Basic Life Insurance & AD&D with Mutual of Omaha
Paid For By Fello
Fello recognizes the importance of planning for the unexpected. Life insurance helps protect your family from financial risk and sudden loss of income in the event of your death. Accidental Death & Dismemberment (AD&D) insurance provides an additional benefit if you lose your life, sight, hearing, speech or use of your limbs due to an accident.
Employee Basic Life and AD&D
Fello provides you with Basic Term Life insurance in the amount of 2x your basic earnings with overtime through Mutual of Omaha at no cost to you.
Employee benefits are reduced to 65% at age 65, reduced to 40% at age 70, and reduced to 25% at age 75.
You have one option for continuing your life coverage if you leave the company:
- Conversion allows you to convert the coverage to an individual policy if any or all of your life insurance ends while you are insured under the group plan.
Additional Voluntary Life and AD&D Insurance
Voluntary Life Insurance provides employees with a way to purchase additional life insurance outside of what Fello provides already to you by way of Basic Life. You may purchase additional life insurance amounts through a convenient payroll deduction. Coverage is provided by Mutual of Omaha.
Employee Coverage | You may elect up to 5× your annual salary, up to $500,000 in increments of $10,000. Medical underwriting is required for an election above $80,000 at your first eligibility and for any amount afterwards should you waive at your first eligibility.
Spouse Coverage | You may elect 100% of your employee amount, up to $250,000 in increments of $5,000 for your spouse. Medical underwriting is required for an election above $30,000 at your spouse’s first eligibility and for any amount afterwards should your spouse waive at first eligibility.
Child(ren) Coverage | You may elect 100% of your employee amount, up to $10,000, in increments of $1,000 for your children under age 26. The minimum benefit is $2,000. Medical underwriting is not required.
If you waive voluntary life insurance when you are first eligible, any amount elected after that will require Evidence of Insurability!
Voluntary Life/AD&D Weekly Contributions For Non-Exempt, Hourly Employees
Voluntary Life Insurance-below are the weekly deductions for Voluntary Life Insurance. The spouse rate is based on the employee’s age bracket. As employee’s move between age brackets, the premiums will increase at the policy renewal. One child election covers all children up to age 26.
How To Calculate Your Voluntary Life Premium
Benefit Amount / $1,000 x Age Rate = Monthly Premium
Monthly Premium x 12 / 26 = Per Pay Premium
$_____________ / $1,000 x_____________ = $_____________
Age Band | Employee & Spouse Rate |
|---|---|
<25 | $0.110 |
25−29 | $0.110 |
30−34 | $0.120 |
35−39 | $0.170 |
40−44 | $0.280 |
45−49 | $0.460 |
