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Plan 1 | Plan 2 | Plan 3 | |||||||
Hospital Admission Indemnity Benefit Amount per Hospital Admission | $500 | $1,000 | $1,000 | ||||||
- Maximum number of Admissions per Plan Year | 1 | 1 | 1 | ||||||
In-Hospital Indemnity Benefit Daily Benefit Amount | $500 | $500 | $500 | ||||||
- Maximum Number of Days per Period of Confinement | 5 | 5 | 5 | ||||||
- Max Benefit Amount per Plan Year | $7,500 | $7,500 | $7,500 | ||||||
Intensive Care Unit Indemnity Benefit Daily Benefit Amount | $500 | $500 | $500 | ||||||
- Maximum Number of Days per Period of Confinement | 5 | 5 | 5 | ||||||
- Max Benefit Amount per Plan Year | $1,250 | $1,250 | $1,250 | ||||||
Emergency Room Indemnity Benefit Amount per Visit | $100 | $150 | $200 | ||||||
- Max Visits per Plan Year | 2 | 2 | 2 | ||||||
Surgical Indemnity Benefit Amount - Major Procedure | N/A | $500 | $750 | ||||||
Surgical Indemnity Benefit Amount - Minor Procedure | N/A | $500 | $750 | ||||||
- Max Inpatient Procedures per Plan Year | N/A | 1 | 1 | ||||||
- Max Outpatient Procedures per Plan Year | N/A | 1 | 1 | ||||||
Anesthesia Indemnity Benefit - Major Procedure | N/A | $100 | $250 | ||||||
Anesthesia Indemnity Benefit - Minor Procedure | N/A | $100 | $250 | ||||||
Advanced Diagnostic Test Indemnity Benefit | N/A | N/A | $250 | ||||||
- Max Tests per Plan Year | N/A | N/A | 1 | ||||||
Diagnostic X-Ray and Lab Indemnity Benefit Amount | N/A | N/A | $100 | ||||||
- Max X-rays and tests per Plan Year | N/A | N/A | 1 | ||||||
Description of Coverage | View | View | View | ||||||
Plan Availability | STATES NOT Available in: | ||||||||
Enrollment Deadline | 18th of month Prior to Effective date | 18th of month Prior to Effective date | 18th of month Prior to Effective date | ||||||
Issue Ages | 18 - 64 | 18 - 64 | 18 - 64 | ||||||
Guaranteedd issue | No health questions are asked, and no health underwriting is required. | ||||||||
Spouse & Child(ren) | Spouse’s benefit amount is equal to the Primary Insured benefit amount. Dependent Child means Your unmarried child from the moment of birth, including a natural child, grandchild, stepchild or adopted child from the date of placement with You. The Dependent Child must be primarily dependent upon You for maintenance and support, and must be: 1) under the age of nineteen (19); | ||||||||
REDUCTION OF BENEFIT AMOUNT FOR ALL BENEFITS PROVIDED | If a Covered Person is age 65 or older on the date of a loss covered under this policy, the benefit otherwise payable will be reduced according to the following schedule:
The Benefit Amount cannot be increased by the Insured Person after age sixty-five (65). | ||||||||
EXCLUSIONS | This insurance does not apply to any loss that is caused by or resulting from, directly or indirectly: 1) any Accident or Sickness caused by or resulting from, directly or indirectly, the Covered Person’s commission or attempted commission of a felony or being engaged in an illegal occupation. (This exclusion does not apply to residents of California and Nevada.) 2) Alcoholism or drug or substance abuse. In addition, the insurance does not apply to any confinement in a detoxification facility or drug or alcohol rehabilitation facility that is not also a Hospital or part of a Hospital. 3) any Accident caused by or resulting from, directly or indirectly, the Covered Person being intoxicated, while operating a motorized vehicle at the time of an Accident. Intoxication is defined by the laws of the jurisdiction where such Accident occurs. (This exclusion does not apply to residents of California and Nevada.) 4) Sickness caused by or resulting from a Covered Person’s Pre-existing Condition if the Sickness occurs during the first 12 months that a Covered Person is insured under this policy. (Preexisting Condition means an Accident or a Sickness for which, in the 6 months before the Covered Person becomes insured under the policy, medical advice, treatment or care was sought by a Covered Person, or was recommended by, prescribed by or received from a Physician.) 5) normal pregnancy; Complications of Pregnancy are covered as any other Sickness. 6) pregnancy of a Dependent Child, unless required by law. 7) Covered Person participating in military action while in active military service with the armed forces of any country or established international authority. 8) related to the Covered Person’s suicide, attempted suicide or intentionally self-inflicted injury. 9) voluntary abortion, except with respect to You or Your covered Spouse or Domestic Partner where such person’s life would be endangered if the fetus were carried to term. 10) any Accident or Sickness caused by or resulting from, directly or indirectly, war, undeclared war, civil war, insurrection, rebellion, revolution, warlike acts by a military force or personnel, any action taken in hindering or defending against any of these or any consequences of any of these acts regardless of any other direct or indirect cause or event, whether covered or not, contributing in any sequence to the loss. 11) routine newborn well baby care, including routine nursery charges. 12) Accident or Sickness arising out of and in the course of any occupation for compensation, wage or profit or which are payable under Occupational Disease Law, Workers Compensation or similar law, whether or not application for such benefits have been made. | ||||||||
This information is a brief description of the important features of this insurance plan. Please refer to your Description of Coverage for a full explanation of the plan benefits, definitions, limitations and exclusions. This policy provides limited benefits on a fixed indemnity basis. It does not constitute comprehensive health insurance coverage (often referred to as “major medical coverage”) and does not satisfy a person’s individual obligation to secure the requirement of minimum essential coverage under the Affordable Care Act (ACA). For more information about the ACA, please refer to http://www.HealthCare.gov. Insurance benefits are underwritten by Federal Insurance Company. Coverage may not be available in all states or certain terms may be different where required by state law. Chubb NA is the U.S.-based operating division of the Chubb company, headed by Chubb Ltd. (NYSE:CB) Insurance products and services are provided by Chubb Insurance underwriting companies and not by the parent company itself. | |||||||||
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