Page 23 - 2022 Benegit Guide

Accident Insurance

Plan Features
24-Hour Coverage On and off the job coverage.
Team Members can keep their coverage at the same
Portability
rates and benefits if they leave the company.
$60 benefit which is payable once per calendar year if
Wellness Benefit
the covered person receives a health screening test.

Covered Accident

Accidental Death—Team Member $50,000
Closed reduction: $360-$5,000
Fractures
Open reduction: $720-$10,000
Paralysis $5,000-$20,000
Burns $100-$12,500
Lacerations $50-$600
Tendons & Ligaments’, Ruptured Disc/Torn Knee
Cartilage, Torn Rotator Cuff $100-$1,000
Eye Injuries $50-$250
Coma $12,500

Concussion $400
Emergency Dental Work $150-$750
Ground/Air Ambulance $500-$5,000

$750 One Device Only
Prosthesis $1,500 More than One Device
Transportation $400

Blood/Plasma $100
Appliances $100-$1,000
Family Lodging Benefit $200, 30 days per year
Accident $25

Physical Therapy $50

The above is a summary of the benefits. Refer to your certificate for complete details, definitions,
limitations, and exclusions.

Your Weekly Cost for Coverage
Team Member $2.55
Team Member + Child(ren) $4.28
Team Member + Spouse $3.66
Family $6.44

Team member must have coverage for spouse and/or child(ren) to be covered.

2022 Health and Benefits Guide 23