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Guaranteed Issue, No Health Questions, No Pre-Existing
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Voluntary Enrollment, Payroll Deduct or Bank Draft
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Employee, Spouse, Children Eligible
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Cost Not Based on Age, Occupation, Sex, Tobacco Status
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Guaranteed Renewable, Not Cancelable Due to Claims
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Personal Coverage, Portable No Increase Premium
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1
Companies With 3+
Participating Employees
.VERY
AFFORDABLE WEEKLY RATES.
Employee Only
$4.50
Employee and Spouse
$6.60
Employee and Children
$8.70
Employee and
Family $10.80 |
Hospital Care Any/All Insureds
Hospital
Admission
$1,500
Hospital
Confinement - Daily up to 30 Days
$375
ICU Confinement
- Daily up to 15 Days
$750
Family Lodging -
Daily up to 30 days
$150
Accidental Death Any/All Insureds
Employee
Common-Carrier
$150,000
Employee Other
Accidents
$75,000
Spouse
Common-Carrier
$37,500
Spouse Other
Accidents
$18,750
Child
Common-Carrier
$15,000
Child Other
Accidents
$7,500
Accidental
Dismemberment Any/All Insureds
Loss of both Hands, Feet, Eyes or
Combination
$22,500
Loss of one Hand, Foot, or
Eye
$11,250
Loss of two or more Fingers or
Toes
$2,250
Loss of one Finger or Toe
$1,125
Paralysis Any/All Insureds
Quadriplegia
$45,000
Paraplegia
$22,500
Coma
$15,000
Emergency Care Any/All Insureds
Air
Ambulance
$900
Ground
Ambulance
$450
Emergency
Room
$300
Diagnostic Exams - MRI, CT, or
EEG
$225
Initial Doctor Office
Visit
$75
Follow-up Doctor Office
Treatment
$75
Laceration(s) under
2
$75
Laceration(s) 2 to
6
$300
Laceration(s) over
6
$600
Laceration(s) Cleaning - No Stitches, Staples or Glue
$37.50
Eye
Injury
$300
Broken Tooth -
Crown
$225
Broken Tooth - Extraction
$75
Concussion
$150
Ruptured
Disc
$600
Physical Therapy up to 6
Visits
$37.50
Blood/Plasma/Platelets
$450
Medical
Equipment
$150
Burn 2nd Degree 36%
Body
$1,125
Burn 3rd Degree 9 to
35
$2,250
Burn 3rd Degree over
35
$15,000
Burn Skin Grafts 25% of Degree Benefit
Varies |
Surgery Any/All Insureds
Open Abdominal, Thoriac
$1,500
Exploratory No Repair
$150
Torn Knee Cartilage
Repaired
$750
Torn Knee Cartilage - Exploratory or
Shaved $150
Tendon/Ligament/Rotator Cuff - Repair more than One $900
Tendon/Ligament/Rotator Cuff - Repair
One
$600
Tendon/Ligament/Rotator Cuff -
Exploratory $150
One Prosthetic Device
$750
Two or more Prosthetic
Devices
$1,500
Dislocation Closed Reduction Any/All Insureds
Hip (Open Reduction
$6,000)
$3,000
Knee (Open Reduction
$3,000)
$1,500
Ankle or Foot (Open Reduction
$2,400)
$1,200
Shoulder (Open Reduction
$900)
$450
Elbow (Open Reduction
$900)
$450
Wrist (Open Reduction
$900)
$450
Toe or Finger (Open Reduction
$300)
$150
Hand (Open Reduction
$900)
$450
Lower Jaw (Open Reduction
$900)
$450
Collar Bone (Open Reduction
$900)
$450
Fracture Closed Reduction Any/All Insureds
Hip (Open Reduction
$5,000) $2,250
Leg (Open Reduction
$2,400)
$1,200
Ankle (Open Reduction
$900)
$450
Kneecap (Open Reduction
$900)
$450
Foot excluding Toes/Heel (Open Reduction
$900) $450
Upper Arm (Open Reduction
$1,050)
$525
Forearm, Hand, or Wrist (Open Reduction
$900) $450
Finger or Toe (Open Reduction
$150)
$75
Vertebrae (Open Reduction
$2,400)
$1,200
Vertebral
Process
$450
Pelvis (excluding Coccyx, Open Reduction
$2,400) $1,200
Coccyx
$300
Face (excluding Nose, Open Reduction
$1,050)
$525
Nose (Open Reduction
$300)
$150
Upper Jaw (Open Reduction
$1,050)
$525
Lower Jaw (Open Reduction
$900)
$450
Collar Bone (Open Reduction
$900)
$450
Ribs or Rib (Open Reduction
$750)
$375
Skull Depressed (Open Reduction
$7,500) $3,750
Skull
Simple
$1,500
Sternum (Open Reduction
$900)
$450
Shoulder Blade (Open Reduction
$900)
$450
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