Benefit Solutions for Federal Employees

Transcription

1 Benefit Solutions for Federal Employees Accident insurance: You re not a kid anymore, even if you still play like one

2 Insurance that helps you act the age you feel Because you re never too old to have fun You re grown up, but you don t always have to act your age. Accident Insurance helps take the risk out of doing the things you love to do. We provide cash for covered accidental injuries, helping you cover the costs of emergency medical care, long-term rehabilitation and unexpected expenses along the way. Introduction FedAdvantage has been serving the needs of federal employees for over 20 years, offering insurance products designed to fill the gaps in their benefits. Over the years we continue to grow and expand by adding new innovative products. Our new accident insurance plan fills the gaps in your health plan by providing cash benefits for covered accidents, protecting your budget from unexpected accident expenses. As a federal employee, you now have access to our new group accident insurance plan, insured by Lincoln Financial Group a Fortune 500, A+ rated insurance company. FedAdvantage s Accident plan offers federal employees comprehensive coverage at discounted group rates. What is Accident Insurance? Why do I need Accident Insurance? Accident Insurance helps you handle the medical and out-ofpocket costs that add up after an accidental injury. This includes emergency treatment, hospital stays, surgeries, and medical exams, and other expenses you may face, such as transportation and lodging needs. Accidents happen to all of us. And, whether it s a broken bone, a sprain, a car accident, or an allergic reaction to a bee sting, meeting the costs of treatment and recovery after an injury can be challenging. An Accident policy can help pay the expense that may or may not be fully covered by your major medical insurance. The Probability of having an accident* A fatal accident happens every 5 minutes A disabling accident occurs every 1.5 seconds In 2007, 34.3 million people (1 in 9) sought medical care for an accident The economic impact was $684.4 billion *Source: National Safety Council 2010 Report

3 How does it work? FedAdvantage s group accident plan is available to federal employees who are actively at work, working at least 20 hours a week and is ideal for: Young Families Families with kids in sports Families with teenagers Active people Older employees Regardless of which health plan you are enrolled under, FedAdvantage s accident plan has got you covered. Benefits paid from FEHB plans are paid directly to the medical providers (doctors, hospitals), there is no benefit that is paid directly to you. FedAdvantage s Accident Insurance program pays you cash when your accident triggers a benefit, regardless of whether or not your health plan pays. Example of How Accident Insurance Works Situation Broken leg suffered from a high school sports injury Benefit Trigger Accident Plan Pays You Ambulance $150 Treatment in Emergency Room $150 Diagnostic Imaging Exam $100 Surgery $1,000 Hospital Admission $1,000 Hospital Confinement $600 ($200 per day, at 3 days) Crutches $25 Follow-up Physician visits $300 ($50 at 6 visits) Total Benefit Paid to You: $3,325 Accident Insurance Can help pay your deductible and coinsurance Can help with the direct and indirect costs associated with an accident Pays lump-sum benefits directly to you regardless of other medical insurance you may have

4 Schedule of Benefits FedAdvantage s Accident Insurance plan, underwritten by Lincoln Financial Group pays you cash benefits if you suffer a covered accidental injury. For each item listed below, you receive the benefit amount shown. Multiple benefits can be paid for multiple injuries from the same covered accident. Emergency Care Ambulance $150 Air Ambulance $600 Initial physician office visit $50 Emergency room $150 Major diagnostic care $100 Treatment Care Hospital admission $1,000 Hospital confinement daily benefit $200 Intensive care unit daily benefit $400 Alternate care and rehabilitative facility daily benefit $100 Follow-up doctor/patient care (up to 6 sessions) $50 Transportation for care (up to 3 times per accident) $175 Companion lodging (up to 30 days per accident) $100 Family care per child (up to 30 days) $20 Fractures (per fracture) Nonsurgery/Surgery Ankle, arm, collarbone, elbow, foot, hand, jaw, kneecap, shoulder $300/$600 blade, sternum, wrist Hip $1,400/$2,800 Skull depressed $2,500/$5,000 Leg, pelvis, skull nondepressed, vertebral column $500/$1,000 Bones of face, vertebrae, coccyx, rib, nose $150/$300 Finger, toe $50/$100 Chip fractures 25% benefit Dislocations (per injury) Nonsurgery/Surgery Ankle, collarbone, foot $400/$800 Collarbone acromio and separation, elbow, hand, lower jaw, $250/$500 shoulder, wrist Finger, toe $50/$100 Hip $1,200/$2,400 Knee, except Kneecap $500/$1,000 Transitional care benefits Crutches $25 Wheelchair for temporary use $50 Wheelchair for permanent use $350 Walker for temporary use $25 Walker for permanent use $50 Prosthesis per limb/device $500 Reasonable modifications to home or vehicle in the case of $2,500 catastrophic loss