50−54 | $0.690 |
55−59 | $1.030 |
60−64 | $1.710 |
65−69 | $3.080 |
70−74 | $4.360 |
75> | $9.410 |
AD&D | $0.030 |
| Weekly Amount | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee | Age | $10,000 | $20,000 | $30,000 | $40,000 | $50,000 | $60,000 | $70,000 | $80,000 | $90,000 | $100,000 |
| 0-29 | $0.32 | $0.65 | $0.97 | $1.29 | $1.62 | $1.94 | $2.26 | $2.58 | $2.91 | $3.23 | |
| 30-34 | $0.35 | $0.69 | $1.04 | $1.38 | $1.73 | $2.08 | $2.42 | $2.77 | $3.12 | $3.46 | |
| 35-39 | $0.46 | $0.92 | $1.38 | $1.85 | $2.31 | $2.77 | $3.23 | $3.69 | $4.15 | $4.62 | |
| 40-44 | $0.72 | $1.43 | $2.15 | $2.86 | $3.58 | $4.29 | $5.01 | $3.72 | $6.44 | $7.15 | |
| 45-49 | $1.13 | $2.26 | $3.39 | $4.52 | $5.56 | $6.78 | $7.92 | $9.05 | $10.18 | $11.31 | |
| 50-54 | $1.66 | $3.32 | $4.98 | $6.65 | $8.31 | $9.97 | $11.63 | $13.29 | $14.95 | $16.62 | |
| 55-59 | $2.45 | $4.89 | $7.34 | $9.78 | $12.23 | $14.86 | $17.12 | $19.57 | $22.02 | $24.46 | |
| 60-64 | $4.02 | $8.03 | $12.05 | $16.06 | $20.08 | $24.09 | $28.11 | $32.12 | $36.14 | $40.15 | |
| 65-69 | $7.18 | $14.35 | $21.53 | $28.71 | $35.88 | $43.06 | $50.24 | $57.42 | $64.59 | $71.77 | |
| 70-74 | $10.13 | $20.26 | $30.39 | $40.52 | $50.65 | $60.78 | $70.92 | $81.05 | $91.18 | $101.31 | |
| 75+ | $21.78 | $43.57 | $65.35 | $87.14 | $108.92 | $130.71 | $152.49 | $174.28 | $196.06 | $217.85 | |
| Spouse | Age | $5,000 | $10,000 | $15,000 | $20,000 | $25,000 | $30,000 | $35,000 | $40,000 | $45,000 | $50,000 |
| 0-29 | $0.16 | $0.32 | $0.48 | $0.65 | $0.81 | $0.97 | $1.13 | $1.29 | $1.45 | $1.62 | |
| 30-34 | $0.17 | $0.35 | $0.52 | $0.69 | $0.87 | $1.04 | $1.21 | $1.38 | $1.56 | $1.73 | |
| 35-39 | $0.23 | $0.46 | $0.69 | $0.92 | $1.15 | $1.38 | $1.62 | $1.85 | $2.08 | $2.31 | |
| 40-44 | $0.36 | $0.72 | $1.07 | $1.43 | $1.79 | $2.15 | $2.50 | $2.86 | $3.22 | $3.58 | |
| 45-49 | $0.57 | $1.13 | $1.70 | $2.26 | $2.83 | $3.39 | $3.96 | $4.52 | $5.09 | $5.65 | |
| 50-54 | $0.83 | $1.66 | $2.49 | $3.32 | $4.15 | $4.48 | $5.82 | $6.65 | $7.48 | $8.31 | |
| 55-59 | $1.22 | $2.45 | $3.67 | $4.89 | $6.12 | $7.34 | $8.56 | $9.78 | $11.01 | $12.23 | |
| 60-64 | $2.01 | $4.02 | $6.02 | $8.03 | $10.04 | $12.05 | $14.05 | $16.06 | $18.07 | $20.08 | |
| 65-69 | $3.59 | $7.18 | $10.77 | $14.35 | $17.94 | $21.53 | $26.12 | $28.71 | $32.30 | $35.88 | |
| Child | Age | $2,000 | $3,000 | $4,000 | $5,000 | $6,000 | $7,000 | $8,000 | $9,000 | $10,000 | |
| 0-29 | $0.11 | $0.16 | $0.21 | $0.27 | $0.32 | $0.37 | $0.42 | $0.48 | $0.53 | ||
Voluntary Life/AD&D Bi-Weekly Contributions For Exempt, Salaried Employees
Voluntary Life Insurance-below are the weekly deductions for Voluntary Life Insurance. The spouse rate is based on the employee’s age bracket. As employee’s move between age brackets, the premiums will increase at the policy renewal. One child election covers all children up to age 26.
