SUITE Pdf Enrollment Kit July 15
User Manual: SUITE
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RCA Benefit Suite Take a look inside! New benefits this year! Enrollment Starts July 15th - August 31st. Table of Contents Voluntary Benefit Summary.................................................................... Page 1 Hospital Indemnity Insurance.................................................................. Page 2 Accident Insurance................................................................................. Page 3 Term Life Insurance................................................................................ Page 5 Short-Term Disability Income Insurance.................................................. Page 8 Critical Illness Insurance......................................................................... Page 8 HealthiestYou......................................................................................... Page 9 Enrollment Form, Payment Form............................................................. Page 10 Eligibility Requirements The eligibility requirements for the Hospital Indemnity Insurance, 10 and 20 Year Term Life Insurance, Short-Term Disability Insurance, Critical Illness Insurance, Accident Insurance through Transamerica Life Insurance Company, Cedar Rapids, IA are as follows: 1. You must be an active member of the National Rural Letter Carriers’ Association to apply for insurance. 2. You must be actively at work and able to perform all duties of your job. 3. If you are a new NRLCA member, there is a 45 day waiting period before a new leave replacement carrier is eligible to enroll. 4. After the 45-day waiting period, new NRLCA members have 30 days to elect to enroll or must wait until the next open enrollment period. During open enrollment - the 45 day waiting period is being waived. Please see policy specifics for dependent eligibility, if a dependent is currently disabled. Please visit www.rc-benefits.com for more information. EBD KGNRLCA 0615 Help Protect You and Your Family with These Voluntary Insurance Products. Hospital Indemnity Insurance Hospital Indemnity Insurance pays a set amount if an insured is confined in a hospital. Even with the best primary insurance plan, out-of-pocket costs from a hospital stay can add up. Hospital Indemnity insurance benefits can help defray expenses that major medical insurance doesn’t cover, like deductibles, co-pays or co-insurance amounts. Benefits can also be used for non-medical expenses such as rent or mortgage, car payment, groceries, or child care. THIS IS NOT MAJOR MEDICAL INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL INSURANCE. IT DOES NOT QUALIFY AS MINIMUM ESSENTIAL HEALTH COVERAGE UNDER THE FEDERAL AFFORDABLE CARE ACT. HealthiestYou Accident Insurance 24 Hour On & Off-the-Job Insurance You and/or your family are covered 24 hours a day against accidents at home, on vacation, playing sports, etc. Benefits are paid directly to you. A set benefit amount is paid for broken bones, dislocations, loss of limbs, sight, accidental death, daily hospital expenses, lump sum hospital expenses and much more. Partial Fee Schedule (see full brochure at www.RC-Benefits.com) • Accident Emergency Treatment by a physician in a Doctor’s office or Hospital........................................$100 • Major Diagnostic Examination CT Scan, MRI, EGG..........................$160 • Follow up Visits (3 per accident) & Physical Therapy (10 per accident)..................................$75 per visit • Initial Accident Hospitalization Benefit.........................................$2,400 • Accident Hospital Income Benefit (Up to 365 days while in the hospital)................................$200 per day Consult with a Doctor 24/7 physician access via phone, email or video HealthiestYou is an innovative and comprehensive telehealth and wellness solution, serving as an accessible complement to any health insurance plan. With access to a 24/7 physician network as well as a one-of-its-kind online wellness program, these services help you save money. Look inside for complete details. Short-Term Disability Income Insurance How long could you go without a paycheck? If you run out of vacation or leave days, will you have enough savings to make it? Would you want to borrow money from family or friends while you’re getting well? Obtaining Social Security disability benefits can be challenging and time consuming. Now the NRLCA is making voluntary short-term disability income insurance available to you. You must satisfy the income requirements to qualify. Benefit Period: 6 months or 12 months Waiting Period: 14 days after a sickness or accident Critical Illness Insurance Pays a lump sum when you are diagnosed with cancer, have a stroke, have a heart attack, need a major organ transplant or end-stage renal failure. Use the lump sum benefit for anything you wish. You can purchase either $10,000 or $20,000 of this lump sum benefit. 