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Voluntary Hospital
Indemnity Coverage 2016–17 Beneits Enrollment
Hospital indemnity coverage, available through Alac, pays a beneit when you are
admitted to the hospital for a covered stay. This coverage can complement your
health insurance to help you pay for the costs associated with a hospital stay. It can
also provide funds which can be used to help pay the out-of-pocket expenses your
medical plan may not cover, such as coinsurance, copays, and deductibles. When you
are admitted into the hospital, you will receive an initial $500 beneit.
Pre-existing condition limitations apply. See plan document for details.
Summary of Benefits*
Hospital Confinement $200 per day
(up to 180 days per confinement)
Hospital Intensive Care $200 per day
(up to 30 days per confinement; benefit is payable in addition to the $200
Hospital Confinement benefit)
* Refer to full plan document for details
Monthly Contributions
Employee $17.68
Employee + Spouse $34.79
Employee + Child(ren) $24.78
Family $41.89
21
Indemnity Coverage 2016–17 Beneits Enrollment
Hospital indemnity coverage, available through Alac, pays a beneit when you are
admitted to the hospital for a covered stay. This coverage can complement your
health insurance to help you pay for the costs associated with a hospital stay. It can
also provide funds which can be used to help pay the out-of-pocket expenses your
medical plan may not cover, such as coinsurance, copays, and deductibles. When you
are admitted into the hospital, you will receive an initial $500 beneit.
Pre-existing condition limitations apply. See plan document for details.
Summary of Benefits*
Hospital Confinement $200 per day
(up to 180 days per confinement)
Hospital Intensive Care $200 per day
(up to 30 days per confinement; benefit is payable in addition to the $200
Hospital Confinement benefit)
* Refer to full plan document for details
Monthly Contributions
Employee $17.68
Employee + Spouse $34.79
Employee + Child(ren) $24.78
Family $41.89
21
