Page 20 - 2017 Benefits Enrollment
P. 20
2017 New Hire Guide
Unum Accident Coverage
Why Accident Here is a brief summary of the covered medical treatment or service. A
Coverage? full list of covered services will be provided in your certiicate.
Accident coverage applies to
non-work related accidents only. Emergency room Plan Pays You $150
If you elect to purchase accident Urgent care, primary care physician or $75
coverage, this plan pays a tax- specialist $1,000 + $200 per day (up to 365 days)
Hospital coninement
free beneit directly to you to Intensive care unit coninement $1,500 + $400 per day (up to 15 days)
help offset unexpected expenses Rehabilitation unit coninement $100 per day (up to 15 days, max 30 per
associated with an accident (off Accidental Death & Dismemberment year)
the job only) for yourself or a Covered employee/spouse/child(ren) $50,000/$20,000/$10,000
covered family member. Loss of limb(s) Up to $100,000
Fractures (open reduction paid at 2x below amount)
Skull (non-depressed/depressed) $1,500/$3,750
How Does It Work? Hip, thigh (femur) $2,250
1. Get the treatment you need Pelvis, leg, vertebrae (body) $1,200
Bones of the face or nose, upper jaw,
$525
2. File a claim with Unum upper arm $450
Lower jaw, shoulder blade, collar bone,
3. You’ll receive a beneit for vertebral process, forearm, hand, wrist,
kneecap, foot, ankle
each covered treatment Rib $375
received Coccyx $300
Finger, toe $75
Chip fracture 25% of non-surgical beneit
Dislocations (open reduction paid at 2x below amount)
Hip joint $3,000
Knee $1,500
Ankle or bones of the foot $1,200
Collar bone (sternoclavicular) $750
Lower jaw, shoulder, elbow, wrist, hand $450
Collar bone (acromioclavicular and $150
separation), inger, or toe
20
Unum Accident Coverage
Why Accident Here is a brief summary of the covered medical treatment or service. A
Coverage? full list of covered services will be provided in your certiicate.
Accident coverage applies to
non-work related accidents only. Emergency room Plan Pays You $150
If you elect to purchase accident Urgent care, primary care physician or $75
coverage, this plan pays a tax- specialist $1,000 + $200 per day (up to 365 days)
Hospital coninement
free beneit directly to you to Intensive care unit coninement $1,500 + $400 per day (up to 15 days)
help offset unexpected expenses Rehabilitation unit coninement $100 per day (up to 15 days, max 30 per
associated with an accident (off Accidental Death & Dismemberment year)
the job only) for yourself or a Covered employee/spouse/child(ren) $50,000/$20,000/$10,000
covered family member. Loss of limb(s) Up to $100,000
Fractures (open reduction paid at 2x below amount)
Skull (non-depressed/depressed) $1,500/$3,750
How Does It Work? Hip, thigh (femur) $2,250
1. Get the treatment you need Pelvis, leg, vertebrae (body) $1,200
Bones of the face or nose, upper jaw,
$525
2. File a claim with Unum upper arm $450
Lower jaw, shoulder blade, collar bone,
3. You’ll receive a beneit for vertebral process, forearm, hand, wrist,
kneecap, foot, ankle
each covered treatment Rib $375
received Coccyx $300
Finger, toe $75
Chip fracture 25% of non-surgical beneit
Dislocations (open reduction paid at 2x below amount)
Hip joint $3,000
Knee $1,500
Ankle or bones of the foot $1,200
Collar bone (sternoclavicular) $750
Lower jaw, shoulder, elbow, wrist, hand $450
Collar bone (acromioclavicular and $150
separation), inger, or toe
20