10 or 20 Year Term Life Insurance If Something Happens to You, Is Your Family Ready for Tomorrow? There is no way to know what will happen tomorrow, but there is a way to help protect your family against the unexpected. Trans Select® 10 or 20 is Transamerica’s term life insurance product to help meet life’s changes — today and tomorrow. Riders Included with Base Policy: • Accelerated Death Benefit for Terminal Illness • Accelerated Death Benefit for Long-Term Care Monthly Benefit: • $800 monthly benefit - must work at least 20 hours per week • $1,500 monthly benefit - must work at least 30 hours per week Income verification at time of claim. Please call (877) 817-4801 or visit www.RC-Benefits.com for more information. 1 Hospital Indemnity Insurance Hospital Select® II Underwritten by Transamerica Life Insurance Company Hospital Indemnity Insurance pays a set amount if an insured is confined in a hospital. Even with the best primary insurance plan, out-of-pocket costs from a hospital stay can add up. Hospital Indemnity insurance benefits can help defray expenses that major medical insurance doesn’t cover, like deductibles, copays or co-insurance amounts. Benefits can also be used for non-medical expenses such as rent or mortgage, car payment, groceries, or child care. Benefits Daily In-Hospital Indemnity Benefit $50.00 per day/Maximum $5,000 per calendar year Pays each day a covered person is confined to a hospital (but not an emergency room, outpatient stay or stay in an observation unit) as the result of a covered accident or sickness. Hospital Confinement Indemnity Benefit $750.00 1 day per confinement/1 day per calendar year Pays if a covered person is confined to a hospital (but not an emergency room, outpatient stay or stay in an observation unit) as the result of a covered accident or sickness lasting a minimum of 24 continuous hours from time of admission. Critical Illness Indemnity Benefit $2,500.00 per person Pays once when the insured is diagnosed with a critical illness (invasive cancer, heart attack, stroke, end stage renal failure, or major organ failure). A subsequent benefit is payable when the insured is diagnosed with a different critical illness 60 or more days after the first diagnosis. Surgical and Anesthesia Benefit $1,000 Inpatient Surgery 1 day calendar year maximum $500 Outpatient Surgery 1 day calendar year maximum $100 Outpatient Minor Surgery 1 day calendar year maximum 30% extra is paid if anesthesia is administered MONTHLY RATES Member Member plus Children Member plus Spouse Member plus Family $32.18 $56.13 $71.01 $87.30 This is a brief summary of Hospital Select® II Group Hospital Indemnity Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, IA. Policy Form Series CPGHI400 and CCGHI400. Forms and form numbers may vary. Coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details. THIS IS NOT MAJOR MEDICAL INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL INSURANCE. IT DOES NOT QUALIFY AS MINIMUM ESSENTIAL HEALTH COVERAGE UNDER THE FEDERAL AFFORDABLE CARE ACT. 2 Accident Insurance AccidentAdvance® 24-Hour On & Off-the-Job Coverage Underwritten by Transamerica Life Insurance Company You and/or your family are covered 24 hours a day against accidents whether you are working as a rural letter carrier, at home, on vacation, playing sports, etc. Benefits are paid directly to you. A set dollar amount is paid for broken bones, dislocations, loss of limbs, sight, accidental death, dally hospital expenses, lump sum hospital expenses and much more. Partial Benefit Schedule: Accident Emergency Treatment.............................................................. $100 Major Diagnostic Examination................................................................ $160 Follow up Visits & Physical Therapy............................................. $75 per visit Initial Accident Hospitalization Benefit..................................................$2,400 Accident Hospital Income Benefit............................................... $200 per day See full brochure at www.RC-Benefits.com Benefits are payable only once per covered person, per accident, unless otherwise noted. Benefits are not payable for services rendered by an immediate family member. Accident Emergency Treatment Accident Emergency Treatment Benefit - For treatment by a physician and X-rays received in a hospital or physician’s office received within 96 hours of the accident. $100 Major Diagnostic Examination Benefit - For one CT Scan, MRI, or EEG completed within 90 days of the accident. $160 Dislocation Benefit For dislocations reduced under general anesthesia. A dislocation reduced without general anesthesia is limited to 25% of the benefit amount for the dislocation involved. Benefits are payable only for the first dislocation of a joint. If multiple dislocations are reduced, we will pay 11⁄2 times the highest benefit amount and no other amount will be paid under this benefit. Dislocated Joint Open Reduction Closed Reduction Hip Knee or Shoulder Collar Bone Ankle or Foot (except toes) Lower Jaw Wrist or Elbow Toe or Finger $3,200 $1,080 $1,720 $1,080 $1,080 $880 $240 $1,080 $440 $320 $320 $560 $440 $120 This is a brief summary of AccidentAdvance®, Accident Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa. Policy form series CPACC100 and CCACC100. Forms and form numbers may vary. This coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details. Fracture Benefit For repair of a fracture sustained in an