Hospital Insurance

Hospital confinement indemnity insurance (“hospital insurance”) pays a daily benefit if you have a covered stay in a hospital or critical care unit. The amount of benefit depends on the type of facility and the number of days you stay.

Hospital confinement indemnity insurance is not health insurance like the Company medical plans, but is a limited benefit policy that supplements your existing health insurance.

The plan also provides you and your covered dependents with an annual wellness benefit if you receive a covered health screening.

How Hospital Insurance Can Help

Hospitalizations are among the highest-cost medical expenses and can result in large out-of-pocket expenses. Hospital insurance can bridge the gap in your medical coverage by helping to pay your medical plan’s deductible and coinsurance.

You can use your hospital insurance benefits to pay for your medical plan expenses and living expenses, such as:

Medical plan deductibles and coinsurance
Travel, food, and lodging expenses for family members
Child care
Everyday expenses like utilities and groceries

Eligibility

You—all active employees working 20+ hours per week. You are automatically enrolled at no cost to you if you are enrolled in a Company medical plan. If you are not enrolled in a Company medical plan, you have the opportunity to enroll for hospital insurance when you are newly hired and during the annual Open Enrollment.
Your spouse or domestic partner—coverage is available only if you are enrolled in hospital insurance. Spouses/domestic partners receive the same benefit as you.
Your child(ren)—to age 26. A child includes a natural child, stepchild, a legally adopted child, a child placed for adoption, or a child for whom you are the legal guardian. Coverage is available only if you are enrolled in hospital insurance. Children receive the same benefit as you. Note: If both you and your spouse/domestic partner are covered under the policy as an employee, then only one, but not both, may cover the same child(ren) under this benefit.

Cost

If you are enrolled in a Company medical plan

If you are enrolled in a Company medical plan, you will be automatically enrolled in the new hospital insurance plan at no cost to you. You may purchase coverage for your dependents through convenient payroll deductions at the following rates:

Employee + Spouse/DP: $13.91
Employee + Child(ren): $6.68
Employee + Spouse/DP + Child(ren): $20.59

If you are not enrolled in a Company medical plan

If you are not enrolled in a Company medical plan, you will have the option to purchase coverage for yourself and your dependents through convenient payroll deductions at the following rates:

Employee only: $10.82
Employee + Spouse/DP: $24.73
Employee + Child(ren): $17.50
Employee + Spouse/DP + Child(ren): $31.41

Hospital Insurance Benefits

Initial confinement (first day of confinement): $1,650
Hospital confinement (per day, up to 30 days): $150
Critical care unit confinement (per day, up to 15 days): $300
Rehabilitation facility (per day, up to 30 days): $75
Observation unit ($500 per day, at least four consecutive hours other than inpatient; not payable for any day that a facility confinement or admission benefit is payable; maximum of one per calendar year)

Hospital confinement benefit example

Tom and Becky were thrilled when Becky gave birth to little Andrew. Becky was enrolled in the CDHP Premier medical plan. The benefit Becky received from the hospital insurance plan helped cover her medical deductibles and coinsurance as well as Tom’s parking and meals during her two-day hospital stay.

$2,000 Health insurance deductible
$1,200 Coinsurance for 2-day hospital stay
$40 Parking
$200 Meals
$3,440 Total expenses

$300 Daily benefit paid under Becky’s policy ($150 x 2 days)
$1,650 Initial confinement benefit
$1,950 Total paid by hospital insurance

Hospital Insurance Wellness Benefit

Covered employees, spouses/domestic partners, and dependent children are eligible for a $75 annual wellness benefit if they complete a covered health screening test. If you receive multiple health screenings, you will only receive one benefit from this plan.

Screenings include, but aren’t limited to:

Blood test for triglycerides
Flexible sigmoidoscopy
Bone marrow testing
Hemoccult stool analysis
Breast ultrasound
Mammography
CA 15-3 (breast cancer)
Fasting blood glucose test
PSA (prostate cancer)
Pap smear
CEA (blood test for colon cancer)
Serum cholesterol test for HDL & LDL levels
Serum Protein Electrophoresis (myeloma)
Chest x-ray
Colonoscopy
Stress test on bicycle or treadmill
Thermography
Any cervical cancer screening test approved by the FDA

Filing Claims

You can file a hospital insurance or wellness benefit claim by phone or online. To file your claim by phone, call Voya at 877-236-7564.

To file your claim online, visit the Voya Claims Center.

For a hospital insurance claim, click the "Get Started" button under "Start a Claim" and follow the instructions.
For a wellness benefit claim, click the “Start Your Claim” button in the “Have a Wellness Benefit Claim?” section and follow the instructions.

Have the following information available:

The group number (CMSU's group number is 694924)
The name, date of birth, and Social Security Number of the patient and his or her relationship to you
Itemized bill if a hospital insurance claim
Type of health screening, medical provider, and the test date if a wellness benefit claim

Exclusions and Limitations

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.
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. Voya 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.
Intoxication or being under the influence of any controlled substance, unless administered on the advice of a doctor. Exception: This exclusion does not apply to a confinement in an eligible hospital or rehabilitation facility for the purpose of treatment for alcoholism or drug addiction.
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.

In addition, 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; 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. “Critical care unit” and “rehabilitative facility” are specifically defined in this policy.

For More Information

Visit the Voya website to learn more about hospital insurance and file a claim
Review the hospital insurance summary plan description