How To Calculate Your Voluntary Life Premium
Benefit Amount / $1,000 x Age Rate = Monthly Premium
Monthly Premium x 12 / 26 = Per Pay Premium
$_____________ / $1,000 x_____________ = $_____________
Age Band | Employee & Spouse Rate |
|---|---|
<25 | $0.110 |
25−29 | $0.110 |
30−34 | $0.120 |
35−39 | $0.170 |
40−44 | $0.280 |
45−49 | $0.460 |
50−54 | $0.690 |
55−59 | $1.030 |
60−64 | $1.710 |
65−69 | $3.080 |
70−74 | $4.360 |
75> | $9.410 |
AD&D | $0.030 |
| Weekly Amount | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee | Age | $10,000 | $20,000 | $30,000 | $40,000 | $50,000 | $60,000 | $70,000 | $80,000 | $90,000 | $100,000 |
| 0-29 | $0.65 | $1.29 | $1.94 | $2.58 | $3.23 | $3.88 | $4.52 | $5.17 | $5.82 | $6.46 | |
| 30-34 | $0.69 | $1.38 | $2.08 | $2.77 | $3.46 | $4.15 | $4.85 | $5.54 | $6.23 | $6.92 | |
| 35-39 | $0.92 | $1.85 | $2.77 | $3.69 | $4.62 | $5.54 | $6.46 | $7.38 | $8.31 | $9.23 | |
| 40-44 | $1.43 | $2.86 | $4.29 | $5.72 | $7.15 | $8.58 | $10.02 | $11.45 | $12.88 | $14.31 | |
| 45-49 | $2.26 | $4.52 | $6.78 | $9.05 | $11.31 | $13.57 | $15.83 | $18.09 | $20.35 | $22.62 | |
| 50-54 | $3.32 | $6.65 | $9.97 | $13.29 | $16.62 | $19.94 | $23.26 | $26.58 | $29.91 | $33.23 | |
| 55-59 | $4.89 | $9.78 | $14.68 | $19.57 | $24.46 | $29.35 | $34.25 | $39.14 | $44.03 | $48.92 | |
| 60-64 | $8.03 | $16.06 | $24.09 | $32.12 | $40.15 | $48.18 | $56.22 | $64.25 | $72.28 | $80.31 | |
| 65-69 | $14.35 | $28.71 | $43.06 | $57.42 | $71.77 | $86.12 | $100.48 | $114.83 | $129.18 | $143.54 | |
| 70-74 | $20.26 | $40.52 | $60.78 | $81.05 | $101.31 | $121.57 | $141.83 | $162.09 | $182.351 | $202.62 | |
| 75+ | $43.57 | $87.14 | $130.71 | $174.28 | $217.85 | $261.42 | $304.98 | $348.55 | $392.12 | $435.69 | |
| Spouse | Age | $5,000 | $10,000 | $15,000 | $20,000 | $25,000 | $30,000 | $35,000 | $40,000 | $45,000 | $50,000 |
| 0-29 | $0.32 | $0.65 | $0.97 | $1.29 | $1.62 | $1.94 | $2.26 | $2.58 | $2.91 | $3.23 | |
| 30-34 | $0.35 | $0.69 | $1.04 | $1.38 | $1.73 | $2.08 | $2.42 | $2.77 | $3.12 | $3.46 | |
| 35-39 | $0.46 | $0.92 | $1.38 | $1.85 | $2.31 | $2.77 | $3.23 | $3.69 | $4.15 | $4.62 | |
| 40-44 | $0.72 | $1.43 | $2.15 | $2.86 | $3.58 | $4.29 | $5.01 | $5.72 | $6.44 | $7.15 | |
| 45-49 | $1.13 | $2.26 | $3.39 | $4.52 | $5.65 | $6.78 | $7.92 | $9.05 | $10.18 | $11.31 | |
| 50-54 | $1.66 | $3.32 | $4.98 | $6.65 | $8.31 | $9.97 | $11.63 | $13.29 | $14.95 | $16.62 | |
| 55-59 | $2.45 | $4.89 | $7.34 | $9.78 | $12.23 | $14.68 | $17.12 | $19.57 | $22.02 | $24.46 | |
| 60-64 | $4.02 | $8.03 | $12.05 | $1606 | $20.08 | $24.09 | $28.11 | $32.12 | $36.14 | $40.15 | |
| 65-69 | $7.18 | $14.38 | $21.53 | $28.71 | $32.88 | $43.06 | $50.24 | $57.42 | $64.59 | $71.77 | |
| Child | Age | $2,000 | $3,000 | $4,000 | $5,000 | $6,000 | $7,000 | $8,000 | $9,000 | $10,000 | |
| 0-29 | $0.21 | $0.32 | $0.42 | $0.53 | $0.64 | $0.74 | $0.42 | $0.96 | $1.06 | ||
Voluntary Life/AD&D Bi-Weekly Contributions For Exempt, Salaried Employees
Fello recognizes the importance of planning for the unexpected. Life insurance helps protect your family from financial risk and sudden loss of income in the event of your death. Accidental Death & Dismemberment (AD&D) insurance provides an additional benefit if you lose your life, sight, hearing, speech or use of your limbs due to an accident.
