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Hospital Income Insurance Plan

The NASW Assurance Services Hospital Income Insurance Plan (HIP) can help support your basic health insurance plan

by paying up to $500/day for each day you are hospitalized for a covered sickness or injury.

Hospital Income Insurance Plan

As good as your plan may be, no plan pays for everything. Copays, deductibles, and policy limitations could add up to substantial costs out of your pocket, not to mention the bills piling up at home while you're hospitalized. The NASW Assurance Services Hospital Income Insurance Plan (HIP) can help you by providing up to $500 a day in benefits to help pay your bills while you are in the hospital.

Overview

Your basic health insurance plan through your employer or other source is important to help pay for overall health care costs. But no plan pays for everything, especially if you’re hospitalized.

Copays, deductibles, policy limitations, and exclusions—let alone other factors like travel for family members to see you, and medical supplies—can all add up to extra cash of out your own pocket.

The NASW Assurance Services HIP Plan can help you by providing up to $500.00/day in benefits. At age 65, all benefits reduce by 41% and are limited to 52 weeks.

Plus, you’re guaranteed acceptance*. And you pay an affordable, members-only group rate.

* This policy is guaranteed acceptance, but does contain a Pre-Existing Conditions Limitation. Please refer to the Terms Tab for more information on exclusions and limitations, such as Pre-Existing Conditions.

Benefits

PAYS BENEFITS FOR COVERED HOSPITAL STAYS

The NASW Assurance Services Hospital Income Insurance Plan provides benefits to help pay for Hospital or medical expenses or all those extra things, such as gas for your family driving to and from the Hospital, motel expenses, meals in restaurants, long-distance phone calls and so on. In addition, it pays for items that make your Hospital stay more comfortable, like books and magazines.

GUARANTEED ACCEPTANCE*

As an NASW member under age 65 who resides in the U.S., you are guaranteed acceptance*.

Your spouse/domestic partner under age 65 and children age 14 days to age 19 (or under age 25 if full time student) are also guaranteed acceptance.*

* This policy is guaranteed acceptance, but does contain a Pre-Existing Conditions Limitation. Please refer to the Terms Tab for more information on exclusions and limitations, such as Pre-Existing Conditions.

CHOOSE BETWEEN FIVE PLANS

You may choose between these five plan options (Plan 3, Plan 4, and Plan 5 are not available to residents of NY)):

  • Plan 1: Collect $80/day in benefits for member and spouse/domestic partner; $15/day benefit for each child.
  • Plan 2: Collect $160/day in benefits for member and spouse/domestic partner; $15/day benefit for each child.
  • Plan 3: Collect $240/day in benefits for member and spouse/domestic partner; $15/day benefit for each child.
  • Plan 4: Collect $320/day in benefits for member and spouse/domestic partner; $15/day benefit for each child.
  • Plan 5: Collect $500/day in benefits for member and spouse/domestic partner; $15/day benefit for each child.

All plans will pay the daily cash benefit amount you select for each day of your hospitalization, up to 365 days per period of Confinement.

Please note: At age 65, all benefits reduce by 41% and are limited to 52 weeks.

PAYS A SKILLED NURSING FACILITY BENEFIT

If you or your spouse/domestic partner become Totally Disabled and are Confined in a Skilled Nursing Facility within one day of your Hospital discharge, you are eligible for $75 per week with Plans 1 and 2, and with Plan 3 you are eligible for $150 per week of Confinement, up to a maximum of 13 weeks.

Skilled Nursing Facility means an institution which:

  1. operates pursuant to law;
  2. primarily and continuously provides skilled nursing care and related services to persons recuperating from Sickness or Injury on an Inpatient basis for which a charge is made;
  3. maintains a daily medical record of each patient;
  4. has established policies developed and executed by a professional group including at least one legally qualified physician and at least one registered professional nurse;
  5. provides adequate procedures for the administration of drugs;
  6. provides each patient with a planned program of medical care by or under the supervision of a physician; and
  7. has a qualified physician available to furnish medical care in case of emergency.

Skilled Nursing Facility does not mean any institution or part thereof used principally as:

  1. a Hospital;
  2. a rest home, a home for the aged, or a place for custodial care; or
  3. a place for the care of drug addicts, alcoholics, or the mentally ill.

BENEFITS ARE PAID DIRECTLY TO YOU OR ANYONE YOU CHOOSE

All benefits are paid directly to you unless you tell us to send them directly to your doctor or Hospital or any other health care facility in which you receive care. And they're paid in addition to any other insurance benefits for which you may qualify.

