Frequently Asked Questions – Specific Benefit

For your convenience we have provided a list of answers to common questions about our benefits. Your HR representative may also be able to provide additional information.

What is accident insurance?
Accident insurance protects your hard earned income or retirement savings and helps to pay for out-of-pocket expenses associated with accidental injury such as:

  • Co-pays
  • Deductibles
  • Out-of-pocket costs

Benefits may cover a wide range: doctor visits, accidental death, dismemberment, fractures, initial hospital confinement, emergency room, fractures, intensive care, and more.

Cash benefits are paid directly to you unless assigned.

What is cancer insurance?
The majority of all medical plans do not cover the expenses incurred with the treatment for cancer. Supplemental cancer insurance can be used to help fill these gaps relieving the financial burden. Cancer can strike anyone at anytime regardless of lifestyle, yet too many people lack the cancer insurance coverage they need to help pay the non-medical costs associated with the treatment for cancer:

  • Out-of-pocket expenses
  • Experimental treatment
  • Travel and lodging
  • Childcare
  • Mortgage

Although cancer survival rates have dramatically increased because of modern medical treatment, these treatments are expensive, and together with other related costs, can create a serious financial burden on the family. Will you be prepared to afford the best care available if cancer touches someone in your family?

Plans features available:

  • Guaranteed renewability
  • Choice of cancer coverage type and amount (individual or family) (high or low options)
  • Helps pay for non-medical costs associated with cancer treatment
  • Benefits paid directly to you unless assigned
  • No reduction in benefits regardless of age or number of claims
What is critical illness?
A form of supplemental health insurance, critical illness insurance is a stand-alone, lump-sum product whose benefit payment helps to offset expenses not reimbursed by other types of insurance when a covered person is diagnosed with one of the covered conditions and meets the requirements of the certificate. Critical illness Insurance is not medical insurance.

  • Heart disease* strikes someone in the US about once every 43 seconds and is the number 1 cause of death.
  • Someone has a stroke* about every 40 seconds and is the leading cause of disability.

*American Heart Association 2015: statistics at a glance

 

Covered conditions may be (depending on your plan):

Category 1 incorporates certain cancer-related conditions: full benefit cancer, partial benefit cancer, and bone marrow transplant.

Category 2 incorporates certain heart-related conditions: heart attack, stroke, coronary-artery bypass graft, and heart transplant.

Category 3 incorporates certain other conditions: major organ transplant (other than bone marrow and heart) and kidney failure.

You can use the lump-sum benefit payment in any way you choose:

  • Co-pays
  • Deductibles
  • Out-of-network treatments
  • Childcare
  • Travel to treatment centers
  • Utility payments.

It’s up to you!

What is dental insurance?
Dental insurance covers the following (benefits may vary depending on the plan your employer offers):
Diagnostics and preventive services covered such as:

  • Exams
  • Fluoride treatments
  • Cleanings
  • X-rays

Basic dental services such as:

  • Fillings
  • Simple extractions
  • Repairs of crowns, bridges, dentures etc.
  • Oral surgery
  • General anesthesia for dental surgery

Major dental services such as:

  • Orthodontics
  • Crowns
  • Root canals
  • Denture adjustments

What is disability insurance?
Like most people, you may have a range of financial obligations you’re responsible for, such as rent or a mortgage, utility bills, doctor co-pays, and everyday expenses. If you become disabled due to sickness or injury, you’ll still need to fulfill your commitments and provide for your loved ones. Something as simple as the flu could mean time off from work — and without pay. Disability insurance pays you directly so you can use the money as you need.

How would you…

  • Pay your bills?
  • Make your monthly rent or mortgage loan payments?
  • Buy your groceries?
  • Make your car payments?
  • Provide for your children’s education?
  • Save for retirement?

There are 2 main types of worksite disability insurance:

  1. Short-term disability: pays a benefit to you when out of work due to an illness, injury or childbirth for several weeks up to a year.
  2. Long-term disability: pays a benefit when you are out of work for an extended period of time

How does a Flexible Spending Account (FSA) work?
Flexible Spending Account (FSA) work?

With an FSA, you determine how much out-of pocket child care and healthcare expenses you have each year, and then you have that amount (divided by the number of payroll periods) automatically set aside from your paycheck. The money is pulled out before taxes are deducted and held in a special account for you. When you start paying healthcare or dependent care expenses, you get reimbursed from your FSA account — and that money never gets taxed. The bottom line: you get more spendable income for paying off credit-card debt, planning a much-needed vacation, saving for retirement, or building up educational funds for your children.

A Flexible Spending Account (FSA) allows you to save up to $2,550 on your eligible healthcare and up to $5000 for dependent care expenses every year by using pretax dollars. Savings can be 25 – 40% depending on your tax bracket on your healthcare expenses!