Voluntary Short-Term Disability (STD)
Short-term disabilities are often the most prevalent in the workplace. Disabilities can stem from minor injuries or illnesses to major instances like surgery or maternity. Once you have been disabled for 15 days due to an accident or illness, your STD plan pays 60% of your weekly base salary up to a maximum of $1,000 per week, for up to 11 weeks.
Eligible employees may enroll in STD insurance at an additional cost. Coverage is offered through Mutual of Omaha.
Long-Term Disability (LTD) Paid for by Fello
Long-term disability insurance can play an essential role in protecting your financial and emotional life. Once you have been disabled for 90 days, your LTD plan pays 60% of your pre-tax monthly base salary up to a maximum benefit amount of $5,000 per month until your Social Security Normal Retirement Age (SSNRA).
Eligible employees will be enrolled in LTD Insurance at no cost. Coverage is offered through Mutual of Omaha.
Benefits | Voluntary Short-Term Disability | Long-Term Disability |
|---|---|---|
Elimination Period | 15th day accident or illness | 90 days |
Benefit Percentage | 60% | 60% |
Max Benefit Amount | $1,000 per week | $5,000 per month |
Benefit Duration | 11 weeks | SSNRA |
Disability Contributions
Weekly Contributions for Non-Exempt, Hourly Employees
The amounts are listed below on a weekly basis for non-exempt, hourly employees.
| Voluntary Short-Term Disability Weekly Employee Rates | |
|---|---|
| Age Band | Employee & Spouse Rate |
| <25 | $0.13 |
| 25–29 | $0.13 |
| 30–34 | $0.13 |
| 35–39 | $0.12 |
| 40–44 | $0.12 |
| 45–49 | $0.13 |
| 50–54 | $0.16 |
| 55–59 | $0.20 |
| 60–64 | $0.24 |
| 65–69 | $0.27 |
| 70< | $0.30 |
Bi-Weekly Contributions for Exempt, Salaried Employees
The amounts are listed below on a bi-weekly basis for exempt, salaried employees.
| Voluntary Short-Term Disability Weekly Employee Rates | |
|---|---|
| Age Band | Employee & Spouse Rate |
| <25 | $0.27 |
| 25–29 | $0.27 |
| 30–34 | $0.26 |
| 35–39 | $0.25 |
| 40–44 | $0.25 |
| 45–49 | $0.27 |
| 50–54 | $0.31 |
| 55–59 | $0.40 |
| 60–64 | $0.48 |
| 65–69 | $0.55 |
| 70< | $0.60 |
Mutual of Omaha Additional Rewards
Will Prep Services
Will Preparation Services, powered by Epoq, Inc., offers a secure account space that allows you to prepare a will and other legal documents.
Services include:
- Last Will and Testament
- Power of Attorney
- Healthcare Directive
- Living Trust
Here’s how it works—life insurance clients simply:
- Log on to willprepservices.com and use the code MUTUALWILLS to register
- Answer simple questions related to your estate
- Download, print and share any document instantly
- Make the document legally binding– clients should check with their state for requirements
This service is provided by Epoq, Inc. To get started, simply visit: willprep.clientsecured.com/willprep
Hearing Discount Service
Mutual of Omaha has partnered with Amplifon USA to provide participants with discount hearing products, hearing aids and batteries. Amplifon works with leading national brands including Phonak, ReSound, Starkey, Siemens and more. Members can take advantage of price guarantees, significant savings and free batteries.