KEEP YOUR COVERAGE FOR THE LONG HAUL

You can keep your HIP Plan as long as you'd like - no matter what your age - no matter what your health. As long as you pay your premiums when due, continue your NASW membership and the Master Policy remains in force, you may continue this valuable protection. Your children may continue their coverage as long as they are under age 19 (under age 25 if full-time students). Your spouse can continue his or her coverage as long as you are not legally separated or divorced.

Get your Coverage Today

You can enroll online or through a downloadable enrollment form. Be sure to include your quarterly payment for member and/or spouse/domestic partner and children coverage.

30-DAY FREE LOOK

When you receive your Certificate of Insurance, read it carefully. If you're not completely satisfied with the terms of your new insurance plan, simply return your Certificate, without claim, within 30 days. If you've paid any premium, it will be promptly refunded.

QUESTIONS?

Simply call toll-free 1-866-591-8267

Quarterly Rates

$80/DAY BENEFIT PLAN

Member's Attained Age Member Member & Spouse or
Domestic Partner
Member, Spouse or
Domestic Partner & Children
Member & Children
Under 40 $7.27 $14.55 $24.63 $17.35
40-49 $11.19 $22.38 $31.68 $20.48
50-59 $16.22 $32.44 $40.06 $23.84
60-64 $20.15 $40.30 $45.79 $25.64

$160/DAY BENEFIT PLAN

Member's Attained Age Member Member & Spouse or
Domestic Partner
Member, Spouse or
Domestic Partner & Children
Member & Children
Under 40 $14.54 $29.10 $49.26 $34.70
40-49 $22.38 $44.76 $63.37 $40.96
50-59 $32.44 $64.88 $80.12 $47.68
60-64 $40.30 $80.60 $91.58 $51.28

$240/DAY BENEFIT PLAN*

Member's Attained Age Member Member & Spouse or
Domestic Partner
Member, Spouse or
Domestic Partner & Children
Member & Children
Under 40 $21.81 $43.65 $73.89 $52.05
40-49 $33.57 $67.14 $95.01 $61.44
50-59 $48.66 $97.32 $120.18 $71.52
60-64 $60.45 $120.90 $137.37 $76.92

$320/DAY BENEFIT PLAN*

Member's Attained Age Member Member & Spouse or
Domestic Partner
Member, Spouse or
Domestic Partner & Children
Member & Children
Under 40 $29.08 $58.20 $98.52 $69.40
40-49 $44.76 $89.52 $126.68 $81.92
50-59 $64.88 $129.76 $160.24 $95.36
60-64 $80.60 $161.20 $183.16 $102.56

$500/DAY BENEFIT PLAN*

Member's Attained Age Member Member & Spouse or
Domestic Partner
Member, Spouse or
Domestic Partner & Children
Member & Children
Under 40 $45.44 $90.94 $153.94 $108.44
40-49 $69.94 $139.88 $197.94 $128.00
50-59 $101.38 $202.75 $250.34 $149.00
60-64 $125.94 $251.88 $286.19 $160.25

*Residents of New York are not eligible for the $240/Day Benefit Plan, $320/Day Benefit Plan, or $500/Day Benefit Plan.

Rates and/or benefits may be changed on a class basis. Rates are based on the attained age of the Insured Person and increase as you enter each new age category.

For your convenience, you will be billed on a quarterly basis.

At age 65, all benefits reduce by 41% and are limited to 52 weeks.

Underwritten by: Hartford Life and Accident Insurance Company, Hartford, CT 06155.

FAQs

I ALREADY HAVE MEDICAL INSURANCE. WHY SHOULD I ENROLL IN HIP?

No matter how good your current health insurance is, you may run up significant medical bills if an Injury or Sickness lands you in the Hospital. You could be faced with deductibles...co-pays...and expenses your medical plan might not cover. And that's where the Hospital Income Insurance Plan shines. We send you or anyone you choose benefits to help take care of the bills that may be piling up at home while your hospitalized. You may even assign benefits to be paid directly to the hospital or other health care facility where you are receiving care.

HOW GOOD ARE THE RATES?

Very good! They're the result of negotiations on behalf of NASW Members all over the U.S. Group rates, such as these, may likely be below what you would pay for the same coverage under an individual plan.

CAN I BE TURNED DOWN?

