Page 16 - 2017 Employee Benefit Highlights

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Accidental Injury insurance | cigna.com

Accidental Injury pays benefits directly to you in the event of a covered accident. How
you use the money is up to you. It can help pay out-of-pocket medical costs (coinsurance/ This is a group accident 24-hour
deductibles) or expenses that may not be covered by medical insurance, like rehabilitation, insurance policy. Benefits are
transportation, and child care. paid when a covered injury results,
directly and independently
The Accidental Injury plan is separate from Epicor’s medical plan and you do not have of all other causes, from a Covered
to be enrolled in the medical plan to elect Accidental Injury insurance. Accident. A Covered Accident is a
sudden, unforeseeable, external
The plan pays a lump sum benefit depending on the covered injury/treatment. event that results directly in a
Covered Injury or Covered Loss and
Sample of Accidental Injury plan benefits. (List is not exhaustive. Refer to benefit occurs while the Covered Person is
summary for full list of covered benefits.) insured under this Policy. Benefits
provided are not intended
Covered injuries/ treatments Benefit payment amount to cover medical expenses.
Initial and emergency care This is not a substitute for
Emergency care treatment $200 comprehensive health insurance.
Physician office visit $200
Ambulance (ground) $200

Hospitalization
Hospital admission (per occurrence) $1,000
Hospital confinement (per day) $200
Accidental Injury insurance
Cigna Wellness Benefit
Physical therapy (per visit) $50 Benefit amount: $75
Dislocations up to $4,000
Fractures up to $4,000 The Cigna Wellness Benefit is
Lacerations up to $200 payable for wellness visits, health
Burns up to $900 screening tests, and preventive care
Concussion $150 services once per calendar year per
covered person. The benefit waiting
period is 30 days following the
You decide who you want to cover effective date of the Wellness rider.
Premiums are paid through payroll deduction: Refer to the policy for definitions of
You only $5.79 per paycheck terms and full conditions.
You + Spouse $10.06 per paycheck
You + Child(ren) $13.01 per paycheck

You + Family $17.27 per paycheck

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