There are no enrollment fees and access to the hearing program is completely free. To start, simple follow the steps below:
- Call Amplifon at 1−888−534−1747. Amplifon’s PatientCare Advocate will help you find a hearing care provider near you.
- The Patient Care Advocate will explain the details of the Amplifon program, help identify a local hearing care provider and assist you with making an appointment.
- Amplifon will send you and your provider all the necessary
- information to activate your program.
Travel Assistance
Travel Assistance can help you, your spouse and dependent children avoid unexpected bumps in the road from 100 miles away from your home to anywhere in the world. Take comfort in knowing that Travel Assistance provided by AXA Assistance USA travels with you worldwide, offering access to a network of professionals who can help you with local medical referrals or provide other emergency assistance services in foreign locations.
Identity Theft
- Comprehensive ID theft assistance guide
- Recovery information regarding the steps to recover from credit card, check,fraud or personal information that’s been compromised
Pre-Trip Assistance
- Information regarding passport visa or other required documentation for foreign travel
- Travel, health advisories and inoculation equirements for foreign countries
- Daily foreign currency exchange rates
Medical Assistance
- Locating medical providers and referrals
- Emergency evacuation if adequate medical facilities are not available, including payment of covered services
- Communication on your medical status with family, physicians, employer, travel company and consulate
Emergency Travel Support Services
- Telephonic translations and interpreter services 24/7
- Baggage– assistance with lost, stolen, or delayed baggage
- Emergency payment and cash—assistance with advance funds for medical expenses or other travel emergencies
- Document replacement—coordination of credit card, airline ticket or other documentation replacement
Services are available for business and personal travel 24 hours a day, seven days a week. For inquiries, please call below:
Within the US: 1-800-856-9947
Outside the US: 312-935-3658
Hospital Indemnity with The Hartford
Intensive Financial Care for Hospital Admissions
The Hartford offers you a supplemental health plan that softens the financial impact of higher medical plan deductibles and other out-of-pocket costs associated with hospital admissions.
With The Hartford Hospital Indemnity, lump-sum benefits are paid directly to you if admitted to a hospital for a covered sickness or injury. These payments can be used for any purpose, such as meeting everyday expenses, whether medical or non-medical.
Maximum Flexibility
The Hartford Hospital Indemnity enables you to select features that best fit with your current medical plan, other supplemental health plans and budget.
Why The Hartford Hospital Indemnity?
Key features:
- Pays indemnity benefits directly to you whether or not charges are covered by your medical plan
- Reduces the financial burden of high deductibles and co-pays
New – Hospital Indemnity plans now include a Health Screening Benefit. Once per year, each covered person may receive $50 for completing a covered health screening. Covered health screenings include EKG, lipid panel, pap smear, mammography, colonoscopy, fasting blood glucose test, and more.
Did You Know?
The average cost for a hospital stay is $1,986 per day?
| Benefits | |
|---|---|
| First Day Hospital Confinement | $500 per day |
| Daily Hospital Confinement (day 2 forward) | $100 per day |
| Daily ICU Confinement (day 2 forward) | $200 per day |
| Dependent Age Limits | Child Birth to 26 years (26 if full time student) |
| Treatments Covered | Sickness and Injury |
| Pre-Existing Condition Limitation |
12 month look back period, 12 month exclusion period, Continuity of Coverage |
Hospital Indemnity, Critical Illness, Accident Contributions
Weekly Contributions for Non-Exempt, Hourly Employees
The amounts are listed below on a weekly basis for non-exempt, hourly employees.
