Page 11 - 2017-18 Centennial Benefits Guide Staff

Rates are based on your age and can be found in the ADP beneit
enrollment portal.

A 12-month pre-existing condition exclusion applies. See plan document for details.

$50 health Screening Beneit payable per covered person, per calendar
year. Wellness claims can be iled over the phone.

Covered wellness exams include the following.

„ Biopsy for skin „ CA 125 „ Mammography
cancer „ CEA „ Pap smear
„ Blood test for „ Chest x-ray „ PSA
triglycerides „ Colonoscopy „ Serum cholesterol

„ Bone marrow Fast blood glucose test to determine
biopsy and „ level of HDL and
aspiration test LDL

„ Breast ultrasound „ Flexible „ Serum protein
sigmoidoscopy
„ CA 15-3 electrophoresis
„ Hemocult stool
„ CA 19-9 analysis „ Stress test or
thermography

Hospital Indemnity Coverage

Being hospitalized for an illness or an accident can hit your pocketbook
hard. This plan helps put money back in your wallet to help with
unexpected expenses. Beneits are paid when you are admitted and then
stack up for each day you are in the hospital.

„ Hospital admission: pays you $1,000

„ Daily hospital beneit: pays you $200 per day, up to 180 days

Coverage begins after a initial 30-day waiting period . First day coverage applies for accidents .
A 12-month pre-existing condition exclusion applies. See plan document for details.
Rates are based on your age and can be found in the ADP beneit
enrollment portal.

Centennial Contractors 11