Page 23 - Intertek 2021 Benefits Guide
P. 23
2021
Intertek Benefits Guide
Accident Coverage
Why Accident Coverage? Features
Accident coverage applies to non-work related X Guaranteed issue: No medical questions or
accidents only. If you elect to purchase accident tests are required for coverage
coverage, Voya’s plan pays a tax-free beneit X Flexible: You can use the beneit payments for
directly to you to help ofset unexpected expenses any purpose you like
associated with an accident (of the job only) for X Portable: If you leave Intertek (or retire), you can
yourself or a covered family member. take your coverage with you
Here is a brief summary of the covered medical
Wellness Benefit treatment or service. A full list of covered services
This beneit pays $50 per calendar year per insured
individual (employee, spouse, and children) if a covered will be provided in your certiicate
health screening test is performed, including blood
tests, chest x-rays, stress tests, mammograms, and Event Beneits
colonoscopies.
Accident hospital care
A full list of covered tests will be provided in your Surgery open abdominal, thoracic $1,200
certiicate. Hospital admission $1,250
Hospital coninement per day, up to $375
Plan Pays You 365 days $750
Transportation per trip, up to three
Monthly Premium per accident
Employee $9.98 Lodging per day, up to 30 days $180
Employee + spouse $16.85 Accident care
$90
Employee + Children $19.03 Initial doctor visit $225
Urgent care facility treatment
Family $25.90 Emergency room treatment $225
Ground ambulance $360
Air ambulance $1,500
Outpatient surgery (one per $225
accident)
X-ray $45
Common injuries
Burns second degree, at least 36% $1,250
of the body
Emergency dental work $350 crown, $90
extraction
Eye injury surgery $350
Ruptured disk surgical repair $800
Concussion $225
Dislocations Closed/open reduction
Hip joint $3,850/$7,700
Knee $2,400/$4,800
Fractures Closed/open reduction
Leg $2,500/$ 5,000
Ankle $1,800/$3,600
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Intertek Benefits Guide
Accident Coverage
Why Accident Coverage? Features
Accident coverage applies to non-work related X Guaranteed issue: No medical questions or
accidents only. If you elect to purchase accident tests are required for coverage
coverage, Voya’s plan pays a tax-free beneit X Flexible: You can use the beneit payments for
directly to you to help ofset unexpected expenses any purpose you like
associated with an accident (of the job only) for X Portable: If you leave Intertek (or retire), you can
yourself or a covered family member. take your coverage with you
Here is a brief summary of the covered medical
Wellness Benefit treatment or service. A full list of covered services
This beneit pays $50 per calendar year per insured
individual (employee, spouse, and children) if a covered will be provided in your certiicate
health screening test is performed, including blood
tests, chest x-rays, stress tests, mammograms, and Event Beneits
colonoscopies.
Accident hospital care
A full list of covered tests will be provided in your Surgery open abdominal, thoracic $1,200
certiicate. Hospital admission $1,250
Hospital coninement per day, up to $375
Plan Pays You 365 days $750
Transportation per trip, up to three
Monthly Premium per accident
Employee $9.98 Lodging per day, up to 30 days $180
Employee + spouse $16.85 Accident care
$90
Employee + Children $19.03 Initial doctor visit $225
Urgent care facility treatment
Family $25.90 Emergency room treatment $225
Ground ambulance $360
Air ambulance $1,500
Outpatient surgery (one per $225
accident)
X-ray $45
Common injuries
Burns second degree, at least 36% $1,250
of the body
Emergency dental work $350 crown, $90
extraction
Eye injury surgery $350
Ruptured disk surgical repair $800
Concussion $225
Dislocations Closed/open reduction
Hip joint $3,850/$7,700
Knee $2,400/$4,800
Fractures Closed/open reduction
Leg $2,500/$ 5,000
Ankle $1,800/$3,600
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