| Critical Illnesses $10,000 Weekly Premium | ||||
|---|---|---|---|---|
| Age | Employee | Employee & Child(ren) | Employee & Spouse | Family |
| 18-24 | $0.48 | $0.83 | $0.72 | $1.12 |
| 25-29 | $0.58 | $0.89 | $0.87 | $1.23 |
| 30-34 | $0.65 | $0.90 | $0.96 | $1.26 |
| 35-39 | $0.84 | $1.06 | $1.26 | $1.51 |
| 40-44 | $1.21 | $1.06 | $1.26 | $1.51 |
| 45-49 | $1.89 | $2.07 | $2.85 | $3.06 |
| 50-54 | $2.64 | $2.81 | $4.02 | $4.21 |
| 55-59 | $3.64 | $3.81 | $5.57 | $5.76 |
| 60-64 | $5.25 | $5.41 | $8.06 | $8.25 |
| 65-69 | $7.41 | $7.57 | $11.34 | $11.53 |
| 70-74 | $5.14 | $5.22 | $7.87 | $8.00 |
| 75-79 | $6.87 | $6.95 | $10.50 | $10.60 |
| Critical Illnesses $20,000 Weekly Premium | ||||
|---|---|---|---|---|
| Age | Employee | Employee & Child(ren) | Employee & Spouse | Family |
| 18-24 | $0.95 | $1.30 | $1.41 | $1.84 |
| 25-29 | $1.16 | $1.47 | $1.74 | $2.10 |
| 30-34 | $1.30 | $1.54 | $1.93 | $2.22 |
| 35-39 | $1.69 | $1.90 | $2.52 | $2.76 |
| 40-44 | $2.43 | $2.61 | $3.62 | $3.83 |
| 45-49 | $3.79 | $3.96 | $5.71 | $5.91 |
| 50-54 | $5.29 | $5.45 | $8.03 | $8.22 |
| 55-59 | $7.29 | $7.45 | $11.15 | $11.34 |
| 60-64 | $10.50 | $10.66 | $16.12 | $16.31 |
| 65-69 | $7.89 | $14.97 | $22.68 | $22.87 |
| 70-74 | $10.28 | $10.36 | $15.74 | $15.83 |
| 75-79 | $13.73 | $13.81 | $20.98 | $21.07 |
| Coverage Details | Employee | Employee & Spouse | Employee & Child(ren) | Family |
|---|---|---|---|---|
|
The Hartford Hospital Indemnity |
$2.12 | $4.39 | $4.06 | $6.62 |
| The Hartford Accident | $1.86 | $2.93 | $3.07 | $4.84 |
Bi-Weekly Contributions for Exempt, Salaried Employees
The amounts are listed below on a bi-weekly basis for exempt, salaried employees.
| Critical Illnesses $10,000 Bi-Weekly Premium | ||||
|---|---|---|---|---|
| Age | Employee | Employee & Child(ren) | Employee & Spouse | Family |
| 18-24 | $0.96 | $1.65 | $1.44 | $2.25 |
| 25-29 | $1.16 | $1.79 | $1.74 | $2.50 |
| 30-34 | $1.29 | $1.76 | $1.93 | $2.51 |
| 35-39 | $1.69 | $2.12 | $2.52 | $3.01 |
| 40-44 | $2.42 | $2.79 | $3.62 | $4.05 |
| 45-49 | $3.79 | $4.14 | $5.71 | $6.12 |
| 50-54 | $5.29 | $5.62 | $8.03 | $8.42 |
| 55-59 | $7.29 | $7.62 | $11.15 | $11.53 |
| 60-64 | $10.50 | $10.82 | $16.12 | $16.50 |
| 65-69 | $14.81 | $15.13 | $22.68 | $23.06 |
| 70-74 | $10.28 | $10.44 | $15.74 | $15.93 |
| 75-79 | $13.73 | $13.90 | $21.00 | $21.17 |
| Critical Illnesses $20,000 Bi-Weekly Premium | ||||
|---|---|---|---|---|
| Age | Employee | Employee & Child(ren) | Employee & Spouse | Family |
| 18-24 | $1.91 | $2.60 | $2.87 | $3.68 |
| 25-29 | $2.32 | $2.95 | $3.47 | $4.20 |
| 30-34 | $1.29 | $3.08 | $3.85 | $4.44 |
| 35-39 | $3.38 | $3.81 | $5.03 | $5.53 |
| 40-44 | $4.85 | $2.61 | $7.24 | $7.67 |
| 45-49 | $7.58 | $7.93 | $11.42 | $11.82 |
| 50-54 | $5.29 | $10.57 | $16.06 | $16.45 |
| 55-59 | $14.58 | $14.91 | $22.29 | $22.68 |
| 60-64 | $21.00 | $21.32 | $32.24 | $32.61 |
| 65-69 | $29.63 | $29.94 | $45.37 | $45.74 |
| 70-74 | $20.55 | $20.71 | $31.48 | $31.67 |