5 Schedule of Benefits Continued Specific injuries or treatments Transfusions $150 Burns $100 - $6,400 Skin Graphs Additional 25% Joint Replacement $1,500 - $2,000 Coma $2,000 Concussion $100 Dental crown once per accident $150 Dental extraction once per accident $50 Eye (removal of foreign body) once per eye/accident $100 Eye (surgical repair) once per eye/accident $300 Laceration $50 - $400 Surgery Arthroscopic $250 Abdominal or thoracic $1,000 Treatment, per repair Ligaments/tendons, knee cartilage $300 Rotator cuff $300 Ruptured disc $400 Accidental Death & Dismemberment (AD&D) Accidental Death Employee $30,000 Spouse $10,000 Child $5,000 Common carrier enhanced death benefit 2x benefit amount Transportation or remains Up to $5,000 Seat belt/helmet AD&D benefit 10% of AD&D Common disaster enhanced death benefit 2x benefit amount Catastrophic loss $50,000 Loss of or loss of use of one hand, foot, arm, leg, eye Up to $7,000 Health Wellness Assessment Benefit Rider - Not available in: CT, IN, KS, NE 23 Wellness Assessment tests covered: Test Examples - Annual well $50 per year women care, PSA screenings, Cancer screenings, EKG, Stress tests Additional Plan Benefits Guarantee Acceptance No health questions Coverage is immediate No waiting periods Peace of mind Your covered 24 hours a day No age penalty Everyone pays the same premium No restrictions You choose your doctors and hospitals No annual or lifetime limits No matter how many accidents you have Fully Portable If you leave federal service you can keep your coverage at the same premiums and the same benefits

6 How to Enroll Are you eligible for this plan? Federal employees working more than 20 hours per week are eligible to enroll on this plan. Enrolling on the FedAdvantage Accident Insurance plan, underwritten by Lincoln Financial Group is as easy as 1, 2, 3. Step 1 Determine Availability The FedAdvantage Accident plan is not yet available in all states; the approved states are listed below. AL AK AZ AR CA CT DE DC FL GA HI ID IL IN IA KS KY MD MA MI MS MO NE NV NJ NM ND OH OK OR PA RI SC SD TN UT VA WV WI WY Step 2 Find Your Premium Premiums are based on the coverage you select and the state in which you live. Bi-weekly Rates Bi-weekly Rates if you reside in the following states: IN, CT, KS, NE Employee Only: $ 9.00 Employee Only: $ 8.00 Employee & Spouse: $13.00 Employee & Spouse: $11.00 Employee & Children: $15.00 Employee & Children: $14.00 Employee & Family: $20.00 Employee & Family: $18.00 Step 3 Enroll Complete and submit the enrollment form, either by fax, , or mail to FedAdvantage: Fax: customerservice@fedadvantage.com Mail: FedAdvantage P.O. Box Dallas, TX Whether you enroll by fax, or by mail, once your enrollment form has been processed we will send you a direct deposit sign-up Form 1199A along with instructions for processing. Actual effective date is determined when your first allotment is received. Questions? Call our customer service center Monday Thursday: 7:30 AM to 4:30 PM (CST); Friday: 7:30 AM to 2:00 PM (CST)