Hospital Daily Benefits Plan

Pays you up to $100.00 a day for every day you are confined in a hospital for a covered injury or sickness. ⁽¹⁾

• No limit on the number of days.

Coverage for outpatient treatment of a covered injury or sickness:

• In an emergency room, trauma center, urgent care center, hosptial outpatient facility and free-standing surgical facility.

Up to an additional $100.00 a day for every day you are confined to a hospital: ⁽¹⁾

• Due to a covered workplace accidental injury or medical emergency that occurs while performing the regular duties of your occupation at the time the accident occurs (this benefit applies to union members only).
• For Cancer, Stroke or Heart Attack. There is no maximum benefit limit, no matter how often or long you are in the hospital for one of these causes.
• For Intensive Care with no limit to the number of covered days.
• For Simultaneous Confinement, if you and your spouse ⁽²⁾ are hospitalized at the same time due to covered injuries that resulted from the same accident.

Pays you up to $100.00 a day up to 60 days for every day that Convalescent Care is required for a covered injury or sickness. ⁽¹⁾

• Benefits include cash payments for confinement to a skilled nursing care facility or if covered injury or illness requires qualified home health care after a Hospital Confinement lasting 3 or more consecutive days.

Labor Dispute Waiver of Premium for active union members:

• For a union-sanctioned Strike or Lockout.
• Pays your premiums for a whole year following the start of any union-sanctioned Strike or Lockout lasting 30 or more days (not available in all states).

This information is only an outline of The Union Labor Life Insurance Company's Hospital Daily Benefits Plan features. Once approved for coverage, it is important that you read your Certificate of Insurance for the exact benefits, terms and conditions of this insurance plan as benefits, limitations, and exclusions may vary by age and State.

⁽¹⁾ Insureds ages 65 and over will be paid one-half of the daily hospital indemnity benefits for the first 60 days of continuous confinement (excluding Intensive Care). See your Certificate of Insurance for details. The daily indemnity benefits will be paid thereafter. Unmarried, dependent children under age 19 (age 25 in NM; age 21 in LA) or age 25, if a full-time student, will be covered at 60% of the daily indemnity benefits you select. The Hospital Daily Benefits Plan pays in addition to negotiated health & welfare plans or any other health insurance policy you may have. The benefits you collect and the premium you pay depend on your age and the plan you choose.

⁽²⁾ Spouse includes Domestic Partner, Civil Union Partner, or Legal Partner as recognized by the jurisdiction in which you reside.

Select your own coverage plan.

• $100.00, $75.00 or $50.00/day

No limit to the number of covered hospitalizations, the number of hospital days, or on the lifetime coverage amount you may collect.

Choice of individual or family coverage.

• You can choose coverage for just you or for you and your spouse ⁽¹⁾ and dependent children.

Flexibility to choose your doctor and hospital.

Acceptance is guaranteed regardless of your health history.⁽²⁾

No individual rate increases under your Union's group master policy.

(1) Spouse includes Domestic Partner, Civil Union Partner, or Legal Partner as recognized by the jurisdiction in which you reside.

(2) Age and state requirements apply. Some pre-existing conditions diagnosed within 6 months of coverage will be excluded for the first 12 months of coverage.

Pre-existing health conditions are not covered the first year. PRE-EXISTING CONDITION means a condition for which medical: advice; diagnosis; care; or treatment was recommended by or received from a Physician during the six-month period immediately prior to your Effective Date of coverage. The Pre-existing Condition Limitation will apply to new Covered Dependents or an increase in benefits on the effective date of the change in coverage, but will not apply to coverage already in force.

The Certificate will not pay a benefit for Hospital Confinements caused by, resulting from or contributed to by:

1. Injuries resulting from active military service; any active participation in a riot; armed conflict, or insurrection;
2. declared or undeclared war or any act of war;
3. the use or taking of any narcotic, barbiturate, or any other drug by the Insured unless administered in a therapeutic dosage as prescribed by a Physician;
4. an Injury that occurs while the Insured has a blood alcohol level of .08 (by weight or volume) or higher;
5. treatment of a Mental Disease or Disorder, alcoholism or drug addiction;
6. pregnancy or childbirth (Complications of Pregnancy are covered on the same basis as Sickness);
7. any Confinement rendered in a Hospital which does not comply with the Hospital definition (e.g., nursing facility, convalescent facility, or rehabilitation facility, are not covered);
8. any rehabilitative care in a Hospital;
9. suicide, attempted suicide or intentionally self-inflicted injury, while sane or insane (in Missouri while sane);
10. expenses incurred or care received outside of the United States beyond a period of 14 days of Hospital Confinement; or
11. an Injury that occurs while the Insured is committing an assault or felony.

NOTE: Any of the above Exclusions regarding mental illness, alcohol, and drug abuse do not apply to individuals who are residents of or employed in the District of Columbia.

Also, the Hospital Accident Confinement rider will not pay a benefit for Hospital Confinements caused by, resulting from or contributed to by:
(1) Sickness or its medical or surgical treatment, including diagnosis; and
(2) bacterial infection except through an accidental injury.

Please contact 1-888-292-7749 for any questions regarding the product exclusions.