Group supplemental health insurance
Hospital indemnity
Injuries, illnesses and childbirth can land employees in the hospital for a night or two. Even with a major medical plan, they can face out-of-pocket costs from copay, coinsurance or deductible requirements.
First Symetra’s hospital indemnity insurance can help close some of these coverage gaps so employees can focus more on recovery and getting back to work as soon as possible.
A financial safety net for the unexpected
Hospital indemnity insurance provides coverage for inpatient hospital stays resulting from on- or off-the-job injuries and illnesses. It pays a preselected, fixed dollar amount each day for eligible services and supplies received in a hospital or authorized facility.
Coverage can include stays in:
Intensive care units (ICUs)
Substance abuse facilities
Mental health facilities
Nursing facilities1
Newborn benefit
If a covered employee gives birth while under the plan, they and the child will both receive a benefit for the initial hospital admission and the following days of their hospital stay. Covered employees’ children are automatically covered for the first 31 days following their birth or adoption.2
Claim example
Meet Anita and William
Anita gives birth to William and they both spend three days in the hospital. Fortunately, both Anita and William receive a benefit from their First Symetra hospital indemnity insurance plan.
|
|||||||
| Initial day confinement (admission) benefit | $240 (first day only) | $240 (first day only) |
| Per-day hospital stay, days 2+ | $120 per day | $120 per day |
| 3-day total | $480 | $480 |
Anita can use the $960 benefit to cover anything she’d like, such as out-of-pocket medical expenses, child care and transportation.
Note: This example is for illustrative purposes only and is meant to provide a general overview of how hospital indemnity insurance works. Any resemblance to actual persons is purely coincidental. Refer to your enrollment materials for your plan’s benefit amounts.
Customize your coverage
Choose your plan's per-day benefit amounts, and whether or not to include these optional coverages:
- Initial day confinement benefit (admission benefit)
- Hospital observation benefit
- Emergency room benefit
- Wellness/preventive care benefit
- Surgical procedure benefits
- Ground and air ambulance transportation
- Outpatient care benefits
Key features
Ability to customize benefits to your group's unique needs.
Portability and extension of coverage options.
No preexisting condition limitations, including pregnancy.
Next steps
To learn more, contact your benefits broker or consultant.
IMPORTANT: This is a fixed indemnity policy, NOT health insurance
This fixed indemnity policy may pay you a limited dollar amount if you’re sick or hospitalized. You’re still responsible for paying the cost of your care.
- The payment you get isn’t based on the size of your medical bill.
- There might be a limit on how much this policy will pay each year.
- This policy isn’t a substitute for comprehensive health insurance.
- Since this policy isn’t health insurance, it doesn’t have to include most Federal consumer protections that apply to health insurance.
Looking for comprehensive health insurance?
- Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to find health coverage options.
- To find out if you can get health insurance through your job, or a family member’s job, contact the employer.
Questions about this policy?
- For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners’ website (naic.org) under “Insurance Departments.”
- If you have this policy through your job, or a family member’s job, contact the employer.
Hospital Indemnity policies are insured by First Symetra National Life Insurance Company of New York, New York, NY. Mailing address: P.O. Box 34690, Seattle, WA 98124. They are not available in all U.S. states or any U.S. territory. They are designed to provide benefits at a preselected, fixed dollar amount. They are not a replacement for major medical or other comprehensive coverage, and do not satisfy the minimum essential coverage requirements of the Affordable Care Act. Base policy number is SBC–00500/NY 6/20. Coverage may be subject to exclusions, limitations, reductions and termination of benefit provisions. For costs and complete details of the coverage, contact your benefits representative.
1 Nursing facility benefits are paid only if following a covered hospital stay of at least three consecutive days.
2 Insureds must enroll a child as a dependent on their plan within 30 days of birth in order for coverage to continue beyond the first 31 days.
WEB-1384/NY 11/24