accident. A chip fracture is limited to 10% of the benefit amount for the fracture involved. If multiple fractures are repaired, we will pay 11⁄2 times the highest benefit amount and no other amount will be paid under this benefit. Open Closed Fractured Bone Reduction Reduction Coccyx $560 $280 Hand (except fingers), Foot (except toes/ $1,360 $680 heel), Wrist,Shoulder Blade, Forearm, Ankle, Elbow, Kneecap, Sternum or Lower Jaw Hip $4,000 $1,360 Leg $1,680 $1,360 Nose, Heel or Fingers $1,360 $280 Rib(s) $2,680 $280 Skull $2,160 $800 Toes $560 $280 Upper Jaw, Upper Arm or Face (except $1,600 $680 Nose), Collar Bone Vertebrae, Pelvis $680 $680 Vertebral Processes $2,680 $400 If dislocations and fractures are both involved, we will pay 11⁄2 times the highest dislocation or fracture benefit amount and no other amount will be paid under the dislocation benefit or the fracture benefit. Follow-Up Visits and Physical Therapy Accident Follow-Up Treatment Benefit – Maximum of 3 $75 follow-up visits per accident. For follow-up treatment visits, original treatment must have been received within 96 hours of the accident. Treatment must begin within 30 days of, and completed within the 6 month period following the later of: (1) the accident; (2) discharge from the hospital from a covered confinement; or (3) discharge from an extended care facility. Treatments must be provided by a physician in their office or in a hospital on an outpatient basis. Physical Therapy Benefit – Maximum of 10 treatments per $75 accident. For physical therapy treatments performed by a licensed Physical Therapist under the advice of a physician. Treatment must begin within 120 days of the accident and be completed within 1 year of the accident. 3 Accident Insurance Initial Accident Hospitalization Paralysis – Lasting a minimum of 30 days Initial Accident Hospitalization Benefit Benefit is payable once for the first hospital admission due to an accident. Benefit is payable once for the first Intensive Care Unit admission due to an accident. The ICU benefit is paid even if admitted to the hospital initially and then transferred to ICU later during the same hospitalization. Ambulance Benefit For ambulance transportation by a licensed ambulance service to the nearest hospital for treatment within 96 hours of the accident. $2,400 Tendons, Ligaments, and/or Rotator Cuffs – Must be detached, torn, ruptured, or severed and surgically repaired by a physician within 1 year of the accident. Only one of the following benefits is payable. Ground Ambulance $480 Air Ambulance $2,400 Accident Hospital and ICU Income Rider Accident Hospital Income Benefit - For hospital confinement for treatment of injuries beginning within 30 days of the accident. Benefit is payable for up to 365 days per accident. $200 Accident ICU Benefit - For ICU confinement while the person is receiving the hospital income benefit. Benefit is payable for up to 15 days per accident. $600 Expanded Benefits Rider The following benefits are payable once, per person, per accident for injuries sustained in a covered accident. Burns - Must be treated by a physician within 96 hours of the accident. One or more skin grafts for a covered burn will be paid at 50% of the burn benefit amount paid for the burn involved. Second-degree burns of at least 25% but not more than 35% of body surface Second-degree burns of more than 35% of body surface Third-degree burns covering 6 through 10 square centimeters of body surface Third-degree burns covering 10 through 25 square centimeters of body surface Third-degree burns covering 25 through 35 square centimeters of body surface Third-degree burns covering more than 35 square centimeters of body surface $480 $1,200 $1,200 $3,200 $7,200 $9,600 Lacerations - Must be treated or repaired within 96 hours of the accident. Lacerations not requiring sutures Single laceration less than 7.5 centimeters Lacerations 7.6 to 20 centimeters Lacerations over 20 centimeters $32 $64 $240 $480 Eye Injury With surgical repair Non-surgical removal of foreign body by a physician $320 $56 Emergency Dental Work One or more broken teeth repaired with crowns One or more broken teeth resulting in extractions Brain Concussion - Must be diagnosed by a physician within 96 hours of the accident. Coma - Unconsciousness for 14 consecutive days with no reaction to external stimuli, no reaction to internal needs, and require the use of life support systems. $12,000 $6,000 Quadriplegia (paralysis of four limbs) Paraplegia (paralysis of lower limbs) $240 $64 $160 Arthroscopic surgery with no repair Repair of one Repair of two or more $160 $400 $800 Ruptured Discs and/or Torn Knee Cartilage – Must be surgcally repaired by a physician within 1 year of the accident. Only one of the following benefits is payable. Shaved cartilage (debridement) or arthroscopic surgery with no repair Repair of one Repair of two or more $160 $400 $800 Major Surgery – For an open abdominal, cranial, or thoracic surgery performed by a physician within 1 year of the accident. Laparoscopic procedures are excluded. $1,200 Appliance – For a medical appliance recommended by a physician as an aid in personal locomotion. Appliances include items such as crutches, leg braces, wheelchairs, and