Rates may be changed by New York Life Insurance Company on any premium due date and any date on which benefits are changed. However, your rates may change only if they are changed for an entire class of insureds.
The rates are based on the covered person's age at issue and will increase according to the age groups shown in the above rate charts. For spouse coverage, locate the rate that corresponds to your spouse's age.
There is no termination age. Coverage will remain in effect as long as you continue to pay premiums when due, and remain otherwise eligible.
Home Recovery Benefits: In addition to the hospital benefits, if you are discharged from the hospital with a home health care plan of treatment approved by a doctor or Medicare, you are eligible to receive $100 per day for up to 20 days for covered services of an RN, LPN, licensed home health aide, homemaker, companion services, speech, occupational or physical therapy. Services must be received within 90 days of discharge after a covered hospital stay. If you are under age 80, you are eligible for two 20-day benefit periods for a total maximum benefit of up to $4,000 per year. For anyone age 80 or older, you are eligible for one 20-day benefit period for a total maximum benefit of up to $2,000 per year.
Hospital:Means a licensed institution which is approved by the Joint Commission of Accreditation of Hospitals. A hospital is not a place of rest, a place primarily for the treatment of tuberculosis, a place for the aged, drug addicts, alcoholics or a place for convalescent, custodial or rehabilitory care.
Successive Periods of Confinement: Successive periods of confinement are treated as if they were one unless they are separated by 90 consecutive days during which you have not been confined to an institution for medical care or treatment or they are due to unrelated causes.
Exclusions & Limitations: At the time your coverage goes into effect, there are certain limitations to the coverage. Any pre-existing conditions you may already be receiving medical treatment for during the 12 months prior to your effective date will not be covered under this policy. Once you have been continuously insured under this policy for twelve months, these limitations do not apply.
Pre-existing Condition: Means an Injury, Sickness or Pregnancy or any related condition for which a person consults a doctor, receives medical services or supplies, or has taken any medication during the twelve month period, immediately before your coverage is effective It does not include any such condition after you have been continuously insured for twelve months.
Effective Date: Coverage will become effective on the first day the premium is deducted from your paycheck following date of approval. If you or your covered spouse is confined at home or a hospital on the date coverage would have been in effect, the insurance will be effective on the day the covered person is no longer confined and is still otherwise eligible.
When Coverage Ends: Coverage ends when you are no longer a dues paying member, premium is not paid when due, when you request that coverage be terminated, or when the group policy is terminated. Spousal coverage ends when your coverage ends, unless your coverage ends due to death.
Your Evidence od Insurance: Once insured, you will receive a certificate of insurance evidencing coverage is provided under Group Policy G-29315-7.
Limited Benefits Health Insurance: The insurance described provides limited benefit health insurance only. It does not provide basic hospital, basic medical, or major medical insurance.
Not a Medicare Supplement Plan: This plan doesn’t provide Medicare supplement insurance, long term care insurance, nursing home insurance only, home care insurance only, or nursing home and home care insurance. If you are eligible for Medicare, contact your local Social Security office and request a copy of the Medicare Supplement buyer’s guide.
1. Simply complete the provided Group Hospital and Home Care Recovery Insurance application authorizing payroll deductions.
Please make sure you complete all the information requested. An incomplete application will be returned, resulting in a delay in processing your application.
2. Return your application to:
You must notify The Voluntary Benefits Plan of any address change for you, your dependents and/or beneficiaries, and any change in employment and union membership status change, life status change (i.e., marriage, divorce, beneficiary or name change), or benefit changes requested. Notice must be in writing.
This is only a brief summary of benefits and is subject to the terms, conditions, exclusions, and limitations of group policy number G-29315-7. Complete terms and conditions are found in the group master policy and are summarized in your certificate.
New York Life has the highest possible financial strength ratings currently awarded to any life insurer from all four of the major credit ratings agencies: A.M. Best (A++), Fitch (AAA), Moody's (Aaa), Standard and Poor's (AA+). *
*As of 7-20-17
To find out more about your member benefits today, click here.
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