Page 8 - 2022 Benefit Guide Fives Inc

Supplemental Health Insurance

Eligibility
• You Coverage Summary
• Your spouse – under age 70 (at the time of enrollment) • No medical questions or medical tests
• Your children – to age 26 • Benefits are paid directly to you
• Do not need to be enrolled in a Fives Health Plan
Wellness Benefit (Accident and Critical Illness Insurance) • Portable – may continue the policy after employment ends.
• Benefit payable of $50 for you and spouse each and $25 for Log on to: presents.voya.com/EBRC/Fives for more
child(ren) for completing a health screening test.
information or call 1-877-236-7564 and reference
Compass Supplement Insurance Plans

All Compass Supplement Plans provide reimbursement to help cover your out-of-pocket medical costs: deductible, coinsurance, etc
Compass Accident Insurance Compass Critical Illness Insurance
Accident Insurance that helps protect you and your family from the Critical Illness provides a lump-sum payment if you or a covered
costs of unexpected injuries and events resulting from a covered family member is diagnosed with a covered medical condition
accident. and meet the policy and certificate requirements. Examples
include: Cancer, Heart Attack, Stroke, Coma, Kidney Failure and
Examples of services eligible for benefits: certain diseases. (see benefit summary for full details)
• Hospital and Emergency Care due to an accident
Benefits Payable:
• Common Injuries – lacerations, burns, concussion
Employee: $10k, $20k or $30k policy
• Fractures and Dislocations • Employee must enroll in a minimum $10k policy, then spouse
• Surgery, x-rays and physician exams due to the covered and/or children may enroll for any level of coverage.
Spouse: $5k, $10k or $15k policy
accident
Child(ren): $5k or $10k policy
• An additional 25% benefit if covered accident is the result of
an organized sport activity Cost: Employee and Spouse premiums are based on age bands.
See benefits at a glance.
• Includes hospitalization due to a sickness
• Benefits payable vary based on the services provided due to the
Log on to: presents.voya.com/EBRC/Fives for more information
covered accident. (see benefit summary for complete details)

Compass Hospital Insurance Accident Insurance Premium
Hospital Confinement pays a benefit if you have a covered hospital, Semi-Monthly
Low
critical care or rehabilitation facility stay.
High

Benefits are paid for the following:
Daily Benefit Amount: Initial Confinement Benefit:

• Low Plan: $200 Low Plan: $1,000
• High Plan $600 High Plan: $3,000
Hospital Benefit: 1x daily benefit up to 30 days
Critical Care Benefit: 2x daily benefit up to 15 days.
Rehabilitation Facility: .5x daily benefit up to 30 days

Above is a brief summary of the insurance. Refer to the brochures and certificate of coverage for complete
provisions, conditions of benefit determination, exclusions and limitations. The Accident, Hospital and Critical Illness
Insurance is issued by ReliaStar Life Insurance Company, a member of the Voya family of companies.

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