Page 21 - Dealer Tire 2022 Benefits Guide
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2022 Benefits Guide
Hospital Indemnity Plan
It’s scary enough being admitted into the hospital, so why worry about whether you’ll be able to cover
unexpected expenses? Hospital indemnity insurance is a supplemental insurance plan designed to pay for the
costs of a hospital admission that may or may not be covered by your insurance. The plan covers employees
who are admitted to a hospital or ICU for a covered sickness or injury.
Bi-Weekly Rates
Low Plan High Plan
Associate Only $3.54 $6.17
Associate + Spouse $9.42 $16.93
Associate + Children $6.30 $11.02
Associate + Spouse and Children $12.18 $21.79
Hospital Benefits
Beneit Limits
Subcategory Beneit Low Plan High Plan
(Applies to Subcategory)
Admission $500 $1,000
ICU supplemental admission (beneit
Admission Beneit 4 time(s) per calendar year paid concurrently with the admission
beneit when a covered person is $500 $1,000
admitted to ICU)
Coninement $100 $200
15 days per calendar year ICU
Supplemental Coninement ICU supplemental coninement (beneit
Coninement Beneit paid concurrently with the coninement
will pay an additional beneit $100 $200
for 15 of those days beneit when a covered person is
admitted to ICU)
Coninement Beneit for 2 day(s) per coninement Coninement beneit for newborn $25 $50
Newborn Nursery Care nursery care
Other Benefits
Beneit Limits
Subcategory Beneit Low Plan High Plan
(Applies to Subcategory)
1 time(s) per calendar year per
Health Screening Beneit Health screening $50 $50
covered person
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Hospital Indemnity Plan
It’s scary enough being admitted into the hospital, so why worry about whether you’ll be able to cover
unexpected expenses? Hospital indemnity insurance is a supplemental insurance plan designed to pay for the
costs of a hospital admission that may or may not be covered by your insurance. The plan covers employees
who are admitted to a hospital or ICU for a covered sickness or injury.
Bi-Weekly Rates
Low Plan High Plan
Associate Only $3.54 $6.17
Associate + Spouse $9.42 $16.93
Associate + Children $6.30 $11.02
Associate + Spouse and Children $12.18 $21.79
Hospital Benefits
Beneit Limits
Subcategory Beneit Low Plan High Plan
(Applies to Subcategory)
Admission $500 $1,000
ICU supplemental admission (beneit
Admission Beneit 4 time(s) per calendar year paid concurrently with the admission
beneit when a covered person is $500 $1,000
admitted to ICU)
Coninement $100 $200
15 days per calendar year ICU
Supplemental Coninement ICU supplemental coninement (beneit
Coninement Beneit paid concurrently with the coninement
will pay an additional beneit $100 $200
for 15 of those days beneit when a covered person is
admitted to ICU)
Coninement Beneit for 2 day(s) per coninement Coninement beneit for newborn $25 $50
Newborn Nursery Care nursery care
Other Benefits
Beneit Limits
Subcategory Beneit Low Plan High Plan
(Applies to Subcategory)
1 time(s) per calendar year per
Health Screening Beneit Health screening $50 $50
covered person
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