University Human Resources
Hospital Indemnity Insurance Benefit Summary
Overview
Insurance Provider: Lincoln Financial
Hospital indemnity insurance is a supplemental health product that provides cash benefits if you or a covered dependent visit a hospital or intensive care unit (ICU) due to a covered illness or injury. The benefits paid can be used for health insurance deductibles, transportation, childcare, or any other recovery expenses.
- Eligibility: All Full-Time Employees
- Contribution: Employee-paid coverage
- Portability: Included (coverage can be portable if you leave your employer)
- Preexisting Conditions: Not applicable
Benefit Schedule
Core Hospital Benefits
- Hospital Admission: $1,000 per day for up to 4 days per calendar year (for initial day of admission due to sickness or injury).
- Hospital Confinement: $200 per day for up to 30 days per calendar year, starting on day 2 of confinement.
- Hospital ICU Admission: $2,000 per day for 1 day per calendar year (for initial day of ICU admission).
- Hospital ICU Confinement: $400 per day for up to 30 days per calendar year, starting on day 2 of confinement.
Confinement & Special Care Benefits
- Rehabilitation Facility: $100 per day for up to 30 days per calendar year.
- Substance Abuse Treatment Facility: $100 per day for up to 30 days per calendar year.
- Mental Disorder Treatment Facility: $100 per day for up to 30 days per calendar year.
- Newborn Care: $500 per day for 1 day per calendar year (for routine postnatal care following birth).
Wellness Benefit
- Health Assessment/Wellness: $50 annual cash benefit for each covered family member who completes a single covered exam, screening, or immunization.
Enhanced Newborn Benefits
- Hospital NICU Admission: Increases the Hospital ICU Admission benefit by 25% for a newborn child's ICU or NICU admission.
- Hospital NICU Confinement: Increases the Hospital ICU Confinement benefit by 25% for a newborn child's ICU or NICU confinement.
Rate Information
| Coverage Tier | Monthly Premium |
|---|---|
| Employee Only | $19.65 |
| Employee + Spouse | $41.97 |
| Employee + Child(ren) | $29.84 |
| Employee + Family | $54.33 |
Exclusions and Limitations
Note: Exceptions to exclusions apply when substance abuse and mental disorder benefits are selected. The policy may not cover treatment/events resulting from:
- Suicide, attempted suicide, or intentionally self-inflicted injury (sane or insane).
- Voluntary intake/use of drugs, poison, gas, or fumes, unless prescribed/administered by a physician and taken as instructed.
- Committing or attempting to commit a felony.
- War or act of war (declared or undeclared), riots, insurrections, rebellions, or acts of terrorism.
- Military duty (including reserves or National Guard).
- Aviation travel, except as a fare-paying passenger on a commercial flight or on a group policyholder aircraft under specified conditions.
- Driving a vehicle while intoxicated.
- Dental care/procedures (unless resulting from a covered event).
- Experimental procedures.
- Travel outside the U.S. and its possessions for the sole purpose of receiving medical care.
- Participation in semi-professional or professional sports, or motor-driven vehicle racing/stunt shows.
- Hazardous recreational activities (e.g., scuba diving, mountaineering, spelunking, bungee jumping, hang
gliding, skydiving). - Being incarcerated in a penal or detention facility.
- Residing outside the United States, U.S. Territories, Canada, or Mexico for more than 12 months.
Disclaimers & Contact Information
- Policy Notes: This summary does not constitute a binding contract. Controlling provisions are detailed in the insurance policy and certificate of coverage.
- Issuer: Group insurance products are issued by The Lincoln National Life Insurance Company (Fort Wayne, IN) or Lincoln Life & Annuity Company of New York (Syracuse, NY).
- Website: LincolnFinancial.com