Page 22 - 2019 CareHere Enrollment Guide
P. 22
2019 BENEFITS ENROLLMENT
Accident Insurance Coverage (included but not Benefit Amount
limited to)
Accidents can happen in an instant Initial and Emergency Care
affecting you or a loved one. Emergency Care Treatment $200
Accident Insurance is designed to Physician Office Visit $200
$50
help families plan for the healthcare Diagnostic Exam (x-ray or lab) $500/$2,000
Ground/Air Ambulance
bumps ahead and take some of the Hospitalization
uncertainty and financial insecurity Hospital Admission Benefit $1,500
out of getting better. The tax-free Hospital Daily Benefit $200 (up to 365 days per accident)
benefit resulting from non-work- ICU Daily Benefit $400 (up to 365 days per accident)
Schedule of Fractures
related injuries or accidents covers Hip or Thigh $5,000
more than 150 events. Some Upper Arm $1,500
examples are shown here. For full Shoulder or Collarbone $1,500
details, please refer to the plan Leg $1,500
Ankle
$1,000
summary. Foot $1,000
Hand or Wrist $1,000
Chip Fracture 25% of closed fracture benefit
Schedule of Dislocations
Hip Joint $3,000
Bones of Foot $3,000
Ankle $1,500
Elbow $800
Shoulder $600
Follow-Up Care
Follow-Up Physician Office Visit $75 (10 treatments per accident,
1 accident per month)
Follow-Up Physical Therapy $50 (10 treatments per accident, 1
accident per month)
Additional Benefits
Burns $300-$10,000 (depending on size/
degree)
General Anesthesia $100
Concussion $150
Coma $10,000
Family Lodging $150 per day (Limited to 30 days, 1 every
12 months)
Health Screening (Wellness) Benefit Payable Once per Year per Covered
Person
Each Covered Member $50
Accident Insurance Bi-Weekly Post-Tax
Contributions (Full-Time and Part-Time Employees)
Employee Only $6.11
Employee + Spouse $9.90
Employee + Child(ren) $10.51
Employee + Family $15.29
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Accident Insurance Coverage (included but not Benefit Amount
limited to)
Accidents can happen in an instant Initial and Emergency Care
affecting you or a loved one. Emergency Care Treatment $200
Accident Insurance is designed to Physician Office Visit $200
$50
help families plan for the healthcare Diagnostic Exam (x-ray or lab) $500/$2,000
Ground/Air Ambulance
bumps ahead and take some of the Hospitalization
uncertainty and financial insecurity Hospital Admission Benefit $1,500
out of getting better. The tax-free Hospital Daily Benefit $200 (up to 365 days per accident)
benefit resulting from non-work- ICU Daily Benefit $400 (up to 365 days per accident)
Schedule of Fractures
related injuries or accidents covers Hip or Thigh $5,000
more than 150 events. Some Upper Arm $1,500
examples are shown here. For full Shoulder or Collarbone $1,500
details, please refer to the plan Leg $1,500
Ankle
$1,000
summary. Foot $1,000
Hand or Wrist $1,000
Chip Fracture 25% of closed fracture benefit
Schedule of Dislocations
Hip Joint $3,000
Bones of Foot $3,000
Ankle $1,500
Elbow $800
Shoulder $600
Follow-Up Care
Follow-Up Physician Office Visit $75 (10 treatments per accident,
1 accident per month)
Follow-Up Physical Therapy $50 (10 treatments per accident, 1
accident per month)
Additional Benefits
Burns $300-$10,000 (depending on size/
degree)
General Anesthesia $100
Concussion $150
Coma $10,000
Family Lodging $150 per day (Limited to 30 days, 1 every
12 months)
Health Screening (Wellness) Benefit Payable Once per Year per Covered
Person
Each Covered Member $50
Accident Insurance Bi-Weekly Post-Tax
Contributions (Full-Time and Part-Time Employees)
Employee Only $6.11
Employee + Spouse $9.90
Employee + Child(ren) $10.51
Employee + Family $15.29
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