There are two flexible spending account types:

  1. Healthcare spending account: A healthcare spending account allows you to pay for eligible expenses not covered by your healthcare plan. Some eligible expenses include:
    • Deductibles, co-payments, and co-insurance for medical and dental plans
    • Prescription medications and approved over-the-counter healthcare products
    • Eye exams, glasses, prescription sunglasses, contact lenses and solutions, and LASIK eye surgery

 

  1. Dependent care spending account: A dependent care spending account reimburses you for care provided by eligible caregivers for dependents age 12 and younger, or for a disabled spouse or other dependents whom you claim for tax purposes. A few examples of eligible dependent care expenses:
    • Care provided in your home by an eligible caregiver
    • Care provided outside your home at a qualified day care provider
    • Care provided at a licensed day care facility
    • Summer day camps
    • Before- and after-school programs

What is hospital indemnity insurance?
Hospital indemnity insurance is a type of plan that pays a set amount – per day, per week, per month or per visit – if you are confined in a hospital. Even with major medical insurance, you may still be responsible for co-payments, deductibles, and other out-of-pocket expenses.

Depending on the plan your employer chooses, you can receive payment to cover expenses for:

  • Hospital admission
  • Out-patient surgery
  • In-patient surgery
  • Diagnostic tests
  • ICU
  • Emergency room
  • Rehabilitation services
  • Lodging and transportation costs for you and a companion

Employees, spouses and children can be covered. Whether you are being treated on an out-patient or in-patient basis, this coverage can help you manage your expenses. Check with your Human Resource representative to see if a plan is available.
What is identity theft insurance?
Identity theft is the act of taking someone’s personal information and using it to impersonate a victim, steal from bank accounts, establish phony insurance policies, open unauthorized credit cards, or obtain unauthorized bank loans. Identity theft insurance provides reimbursement to crime victims for:

  • Restoring identity
  • Repairing damaged credit

It generally covers expenses such as: phone bills, lost wages, notary and certified mailing costs, and sometimes attorney fees (with prior consent of the insurer).

What is life insurance?
Life insurance is powerful protection for your loved ones. In the event of your passing life insurance is a guaranteed promise to pay money directly to your beneficiaries. Life insurance helps to pay for:

 

Rent and Mortgage      Retirement       Long-term care with “accelerated death benefit”
Household expenses    Family debt     Education        Final Expense

 

There are 3 basic forms of life insurance:

  1. Term life provides an affordable death benefit for a specific length of time, usually 20 – 30 years. Coverage expires at the end of the term. There are no cash values.
  2. Whole life provides a death benefit plus an investment option where cash values accumulate. The accumulated cash value can be used to borrow against or pay your premium. Your policy is in-force as long as premiums are paid or if a paid-up option is available. Premiums do not change as you grow older.
  3. Universal life provides flexible coverage options where you can change your premiums or coverage amount to meet your current need. This policy can last through retirement and may gain cash value over time. In other words: life coverage that adjusts to your life.

 

Additional features/ riders that may be added to a life policy are:

  • Family coverage
  • Accelerated death benefit
  • Early payouts for terminal illness
  • Long-term care rider
  • Waiver of premium
  • Accidental death benefit

What is long-term care insurance?
Many of us worry about who would take care of us if something happens, and no one wants to be a burden. Long-term care (LTC) is the assistance or supervision you may need when you are not able to do some of the basic activities of daily living (ADL) such as:

  • Bathing
  • Dressing
  • Eating
  • Continence
  • Toileting
  • Moving in and out of bed

A need for long term care may result from:

  • Accidents
  • Illness
  • Advanced aging
  • Stroke
  • Other chronic conditions

Providing long-term care can be time consuming, expensive, and exhausting. Help protect your family and get the information you need to see if long-term care insurance should be a part of your plan.

Estimated daily cost for long-term care

  • The cost for a private room was $87,600 or $240 per day. Assisted living at home can cost more than $41,680 per year or $20.00 per hour for a home healthcare aid. All of these long-term care costs can be considerably higher in larger metropolitan areas.
  • The average stay in a nursing home is about 2.5 years, but can vary considerably.

What is telemedicine?
In brief, telemedicine is the remote delivery of healthcare services and clinical information using telecommunications technology. This includes a wide array of clinical services using internet, wireless, satellite, and telephone media. You will benefit from reduced medical costs, convenience, and potentially fewer medical complications. Telemedicine has been growing rapidly because it offers four fundamental benefits:

  • Improved access for both the patient and physicians and health facilities
  • Cost efficiencies
  • Improved quality
  • Patient/ employee demand

What is vision insurance?

Vision insurance helps you to maintain good eyesight and healthy eyes, and saves you money while you’re at it. Plans may cover eye exams and materials depending on the plan you have. Depending on your plan, benefits may include:

  • Personalized ID card
  • Comprehensive eye exam
  • Frame allowance
  • Single vision, bifocal, or trifocal lenses
  • Progressive lens upgrade
  • Contact lens allowance
  • Stand-alone contact lens fitting exam
  • Medically necessary contact lenses
  • Discounts on allowance overages and lens options
  • Significant discounts on an unlimited number of additional eyeglasses and contact lens purchases
  • Online contact lenses – great discounts, and in-network
  • LASIK discounts
  • Vision Wellness Program
  • Materials discount