Page 18 - Ampact 2022 Benefit Guide

Accident Insurance

Accident Insurance provides benefits to help cover the costs

associated with unexpected bills due to covered accidents on
and off the job, regardless of any other insurance you have. If

you purchase coverage and are hurt in a covered accident,
you will receive a cash benefit for covered injuries that you
may spend as you like.

Accident Plan
Cash benefit based on type of accident (ranges from $100-
$4,000)

Examples of covered injuries:

• Broken bones • Burns • Torn ligaments • Eye injuries
• Cuts repaired by stitches • Ruptured discs • Concussion

Employee Employee + Employee + Family
Spouse/DP Child(ren)
$3.99 $5.31 $5.61 $8.31

*Cost per pay period

Hospital Indemnity

Insurance

Hospital Indemnity Insurance provides a fixed lump-sum
payment that can help cover hospital expenses not covered by
insurance, or to pay for expenses while you, your
spouse/domestic partner, and/or dependents are in the
hospital.

• The plan pays $1,500 (limit of one time per plan year) for
the initial hospital admission, as well as $150 per day, for
up to 365 days, that an individual is hospitalized.
• An additional $300 per day is provided if the individual is
in intensive care, and $500 upon admission
• There is no limitation for pre-existing conditions

Employee Employee + Employee + Family
Spouse/DP Child(ren)
$9.41 $15.61 $14.76 $22.25

*Cost per pay period

This policy is not considered health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.

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Effective August 1, 2022-July 31, 2023