Provided By
Mutual of Omaha
Provider Website
Customer Service
Additional Benefits
You have the option to purchase accident insurance, which helps to protect your finances after an accident. You are paid a lump sum if you have a covered injury and can use the money to help pay out-of-pocket medical costs or everyday expenses.
Health Screening Benefit Pays a flat, annual benefit of $125 for a health screening test.
Benefits |
|
|---|---|
Initial Care |
|
Emergency Room |
$200.00 |
Urgent Care |
$125.00 |
Initial Physician Office Visit |
$100.00 |
Ambulance |
Up to $1,500 |
Specified Injuries |
|
Fractures (Surgical/Non-surgical) |
Up to $6,00/ Up to $3,000 |
Dislocations (Surgical/Non-surgical) |
Up to $9,000/ Up to $4,500 |
Lacerations |
Up to $800 |
Burns |
Up to $15,000 |
Dental |
Up to $300 |
Hospital, Surgical & Diagnostic |
|
Admission |
$1,500 |
Daily Confinement |
$300 per day |
ICU Confinement |
$600 per day |
Rehab. Facility Confinement |
$150 per day |
Surgical |
Up to $2,000 |
Diagnostic |
Up to $300 |
Follow-Up Care |
|
Physician Follow-Up Office Visit |
$100; Up to 6 per accident |
Therapy Services |
$50; Up to 6 per accident |
Medical Device |
$200 |
Prosthetic Device(s) |
$1,000; Up to 2 per accident |
Principal Sum |
|
Employee |
$50,000 |
Spouse |
$25,000 |
Children |
$10,000 |
Monthly Cost |
|
|---|---|
Employee Only |
$14.52 |
Employee + Spouse |
$23.37 |
Employee + Child(ren) |
$32.36 |
Family |
$43.30 |
You have the option to purchase critical illness insurance, which provides a fixed, lump-sum benefit upon the diagnosis of a serious illness like heart attack, stroke, or cancer. Benefits are paid directly to you and may be used for any reason from deductibles and prescriptions to travel expenses, childcare or other everyday expenses.
Health Screening Benefit Pays a flat, annual benefit of $125 for a health screening test.
Benefits |
|
|---|---|
Heart/Circulatroty/Motor Function |
|
Heart Attack |
100% |
Heart Transplant |
100% |
Stroke |
100% |
ALS (Lou Gehrig's) |
100% |
Advanced Alzheimer |
100% |
Advanced Parkinson's |
100% |
Heart Valve Surgery |
100% |
Coronary Artery Bypass |
100% |
Aortic Surgery |
100% |
Organ |
|
Major Organ Transplant |
100% |
End-Stage Renal Failure |
100% |
Acute Respiratory Distress |
25% |
Childhood/Developmental |
|
Cerebral Palsy |
100% |
Structural Congenital Defects |
100% |
Genetic Disorders |
100% |
Congenital Metabolic Disorders |
100% |
Type 1 Diabetes |
100% |
Cancer |
|
Invasive |
100% |
Bone Marrow Transplant |
50% |
Carcinoma in Situ |
25% |
Benign Brain Tumor |
25% |
Employee |
|
Employee Benefit Level |
$10,000 |
Employee GI |
$10,000 |
Spouse |
|
Spouse Benefit Level |
$10,000 |
Spouse GI |
$10,000 |
Children |
|
Children Benefit Level |
$3,000 |
Children GI |
$3,000 |
Employee Rates by Age |
per $1,000 |
|---|---|
Age |
Monthly |
0-29 |
$0.40 |
30-39 |
$0.71 |
40-49 |
$1.54 |
50-49 |
$3.31 |
60-69 |
$7.01 |
70-79 |
$13.06 |
80-99 |
$17.83 |
Provided By
Mutual of Omaha
Provider Website
Customer Service