Hospital Confinement Indemnity Insurance

Hospital Confinement Indemnity Insurance  

Overview

If you become injured or ill and are hospitalized, your health insurance will pay a portion of your medical costs. But no plan pays for everything. Your share of the hospital bill with coinsurance, copays and deductibles could be costly—let alone the extra out-of-pocket expenses that might occur. Hospital Confinement Indemnity Insurance pays a daily benefit if you have a covered stay in a hospital, critical care unit, or rehabilitation facility*, on or after your coverage effective date. The benefit amount is determined based on the type of facility and the number of days you stay. Features of this insurance include:

  • Guaranteed acceptance means no medical questions or tests are required for coverage. Flexibility to use the benefit money to address out-of-pocket-expenses like transportation and meals for family members, help with child care, or time away from work.
  • Ability to keep your coverage if you leave your employer (with certain stipulations)
  • Offered by a leading hospital indemnity insurance provider: Voya Employee Benefits
  • This is designed to complement your comprehensive medical plan insurance. It is not a replacement for medical insurance.
  • Hospital Confinement Indemnity Insurance is a limited benefit policy. This is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. 

 

Tell Me More

Your employer offers you the opportunity to purchase the following coverage:

  • Hospital— $100 OR $200 per day, up to 30 days per confinement.
  • Critical care unit (CCU)— $200 or $400 per day, up to 15 days per confinement.
  • Rehabilitation facility— $50 or $100 per day, up to 30 days per confinement.

 

Hospital Confinement Indemnity Rates by Level

Composite Rate

Daily Benefit

Bi-weekly Rate

Employee $100 8.16
Employee + Spouse $100 15.93
Employee + Children $100 12.62
Employee + Family $100 20.39

Hospital Confinement Indemnity Rates by Level

Composite Rate

Daily Benefit

Bi-weekly Rate

Employee $200 15.18
Employee + Spouse $200 29.57
Employee + Children $200 22.93
Employee + Family $200 37.32

 

*A hospital does not include an institution or part of an institution used as: a hospice care unit; a convalescent home; a rest or nursing facility; a free-standing surgical center; a rehabilitative center; an extended care facility; a skilled nursing facility; or a facility primarily affording custodial, educational care, or care or treatment for persons suffering from mental diseases or disorders, or care for the aged, or drug or alcohol addiction. “Critical care unit” and “rehabilitative facility” are specifically defined in this policy. See the certificate for details.

Enrollment

Add hospital confinement indemnity coverage to help offset costs that may not be covered under your employer's existing medical plan.


2020 Annual Enrollment
ENROLL NOW

Contact Us

 Address
Mercer Consumer
12421 Meredith Drive
Urbandale, IA 50398
 Phone
1-855-290-5661
 Hours
 M-F 9a-6p ET
 Email
customer.service@mercer.com

How It Works

FAQs

Answers about the plan, including eligibility, options, enrollment, customer service and more.

  • Can I meet with someone one-on-one to get a better understanding of this insurance product?

    Yes, Baystate Health has partnered with the Farmington company during benefits open enrollment. Specially trained Licensed Agents are available onsite at Baystate throughout the open enrollment period, to assist with questions and help you make informed decisions.

  • Who is the provider?

    Hospital Confinement Indemnity Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Voya Employee Benefits is a division of ReliaStar Life Insurance Company.

  • Who is eligible?

    All Baystate and Baycare employees who work at least 16 hours/wk or BVNAH employees who work at least 15 hours/week.

  • Who can enroll?

    This policy is available for individuals, single-parent families, individuals with spouses* or another adult dependent and families.

     

    *The use of “spouse” means a person insured as a spouse as described in the certificate of insurance or rider.

  • When can I enroll?

    You can enroll in this benefit during Baystate’s benefits open enrollment each Oct-Nov timeframe. If you are a new hire or have a “qualifying change in life status”, you can enroll within 15 days of your hire date.
  • When is my coverage effective?

    The effective date of coverage is the date you are eligible to begin filing claims.

     

    OPEN ENROLLMENT

    • Your coverage becomes effective on January 1 following the election of coverage. Coverage for your spouse and/or children becomes effective on the same date as your coverage.

     

    New Hires

    • Coverage becomes effective at 12:01 AM on the latest of the following:
      • First of the following month after you complete your enrollment.
      • The first day of the month following the date you return to active employment, if you are not in active employment when your coverage would otherwise become effective.
    • Coverage for your spouse and/or children becomes effective on the same date as your coverage.
  • When/how can I cancel my coverage and when would it take effect?

    You can cancel your coverage at any time by contacting Mercer at 855-290-5661 or selecting the Current Benefit Elections option at www.BHBenefitsplus.com, logging in, and declining the benefit(s) you wish to cancel (leave others unchanged). The cancellation would become effective the first day of the month after the request and you would not be able to re-enroll until a subsequent annual enrollment. Your first or second paycheck after the cancellation is processed would reflect the change and a refund should be issued by Voya within 30 days of the date the cancellation is processed, if applicable.
  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your coverage without interruption, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available if you retire or leave your company you will be billed directly by the insurance carrier.
  • How do I pay for this benefit?