| 75-79 | $27.47 | $27.63 | $41.93 | $42.15 |
| Coverage Details | Employee | Employee & Spouse | Employee & Child(ren) | Family |
|---|---|---|---|---|
|
The Hartford Hospital Indemnity |
$4.25 | $8.78 | $8.13 | $13.25 |
| The Hartford Accident | $3.72 | $5.86 | $6.14 | $9.69 |
Critical Illness with The Hartford
The Hartford Critical Illness Insurance
It takes a lot to beat a serious illness. Unfortunately, it can also cost a lot. When you or a family member suffers a serious illness such as a stroke or heart attack, Critical Illness Insurance can help with expenses that medical insurance doesn’t cover such as deductibles or out of pocket costs, or services such as experimental treatment. Critical Illness supplements your medical and your disability income insurance. The lump sum benefit is paid when you need it most, upon diagnosis, so you can rest assured that you will have funds to offset upcoming out of pocket costs, and that you’ll have the flexibility to elect treatments with less worry about the cost.
Employees have the opportunity to purchase this plan through a convenient payroll deduction. Contributions are made on a post-tax basis. Employees also have the option of portability.
New – Critical Illness plans now include a Health Screening Benefit. Once per year, each covered person may receive $50 for completing a covered health screening. Covered health screenings include EKG, lipid panel, pap smear, mammography, colonoscopy, fasting blood glucose test, and more.
| What Your Benefits Cover - Benefit Amounts | |
|---|---|
| Employee | Choose a lump sum benefit of $10,000–20,000 |
| Spouse/Domestic Partner Benefits | Choose a lump sum benefit of $5,000–10,000 |
| Child | $5,000 per child |
| What Your Benefits Cover | 1st Occurrence | 2nd Occurrence |
|---|---|---|
| Cancer | ||
| Invasive Cancer | 100% | |
| Carcinoma in Situ | 25% | |
| Benign Brain Tumor | 100% | |
| Vascular | ||
| Heart Attack | 100% | 100% |
| Stroke | 100% | 100% |
| Heart Failure | 100% | 100% |
| Aneurysm | 25% | 0% |
| Additional Conditions | ||
| Coma | 100% | 100% |
| Paralysis | 100% | N/A |
| Major Organ Transplant | 100% | 100% |
| Loss of Hearing | 100% | N/A |
| Loss of Speech | 100% | N/A |
| Loss of Vision | 100% | N/A |
| Bone Marrow Transplant | 25% | N/A |
Child - 300% of Coverage Amount
Accident with The Hartford
The Hartford Accident Insurance
Accidents happen every day. If you were injured from an accident, chances are you will have expenses that you were not anticipating. Accident Insurance can help you deal with those expenses. Benefit payments can help you with your medical deductibles and copays, and cover household expenses such as groceries, mortgage payments and childcare, which can begin to pile up if you have to take some time off from work.
Employees have the opportunity to purchase this plan through a convenient payroll deduction. Contributions are made on a post-tax basis. Employees also have the option of portability.
