays your
to use the benefit. beneficiary a lump-sum benefit upon death; a critical illness plan pays you a
cash benefit upon a diagnosis of a covered illness. Employees can purchase up
Accident Coverage to $30,000 of coverage; spouses and children can purchase up to $15,000 of
coverage. All coverage is offered on a guarantee issue basis. Covered diagnoses
Injuries occurring off the job can include but are not limited to the following.
be protected with MetLife accident
insurance. This plan is designed Cancer Organ transplant
to pay cash directly to you, the Heart attack Stroke
employee. This additional cash
support can be used to help pay any Critical Illness Monthly Rates per $1,000 of Coverage
out-of-pocket expenses related to the Attained Age Employee Employee + Employee + Family
Only
injury. Payments are made tax free, <25 $0.62 Spouse Child(ren) $1.31
$0.93
$0.99
to be used at your direction. 25-29 $0.65 $1.06 $0.97 $1.37
30-34 $0.85 $1.35 $1.17 $1.66
Example: Broken $ Paid to 35-39 $0.97 $1.54 $1.29 $1.85
Ankle You 40-44 $1.12 $1.79 $1.44 $2.11
Emergency Room $200 45-49 $1.61 $2.57 $1.93 $2.89
X-Ray $200 50-54 $2.29 $3.67 $2.61 $3.99
Broken Ankle, Closed $500 55-59 $3.20 $5.14 $3.52 $5.45
Reduction 60-64 $4.30 $6.93 $4.61 $7.24
(no surgery) 65-69 $5.92 $9.60 $6.23 $9.91
Ankle Brace $100 70+ $8.84 $14.17 $9.15 $14.49
Crutches $100
Physical Therapy $150 total Wellness Benefit
(six sessions) for 6
sessions This benefit pays $50 per calendar year per insured individual if a
Physician Follow-Up $75 covered health screening test is performed, including blood tests, chest
Total Dollars Payable $1,325 x-rays, stress tests, mammograms, and colonoscopies. A full list of
To Employee covered tests will be provided in your certificate. This wellness benefit
See SPD for full listing of coverages. applies for both the accident and critical illness coverage plans. If a
policy holder is enrolled in both plans, then they will receive a wellness
10 benefit for each plan.
ADDITIONAL VOLUNTARY COVERAGE
Regular expenses, big and small, Accident Monthly Premiums
can add up. Think about your ability Coverage Level You Pay
to pay for those expenses if you or Employee $9.07
your family member experienced Employee + Spouse $18.06
a covered accident, illness, or Employee + Child(ren) $18.66
hospitalization. MetLife’s accident Family $23.37
and critical illness coverage can Critical Illness Coverage
supplement your health plan and
provide you and your family with the There are a lot of expenses associated with a critical illness and a major
additional financial protection you medical plan usually won’t cover them all. Critical illness coverage, provided
may need. These plans pay benefits by MetLife, helps you focus on recuperation instead of being distracted by the
directly to you and you decide how extra expenses you may be facing. Similar to life insurance which pays your
to use the benefit. beneficiary a lump-sum benefit upon death; a critical illness plan pays you a
cash benefit upon a diagnosis of a covered illness. Employees can purchase up
Accident Coverage to $30,000 of coverage; spouses and children can purchase up to $15,000 of
coverage. All coverage is offered on a guarantee issue basis. Covered diagnoses
Injuries occurring off the job can include but are not limited to the following.
be protected with MetLife accident
insurance. This plan is designed Cancer Organ transplant
to pay cash directly to you, the Heart attack Stroke
employee. This additional cash
support can be used to help pay any Critical Illness Monthly Rates per $1,000 of Coverage
out-of-pocket expenses related to the Attained Age Employee Employee + Employee + Family
Only
injury. Payments are made tax free, <25 $0.62 Spouse Child(ren) $1.31
$0.93
$0.99
to be used at your direction. 25-29 $0.65 $1.06 $0.97 $1.37
30-34 $0.85 $1.35 $1.17 $1.66
Example: Broken $ Paid to 35-39 $0.97 $1.54 $1.29 $1.85
Ankle You 40-44 $1.12 $1.79 $1.44 $2.11
Emergency Room $200 45-49 $1.61 $2.57 $1.93 $2.89
X-Ray $200 50-54 $2.29 $3.67 $2.61 $3.99
Broken Ankle, Closed $500 55-59 $3.20 $5.14 $3.52 $5.45
Reduction 60-64 $4.30 $6.93 $4.61 $7.24
(no surgery) 65-69 $5.92 $9.60 $6.23 $9.91
Ankle Brace $100 70+ $8.84 $14.17 $9.15 $14.49
Crutches $100
Physical Therapy $150 total Wellness Benefit
(six sessions) for 6
sessions This benefit pays $50 per calendar year per insured individual if a
Physician Follow-Up $75 covered health screening test is performed, including blood tests, chest
Total Dollars Payable $1,325 x-rays, stress tests, mammograms, and colonoscopies. A full list of
To Employee covered tests will be provided in your certificate. This wellness benefit
See SPD for full listing of coverages. applies for both the accident and critical illness coverage plans. If a
policy holder is enrolled in both plans, then they will receive a wellness
10 benefit for each plan.
