You can customize your plan selection(s) by adding any of all of the following benefits. Each benefit added will, or course, increase the plan monthly premium. ALL OPTIONS ARE NOT AVAILABLE IN ALL STATES For a premium illustration of one of our standard plans with any of the Plan Options below or for a custom plan, please complete the Request for Proposal Form and fax it to Eagle Administrators, Inc. CUSTOM PLANS ARE AVAILABLE UPON REQUEST FIRST DAY HOSPITAL ADMISSION INDEMNITY BENEFIT If elected, this Benefit Rider will pay two times the daily rate shown in the schedule of benefits for the first day of a hospital stay. The Double First Day Benefit does not apply to the Intensive Care, Substance Abuse, Mental Illness, or Skilled Nursing Facility benefits. ANESTHESIA INDEMNITY BENEFIT If elected, this benefit will pay an amount equal to 25% of the benefit paid for a surgical procedure covered under the plan. The amount paid is in addition to the surgical schedule. SHORT TERM DISABILITY BENEFIT If elected, this benefit will pay for a covered illness or accident, after a 15-day elimination period. The benefit is up to $300 per week with a benefit period maximum duration of 13 weeks. DENTAL & VISION BENEFIT (benefits cannot be separated) There are three (3) Dental & Vision Plan Options. All plans have a $50 deductible per person, with 3 deductible maximum per family, per calendar year. Plans pay 80% of Type-I & Type-II procedures, and 50% of Type-III and Type-IV. The lifetime maximum orthodontia benefit is 50% of the annual maximum plan benefit. Calendar year maximum benefit options per covered person are as follows:
Vision Benefit pays 80% of covered vision expenses, including eye wear, up to a maximum annual benefit of $300 per covered person. |