    Payments are made via Baystate Health payroll deduction.
  • What benefits are included in this plan?

    The following list includes the benefits provided by Hospital Confinement Indemnity Insurance. The benefit amounts paid depend on the type of facility and number of days of confinement. For a complete description of your available benefits, along with applicable provisions, exclusions and limitations, see your certificate of insurance and any riders.

    • Hospitalization
    • Critical care unit (CCU)
    • Rehabilitation facility
    • Initial Confinement Benefit

     

    Below are a few examples of how your Hospital Confinement Indemnity Insurance benefit could be used (coverage amounts may vary):

    • Medical expenses
    • Travel, food and lodging expenses for family members
    • Child care
    • Everyday expenses like utilities and groceries
  • Exclusions and Limitations

    Exclusions for the certificate, Initial Confinement Benefit, Spouse Hospital Confinement Indemnity Insurance and Children's Hospital Confinement Indemnity Insurance are listed below.  (These may vary by state.)  Benefits are not payable for any loss caused in whole or directly by any of the following:

    • Participation or attempt to participate in a felony or illegal activity.
    • Operation of a motorized vehicle while intoxicated.
    • Suicide, attempted suicide or any intentionally self-inflicted injury, while sane or insane.
    • War or any act of war, whether declared or undeclared, other than acts of terrorism.
    • Loss that occurs while on full-time active duty as a member of the armed forces of any nation. We will refund, upon written notice of such service, any premium which has been accepted for any period not covered as a result of this exclusion.
    • Alcoholism, drug abuse, or misuse of alcohol or taking of drugs, other than under the direction of a doctor.
    • Elective surgery, except when required for appropriate care as a result of the covered person’s injury or sickness.
    • Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.
    • Operating, or training to operate, or service as a crew member of, or jumping, parachuting or falling from, any aircraft or hot air balloon, including those which are not motor-driven. Flying as a fare-paying passenger is not excluded.
    • Engaging in hang-gliding, bungee jumping, parachuting, sail gliding, parasailing, parakiting, kite surfing or any similar activities.
    • Practicing for, or participating in, any semiprofessional or professional competitive athletic contests for which any type of compensation or remuneration is received.

     

    *Exclusions and limitations may vary by state. Consult your certificate of insurance for exact language.

  • Are there any pre-existing condition limitations with this plan?

    The Voya Accident, Critical Illness, and Hospital Indemnity Plans do not have a pre-existing condition limitation. This will be true for all future Baystate Health Benefits Open Enrollments barring any benefit changes from the initial plan offering.
  • What is the Wellness Benefit, and how do I claim my $100?

    The Wellness Benefit is a rider that is automatically included with your Accident, Critical Illness, and/or Hospital Confinement Indemnity Insurance coverage. It provides an annual benefit payment if you complete a health screening test, whether there is any out-of-pocket cost to you or not. You are eligible to receive one annual benefit of $100, regardless of how many screening tests you may complete. If enrolled, your spouse is eligible to receive the $100 wellness benefit and your children are eligible to receive $50 each, up to a maximum of $200 for all children in a calendar year, if they complete a screening. If you participate in Baystate’s health screenings for employees through the Baystate Healthy program, this screening qualifies for the $100 benefit.

     

    Click here to view more details about what types of screenings qualify on the wellness benefit and here for how to claim it. Personal information provided on a claim form and supporting documentation confirming the name of the person/organization you saw and date of the screening is, generally, what Voya requires. Information regarding other insurance is not needed for this type of claim.

  • I have Voya coverage under more than one plan (Accident, Critical Illness, and/or Hospital Indemnity) that includes a $100.00 wellness benefit. Am I eligible to be reimbursed for that benefit under more than one plan for the same service?

    As long as your coverage under each plan was active on the date of service you are eligible to receive the benefit under each plan.
  • How do I access a claim form and how do file a claim for benefits?

    1. Visit the Voya.com/claims and click on "Get Started".
    2. Complete the questionnaire.
      This generates a custom claim form package for you.
    3. Download your claim form package.
    4. Complete the form package.
      Have each form completed by the appropriate party, as outlined in the claim form package.
    5. Gather additional documents.
      Collect any additional supporting documents, as instructed on the claim form "for you".
    6. Submit.
      Using your preferred submission method, submit your completed and signed forms, as well as any supporting documents.
      • To submit online via a secure upload, visit Voya.com/claims and click on "Upload Documents".
      • To mail or fax your submission, see the top of your custom claims form package.

This is a summary only. Please review your enrollment materials and any other applicable brochures prior to enrolling in coverage. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern. To keep coverage in force, premiums are payable up to the date of coverage termination. Hospital Confinement Indemnity Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Policy Form #RL-HI-POL-12. Form numbers, provisions and availability may vary by state.

 

Forms

Mercer's Role & Compensation

Details of the Mercer disclosure of the compensation.