Accident plans include a Health Screening Benefit. Once per year, each covered person may receive $50 for completing a covered health screening. Covered health screenings include EKG, lipid panel, pap smear, mammography, colonoscopy, fasting blood glucose test, and more.
| Coverage Details | Benefits |
|---|---|
| Accidental Death & Dismemberment | |
| Employee | $10,000 |
| Spouse/Domestic Partner w/ Benefits | $5,000 |
| Child | $5,000 |
| Features | |
| Accident Emergency Room Treatment | $150 |
| Accident Follow-Up Visit | $75 |
| Air Ambulance | $900 |
| Ambulance | $300 |
| Appliance - wheelchair, brace, crutches, boot | $100 |
| Blood/Plasma/Platelets | $200 |
| Burns (2nd Degree/3rd Degree) | Schedule up to $10,000 |
| Coma | $10,000 |
| Concussions | $150 |
| Dislocations | Schedule up to $2,000 |
| Diagnostic Exam (Major) | $200 |
| Eye Injury | Schedule up to $400 |
| Fracture | Schedule up to $6,000 |
| Hospital Admission | $1,000 |
| Hospital Confinement | $200 per day |
| Hospital ICU Confinement | $400 per day |
| Urgent Care Facility Treatment | $75 |
| Joint Replacement | $2,000 |
| Laceration | Schedule up to $600 |
| Physical Therapy | $25/day |
| Tendon/Ligament/Rotator Cuff | Schedule up to $1,000 |
| X-Ray | $50 |
Legal Assistance Plan with Country Wide
Legal Assistance Plan
Fello offers a voluntary benefit designed to offer comprehensive legal coverage through a nationwide network of skilled attorneys. Plan members can contact an approved firm in their area to receive advice on a number of legal issues and to accomplish several legal tasks, such as preparation of wills, traffic violations, buying or selling a home and many more. Benefits will be payroll deducted on a pre-tax basis.
Countrywide offers:
- General Legal Services
- Auto Legal Services
- Consumer/Contract Legal Services
- Criminal Legal Services
- Estate Planning Legal Services
- Family Law Legal Services
- Real Estate Legal Services
You must utilize the network of attorneys available under the program in order to receive plan benefits. For those who enroll, a membership kit will be mailed to you that contains information about how to access attorneys.
The Following Chart Outlines The Benefits Provided Under The Program
| Services | Private Attorney’s Fees | Your Fees with Countrywide |
|---|---|---|
| Unlimited Phone Consultations and Advice | $250–$450 per hour | NO CHARGE |
| Face-to-Face Consultations | $250–$450 per hour | NO CHARGE |
| Simple Wills | $400–$1,000 each | NO CHARGE |
| Living Wills & Medical Powers of Attorney | $250–$650 per hour | NO CHARGE |
| Review of Legal Documents (up to 6 pages) | $250–$450 per hour | NO CHARGE |
| Advice on Government Programs | $250–$450 per hour | NO CHARGE |
| Advice on Small Claims Court | $250–$450 per hour | NO CHARGE |
| Legal Letters & Phone Calls | $250–$450 per hour | NO CHARGE |
| Consumer Protection & Warranty Problems | $250–$450 per hour | NO CHARGE |
| IRS State & Tax Relief Advice | $250–$850 per hour | NO CHARGE |
| Identity Theft Prevention & Assistance | $250–$450 per hour | 25% Preferred Discount on Hourly Rates |
| Guaranteed Reduced Rates on Other Legal Matters | $250 and up per hour | 10% Preferred Discount on Contingency Fees |
Weekly Contributions for Non-Exempt, Hourly Employees
The amounts are listed below on a weekly basis for non-exempt, hourly employees.
| Employee | Employee & Children | Employee & Adult | Family | |
|---|---|---|---|---|
| Legal | $3.18 | $3.18 | $3.18 | $3.18 |
Bi-Weekly Contributions for Exempt, Salaried Employees
The amounts are listed below on a bi-weekly basis for exempt, salaried employees.
| Employee | Employee & Children | Employee & Adult | Family | |
|---|---|---|---|---|
| Legal | $6.36 | $6.36 | $6.36 | $6.36 |