| ▪ First Hospital Confinement Benefit |
| Pays for the insured's First Hospital Confinement for a covered Sickness or Injury during the Calendar Year based on the total number of days of Hospital Confinement. Benefit is not cumulative and will not exceed $5,000 (Schedule:1 day- $500; 2 days - $1000; 3 days - $2000; 4 days - $3000; 5 days - $4000; 6 days - $5000). |
| ▪ Hospital Confinement |
| Pays the Daily Benefit of $30 for Hospital Confinement (resident bed patient) due to a covered injury or sickness beginning with the first day up to 180 days. |
| ▪ Outpatient Sickness |
| Pays $50 for the treatment in an Out-of-Hospital facility (including a Physician's office), due to a covered Sickness. Up to 4 different covered sickness in a Calendar Year. |
| ▪ Hospital Emergency Room |
| Pays $75 per sickness for treatment in a Hospital Emergency Room. Up to 4 different covered sickness in a Calendar Year. |
| ▪ Intensive Care Unit |
| Pays the Daily Benefit of $150, up to 20 days confinement in a Hospital's Intensive Care Unit for a covered injury or sickness. |
| ▪ Private Duty Nurse |
| Pays a Daily Benefit of $ 50 for required services of a Private Duty Nurse for at least 8 hours a day up to 30 days. |
| ▪ Emergency Accident |
| Pays $100 for Emergency Care rendered within 72 hours of the Injury by a physician in a Hospital Emergency Room or Physician's office. Up to 4 different Covered Injuries in a Calendar Year. |
| ▪ Surgical Plus Benefit |
| $1000 per Surgery. Benefit per surgery as listed in the schedule of Surgical Benefits. Benefit for Anesthesia: Equal to 25% of Surgical Indemnity Benefit Amount. |
*** Excel Plan is underwritten by Professional Insurance Company and only NJ state is not available.
Disclaimer:
Every attempt has been made to make the information contained in this proposal as accurate and up-to-date As possible. To accurately reflect all required information this proposal shall be presented in its' entirely. Unless otherwise noted all amounts in this proposal are presented in dollars. Company is not responsible for any typographical errors contained in this proposal. This proposal is not intended to create a contract. |
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