Hospital Indemnity

Symetra

ABOUT HOSPITAL INDEMNITY

This is an affordable supplemental plan that pays you should you be inpatient hospital confined. This plan complements your health insurance by helping you pay for costs left unpaid by your health insurance.

For full plan details, please visit your benefit website: www.mybenefitshub.com/wylieisd

EMPLOYEE BENEFITS

An injury or illness can land you in the hospital for a night or two—or even longer. If that happens, unexpected costs from deductibles, copays or coinsurance, as well as non-medical expenses like child care or transportation could take a serious toll on your family’s financial health. That’s where hospital indemnity insurance comes in. It’s offered through your work and can reduce the burden of a hospital stay by helping cover the cost. What is it?

Hospital indemnity insurance pays a fixed dollar amount per day for services and supplies you receive during a hospital stay, up to a maximum number of days each year. Stays in a mental health, substance abuse or nursing facility are also covered. There are no preexisting condition limitations, no health questions to answer and no medical tests to take. You’re paid the full per-day benefit no matter what other insurance you have. Why hospital indemnity insurance?

If you end up in the hospital, your focus should be on your recovery, not your medical bills. Hospital indemnity insurance can help with the cost of your stay, giving you and your family some financial peace of mind.

Select Benefits Plan Summary for: 12433000 - Wylie Independent School District

Fixed-Payment Indemnity Policy

Base Plan Inpatient Hospital Benefits 500 days per lifetime unless noted

Hospital Confinement $1,000 initial day, $100 day 2+, 30 Days pp/pcy1

Intensive Care Unit

Substance Abuse Facility Mental Health Facility 180 days lifetime maximum

$1,000 initial day, $100 day 2+, 30 Days pp/pcy $100 per day, 30 Days pp/pcy $100 per day, 30 Days pp/pcy

Nursing Facility This benefit is paid only if following a covered hospital stay of at least three consecutive days. $100 per day, 30 Days pp/pcy

Health Advocacy Services EAP+Work/Life Program Wellness Program Pharmacy Discount Program Survivor Benefit Included Included Included Included Included

Monthly Premium Employee Employee + Spouse Employee + Children Family $14.17 $30.19 $23.23 $42.04 Classic Plan

$2,500 initial day, $100 day 2+, 30 Days pp/pcy1 $2,500 initial day, $100 day 2+, 30 Days pp/pcy $100 per day, 30 Days pp/pcy $100 per day, 30 Days pp/pcy

$100 per day, 30 Days pp/pcy Included Included Included Included Included

$28.92 $61.64 $47.41 $85.82 Premier Plan

$5,000 initial day, $100 day 2+, 30 Days pp/pcy1 $5,000 initial day, $100 day 2+, 30 Days pp/pcy $100 per day, 30 Days pp/pcy $100 per day, 30 Days pp/pcy

$100 per day, 30 Days pp/pcy Included Included Included Included Included

$53.51 $114.04 $87.72 $158.78

Zurich

ABOUT MEDICAL SUPPLEMENT

This plan provides supplemental coverage to help offset out-of-pocket costs that you may experience due to deductibles, co-payments and coinsurance of your employer’s medical plan.

For full plan details, please visit your benefit website: www.mybenefitshub.com/wylieisd

EMPLOYEE BENEFITS

The GAP Plan provides coverage for medically necessary eligible out-of-pocket expenses related to the insured’s major medical plan’s co-insurance and deductibles up to the maximum benefit selected, provided such expenses are the result of treatment for a covered injury or sickness.

SIS (GAP) Under 40 40-49 50+

Employee Employee + Spouse

$30.93 $56.86 Employee + Children $74.34 $40.72

$85.53 $74.83 $157.15 $80.82 $147.38

Family $99.57 $113.21 $217.13

Inpatient Hospital Benefit:

The benefit is $1500 In-Hospital benefit per covered person per calendar year. Note: This coverage may not cover 100% of out-of-pocket expenses. Benefits Include: • Coverage for out-of-pocket expenses due to an inpatient hospital confinement • Coverage for inpatient hospital charges for eligible out-of-pocket expenses resulting from the treatment of an accidental injury or sickness • Emergency room treatment and ambulance for a covered injury or sickness when it results in hospital confinement within 24 hours • Durable medical equipment Outpatient Hospital Benefit:

The Outpatient Hospital benefit limit is up to $1500 for 4 outpatient occurrences per family per benefit year. Benefits Include: • Emergency room treatment and ambulance as long as the person is NOT hospitalized within 24 hours of being transported to the hospital and ER Treatment • Outpatient surgery in an outpatient surgical facility, emergency facility or physician’s office • Diagnostic testing, e-rays, labs, MRIs, or CT scans • Outpatient radiation therapy or chemotherapy • Physical therapy or chiropractic care • Durable medical equipment The outpatient benefit does not cover a physician’s office visit charge Please note that in order for a service to be covered under the GAP plan, it needs to be covered under the major medical plan.