walkers. This benefit is not payable for prosthetic devices. $160 Prosthetic Devices – For one or more prosthetic devices received within 1 year of the accident. This benefit is not payable for hearing aids, dental aids (including false teeth), eye glasses, or for cosmetic prosthetic devices such as hair wigs. We will not pay for joint replacement, such as an artificial hip or knee. One prosthetic device $600 Two or more prosthetic devices $1,200 Blood, Plasma, and Platelets – Required for the treatment of injuries due to a covered accident. Immunoglobulins are not covered. $320 Transportation – Benefit is payable for up to 2 round trips to the hospital per accident per covered person if special treatment and hospital confinement occurs within 30 days of the accident. The local attending physician must prescribe treatment that is not available locally. Benefits are not payable for transportation to any hospital within a 100-mile radius of the site of the accident or the residence of the covered person. $480 MONTHLY RATES Member Member plus Children Member plus Spouse Member plus Family $13.58 $19.14 $21.36 $27.08 $12,000 4 10 Year Term Life Insurance (includes Accelerated Death Benefit for Long Term Rider) Trans Select® 10 Underwritten by Transamerica Life Insurance Company If Something Happens to You, Is Your Family Ready for Tomorrow? There is no way to know what will happen tomorrow, but there is a way to help protect your family against the unexpected. Trans Select® 10 is Transamerica’s term life insurance product to meet life’s changes - today and tomorrow. At the end of each term, the policy will automatically renew unless cancelled by the owner. The new premium rate, based on the attained age of the insured and the death benefit, will be presented. The premium change will occur on the group renewal date. Subsequent term periods are 10 years until the expiration date, if earlier. Riders included with Base Policy • Accelerated Death Benefit for Terminal Illness • Accelerated Death Benefit for Long-Term Care 10 Year Term Life Insurance Monthly Rates Please review the flowchart on how the Accelerated Death Benefit for Long Term Care Rider benefits work Page 7 Note: • Spouses can only elect the $15,000 benefit amount • The minimum member benefit is $30,000 All Rates are Monthly This is a brief summary of Trans Select® Group Term Life Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa 52499. Policy form series CPVTL200 and CCVTL200; Rider form series CRTIVT00, CRWPL200 and CRCHL200. Forms and form numbers may vary. Coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details. 5 20 Year Term Life Insurance (includes Accelerated Benefit for Long Term Care Rider) Trans Select® 20 Underwritten by Transamerica Life Insurance Company If Something Happens to You, Is Your Family Ready for Tomorrow? There is no way to know what will happen tomorrow, but there is a way to help protect your family against the unexpected. Trans Select® 20 is Transamerica’s term life insurance product to meet life’s changes - today and tomorrow. At the end of each term, the policy will automatically renew unless cancelled by the owner. The new premium rate, based on the attained age of the insured and the death benefit, will be presented. The premium change will occur on the group renewal date. Subsequent term periods are 20 years until the expiration date, if earlier. Riders included with Base Policy • Accelerated Death Benefit for Terminal Illness • Accelerated Death Benefit for Long-Term Care 20 Year Term Life Insurance Monthly Rates Please review the flowchart on how the Accelerated Death Benefit for Long Term Rider benefits work Page 8 Note: • Spouses can only elect the $15,000 benefit amount • The minimum member benefit is $30,000 All Rates are Monthly This is a brief summary of Trans Select® Group Term Life Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa 52499. Policy form series CPVTL200 and CCVTL200; Rider form series CRTIVT00, CRWPL200 and CRCHL200. Forms and form numbers may vary. Coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details. 6 7 Your beneficiaries would receive $25,000. EXAMPLE: If you die anytime during or after your have exhausted the Extension of Benefits coverage, your beneficiaries will receive 25% of the life insurance policy amount. Is There Any Life Insurance Left? YES!!! • Bathing • Continence • Dressing If you used $35,000 of the $100,000 life insurance policy for NH or HH expenses and then die. Your beneficiaries would receive the balance of $65,000 tax–free. The Extension of Benefits Coverage provides up to an additional $100,000 of benefit. The payout process is the same as above. 