Hospital Indemnity Insurance Benefits Overview

ONE SM Putting Bene昀椀ts To Work For People Don’t let the cost of a hospital stay derail your recovery New York Life Group Benefit Solutions Hospital Indemnity insurance Worried about surprise medical bills after a hospital stay? Hospital indemnity insurance can help. It pays you a fixed cash benefit directly if you’re admitted to the hospital, regardless of your other health insurance coverage. It can be used for out-of-pocket expenses or anything you need during your recovery. Who is eligible for hospital indemnity insurance? All active, Full-Time and Part-Time Employees of the Employer regularly working a minimum of 30 hours per week in the United States, who are citizens or permanent resident aliens of the United States. What are some of the covered hospital services under this plan? Standard Employee Employee + Spouse Coverage Tier Employee + Child(ren) Employee + Family Admission benefits Hospital admission benefit $1,000 Confinement benefits Daily inpatient hospital confinement benefit $100 Intensive Care Unit (ICU) confinement benefit $200 Short stay/observation unit $100

ONE Health screening benefits Our health screening benefit provides additional payments for taking care of your health. Standard Health screening benefit 1 $50 per screening, limited to 1 per calendar year Provides a payment if a health screening test is completed. What other benefits are offered as part of my coverage? Your hospital indemnity insurance may include access to benefits that can help in certain scenarios, available on your first day of coverage. 2 › Take your hospital indemnity coverage with you if you leave your job (also known as “Portability”) If your employment is terminated, you can continue your hospital indemnity insurance, and hospital indemnity insurance for your insured spouse and dependent children, on a direct-bill basis. › Support for your health care questions. Through our Health Care Support program, you’ll have access to trained advocates and registered nurses to help you 3 effectively navigate your health care plan and provide support for your questions and concerns. Contact Human Resources to review the hospital indemnity insurance benefits summary and policy documents to learn more about plan details, exclusions, and limitations. 1 The benefit is only payable once per day even if multiple Health Screenings are provided in a single day. 2 Portability is referred to as Continuation due to loss of Eligibility in some states. Refer to your certificate. 3 These programs are NOT insurance and do not provide reimbursement for financial losses. Some restrictions may apply. This service is provided exclusively by ® ComPsych Corporation. Customers are required to pay the entire discounted charge for any discounted products or services available through these programs. Some services are available at the option of the employer for an additional cost. Programs are provided through third party vendors who are solely responsible for their products and services. Full terms, conditions and exclusions are contained in the applicable client program description and are subject to change. Program availability may vary by plan type and location and are not available where prohibited by law. Not available for individuals who reside in Washington. Hospital Indemnity Insurance is a limited benefit policy. This product is not health care insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. New York Life Group Benefit Solutions’ Hospital Indemnity Insurance is underwritten by New York Life Insurance and Annuity Corporation, a subsidiary of New York Life Insurance Company. Policy provisions and product availability may vary by state. Policy form: Hospital Indemnity: GBS-HI-1000.00. New York Life Insurance Company 51 Madison Avenue, New York, NY 10010 © 2024, New York Life Insurance Company. All rights reserved. NEW YORK LIFE, and the NEW YORK LIFE Box Logo are trademarks of New York Life Insurance Company. 123996 0524 SMRU 6650103.1 (Exp. 05.28.2026) Elkhart Community Schools SR 67500262-152752583