2024 Employee Benefit Guide - Salaried - Yeled 11.3.23

PLAN HIGHLIGHTS

Hospital Admission

$1,500 per insured per calendar year

Daily Hospital Confinement

$165 per day; to a maximum of 60 days per calendar year

Portability

Included

Family Coverage Options

Employee, Spouse or Domestic Partner and Child Employee must have coverage in order for spouse and child to participate Employee/Spouse At initial enrollment or when first eligible, health questions are not required for the employee or spouse Pre-Existing Conditions are not covered under the plan. This means any covered person having a sickness or physical condition for which medical advice or treatment was recommended by a physician or received from a physician within 6 months before the coverage effective date. After this policy has been in force for 12 months, Unum will pay benefits for any loss as a result of a pre-existing condition not excluded by name or specific description if the covered loss began 12 months after the effective date of the policy.

Evidence of Insurability (Health Questions)

Pre-existing Condition Limitation

MONTHLY PREMIUMS

Employee + Spouse

Employee + Child(ren)

Age Band

Employee

Family

17 - 49

$17.80

$35.65

$26.15

$44.00

50 - 59

$23.19

$47.67

$31.54

$56.02

60 - 64

$32.46

$67.00

$40.81

$75.35

65+

$48.93

$101.39

$57.28

$109.74

For additional plan information, please refer to your detailed plan design provided by the carrier. In the event of a discrepancy, the carrier Plan Document shall prevail.