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Accident Insurance
Accidents can happen in an instant affecting you or a loved one. Accident
Insurance is designed to help families plan for the healthcare bumps ahead
and take some of the uncertainty and inancial insecurity out of getting
better. The tax-free beneit resulting from non-work-related injuries or
accidents covers more than 150 events.
You may elect coverage and pay premium with after tax contributions as
shown below. Please see the additional beneit summary in ADP/WFN.
Coverage Tier Bi-Weekly* Weekly
Employee $7.24 $3.34
Employee/Spouse $13.71 $6.33
Employee/Child(ren) $15.72 $7.26
Family $19.67 $9.08
Beneit Type 1 MetLife Accident Insurance Beneit Type 1 MetLife Accident Insurance
Pays YOU
Pays YOU
Injuries Hospital Coverage (Accident)
Fractures $400–$10,000 Admission $1,000 (non-ICU)–$2,000
Dislocations $350–$8,000 (ICU) per accident
Second and Third Degree $100–$10,000 Coninement $200 a day (non-ICU)–up to
Burns 365 days
$400 a day (ICU)–up to
Concussions $450 30 days
Cuts/Lacerations $50–$400 Inpatient Rehab $200 a day, up to 15 days
Eye Injuries $420 (paid per accident)
Medical Services & Treatment Other Beneits
Ambulance $600-$2,500 Lodging—Pays for lodging for $225 per night, up to 31
companion up to 31 nights
Emergency Care $120–$250 per calendar year nights; up to $6,975 in total
lodging beneits available per
Non-Emergency Care $50 Health Screening Beneit calendar year
Physician Follow-Up $120 (Wellness) $50 payable 1× per
calendar year
beneit provided if the
Therapy Services $25–$75 covered insured takes one
(including physical therapy) of the covered screening/
Medical Testing Beneit $500 prevention tests
Medical Appliances $100–$1,000
Inpatient Surgery $200–$2,500
* During the two months in a year that have three pay periods
(January and July), beneits will only be deducted from the irst
two paychecks.
Dawson 29
Accidents can happen in an instant affecting you or a loved one. Accident
Insurance is designed to help families plan for the healthcare bumps ahead
and take some of the uncertainty and inancial insecurity out of getting
better. The tax-free beneit resulting from non-work-related injuries or
accidents covers more than 150 events.
You may elect coverage and pay premium with after tax contributions as
shown below. Please see the additional beneit summary in ADP/WFN.
Coverage Tier Bi-Weekly* Weekly
Employee $7.24 $3.34
Employee/Spouse $13.71 $6.33
Employee/Child(ren) $15.72 $7.26
Family $19.67 $9.08
Beneit Type 1 MetLife Accident Insurance Beneit Type 1 MetLife Accident Insurance
Pays YOU
Pays YOU
Injuries Hospital Coverage (Accident)
Fractures $400–$10,000 Admission $1,000 (non-ICU)–$2,000
Dislocations $350–$8,000 (ICU) per accident
Second and Third Degree $100–$10,000 Coninement $200 a day (non-ICU)–up to
Burns 365 days
$400 a day (ICU)–up to
Concussions $450 30 days
Cuts/Lacerations $50–$400 Inpatient Rehab $200 a day, up to 15 days
Eye Injuries $420 (paid per accident)
Medical Services & Treatment Other Beneits
Ambulance $600-$2,500 Lodging—Pays for lodging for $225 per night, up to 31
companion up to 31 nights
Emergency Care $120–$250 per calendar year nights; up to $6,975 in total
lodging beneits available per
Non-Emergency Care $50 Health Screening Beneit calendar year
Physician Follow-Up $120 (Wellness) $50 payable 1× per
calendar year
beneit provided if the
Therapy Services $25–$75 covered insured takes one
(including physical therapy) of the covered screening/
Medical Testing Beneit $500 prevention tests
Medical Appliances $100–$1,000
Inpatient Surgery $200–$2,500
* During the two months in a year that have three pay periods
(January and July), beneits will only be deducted from the irst
two paychecks.
Dawson 29