4% or 2% depending on the typeof care you are receiving. EXAMPLE: EXAMPLE: What Happens if You Die While Receiving Payments for NH or HH Care? Then the Extension of Benefits Coverage Is Activated - Giving up to an Additional 25 months for Nursing Home or 50 months for Home Health Care Expenses 50 months for Home Health Care OR 25 months for Nursing Home Care What If You Still Need Care After: The Policy would pay out $2000 a month for 25 months for nursing home and assisted living facility expenses. EXAMPLE: If Receiving Home Health, Care, 2% of the Benefit Amount is Paid Out for up to 50 Months The Policy would pay out $4000 a month for 25 months for nursing home and assisted living facility expenses. EXAMPLE: If Receiving Nursing Home or Assisted Living Care, 4% of the Benefit Amount is Paid Out for up to 25 Months Life Insurance and Long Term Care Benefits -- All in one policy. You die and $100,000 is paid to your beneficiary. EXAMPLE: If Death Occurs • Transferring • Toileting • Eating EXAMPLE: $100,000 If You Need NH or HH Care You are unable to perform 2 of the 6 activities of daily living or have a cognitive impairment. Life Insurance Purchased NH=Nursing Home HH=Home Health The Accelerated Death Benefit for Long Term Care can be used for Nursing Home & Home Health Care Expenses! Short-Term Disability Income Insurance TransDI® Plus Base Coverage Underwritten by Transamerica Life Insurance Company Waiver of Premium- An insured member does not pay premiums after 90 consecutive days of total disability or the satisfaction of the elimination period, whichever is later. How would your bills be paid if you were suddenly disabled and could not work? Partial Disability Benefit- A partial disability will be paid if an insured becomes partially disabled due to the same cause as total disability The benefit is 50% of the initial benefit. How long can you go without an income? A serious illness or accidental injury can deplete your saving in a relatively short period of time. TransDI® Plus helps replace up to 60% of your salary if you are unable to work because of a disability. You can use the benefit for: • Mortgage or rent • Food • Utilities • Clothing Accelerated Benefit for Terminal Illness- If a member is diagnosed with a terminal illness for the first time, on or after the effective date, we will accelerate the monthly disability benefit for the remaining months of payments of the maximum disability period of the contract, up to 12 months. Rider Form Series CRDITI00. • Credit cards and other debts • Health, life and auto insurance premiums • Car payments • Other transportation expenses Mental Illness Limited Benefit- Totally Disabled due to a Mental Illness, regardless of the cause, Disability Benefits will be paid for the period. Mental Illness means Disability due to or resulting from psychiatric or psychological conditions, regardless of cause. The term Mental Illness does not apply to dementia, if due to Stroke, Trauma, Viral infection, Alzheimer’s disease, or other conditions not usually treated by a mental health provider using psychotherapy, psychotropic drugs, or other similar modalities. Eligible Benefits and Amounts An employee is eligible to receive benefits • When totally disabled • Under a physician’s care • The accident or sickness is non-work related • The selected elimination period has been satisfied When do benefits begin? Pre-Existing Condition Limitation • No benefit for a pre-existing condition until the insured has been continuously covered under the policy for 12 consecutive months • Must be performing the duties of his or her occupation for 30 continuous days after the first 12 months of coverage After satisfying a 14 day waiting period for either a sickness or accident, the plan will pay the selected benefit amount for maximum of 180/365 days or the end of the disability which ever is sooner. Short-Term Disability Insurance Monthly Premium Income Qualifications • Plan 1 - $800 monthly benefit - 6 months (20 hours per week minimum) • Plan 2 - $1,500 monthly benefit - 6 months (30 hours per week minimum) • Plan 3 - $800 monthly benefit - 12 months (20 hours per week minimum) • Plan 4 - $1,500 monthly benefit - 12 months (30 hours per week minimum) Income verification at time of claim. This is a brief summary of TransDI® Plus Group Short-Term Disability Income Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa. Policy form series CPDI0100 and CCDI0100. Forms and form numbers may vary. Coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details. Ages 18-49 Ages 50-59 6 MONTHS 12 MONTHS $800 $19.04 $24.16 $800 $23.20 $28.96 $1,500 $35.70 $45.30 $1,500 $43.50 $54.30 Critical Illness Insurance Underwritten by Transamerica Life Insurance Company Critical Illness insurance pays a lump sum benefit when you are diagnosed with cancer, have a stroke, have a heart attack, need a major organ transplant or during end-stage renal failure. This benefit is paid directly to you. Use the lump sum benefit for anything you wish. You can select either a $10,000 or $20,000 lump sum benefit amount. BENEFITS This policy does not increase with age. Premiums and benefits stay level throughout your lifetime. Spouse and child benefits are 50% of the elected member benefit. Lifetime Maximum Benefit - Total Critical Illness and Recurrent Benefits are limited to 3 times the elected Benefit. This is a brief summary of CriticalAssistance AdvanceSM, Critical Illness Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa. Policy form series CPCI0400 and CCCI0400. Forms and form numbers may vary. This coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details. 8 9 NRLCA 2015 Benefit Enrollment Form For More Information (877) 817-4801 10 11
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