As long as you or your spouse are under age 65 and an NASW member - ABSOLUTELY NOT. You are guaranteed acceptance* in the Hospital Income Insurance Plan. Subject to Pre-Existing Condition Limitation**.

I'VE HAD SOME HEALTH PROBLEMS. CAN I STILL SIGN UP?

By all means! This plan is guaranteed acceptance, so you won't be turned down for health problems. This plan does include a Pre-existing Conditions Limitation, however. So, any hospital stays due to Pre-existing Conditions will not be covered during the first 24 months of coverage. Please review the Pre-existing Conditions Limitation under "Terms" for details.

WHAT IF I END UP IN THE HOSPITAL MORE THAN ONCE?

You can rest assured the NASW Hospital Income Plan will stay right by your side. First, your cash benefits can continue for up to two years while you're in the Hospital for the same health condition. Then, if you go to the Hospital for a different cause, you get a whole new year benefit period. There is NO LIMIT to the number of one year periods you can have.

HOW WILL HIP INSURANCE BENEFITS BE USED?

We send cash benefits directly to you or anyone you choose ... there are no restrictions on how you use your benefits. (Please check with your tax advisor for specifics on your tax situation.)

*This policy is guaranteed acceptance, but does contain a Pre-Existing Conditions Limitation. Please refer to the Terms Tab for more information on exclusions and limitations, such as Pre-Existing Conditions.

**During the first two years of coverage, losses incurred for Pre-Existing Conditions are not covered. A Pre-Existing Condition means any Injury or Sickness, diagnosed or undiagnosed, for which you have received medical care within the 12-month period prior to your coverage effective date or the date of an increase in coverage. During that time, benefits for all other Injuries or Sickness will be paid under the policy provisions. You are urged to consider waiting until this period is over before dropping any coverage you may currently have.

Terms

Eligibility:

As an NASW member under age 65 who resides in the U.S., you are guaranteed acceptance*.

*This policy is guaranteed acceptance, but does contain a Pre-Existing Condition Limitation. Please refer to the Pre-Existing Condition Limitation section for more information on exclusions and limitations, such as Pre-Existing Conditions.

Eligible Dependents:

Eligible Dependents are defined as follows:
Spouse means your Spouse, provided you and your Spouse are not legally separated or divorced.
Spouse also means an individual who is either:

  1. in a marriage with the member which is recognized by the law in the state of residence; or
  2. the member's domestic partner.

The term "domestic partner" means any individual with whom the member executes a Domestic Partner Affidavit acceptable to The Hartford1, to establish that they are domestic partners for purposes of this Policy. Such person will remain a domestic partner as long as he or she continues to meet the requirements described in the Domestic Partner Affidavit.

Child means the Eligible Member's unmarried child, stepchild, legally adopted child, foster child or child in the process of adoption, who is:

  1. at least 14 days but not yet age 19; or
  2. not yet age 25 if a full time student at an accredited school and dependent on the Eligible Member for principal support. A stepchild must also be dependent on the Eligible Member or Spouse for financial support. A foster child must also:
    1. live with the Eligible Member;
    2. receive principal support from the Eligible Member; and
    3. be approved in writing by The Hartford1 as an Eligible Child.

A Spouse's child who otherwise qualifies as an unmarried child, legally adopted child, foster child or child in the process of adoption, or if the Member or Spouse is the Child's guardian by court order, also qualifies as an Eligible Child.

Eligibility Restrictions:

The Eligible Member must enroll for coverage under this Policy in order to enroll Dependents for coverage. If a husband and Spouse are both Eligible Members, only one may claim the other as a Dependent. Spouses are not eligible for a Daily Benefit greater than the Eligible Member's. Children are not eligible for the Skilled Nursing Facility Benefit.

When Coverage Begins:

Your coverage will become effective on the first day of the month following the Administrator's receipt of your enrollment form and first premium payment.

Exclusions:

The policy does not cover: intentionally self-inflicted injuries, suicide or attempted suicide, whether sane or insane, (in Missouri or Colorado while sane); any loss caused or contributed to by war or act of war, whether war is declared or not; or Confinement in a Veterans Administration or any other National Government owned or operated Hospital.

Limitations:

The Hospital Confinement benefits of the policy will be limited as follows: Benefits will not be paid for more than a Maximum Benefit Period of 365 days for Injury or Sickness for eligible members under age 65 and 52 weeks for eligible members over age 65.

Successive Periods of Confinement:

Periods of Confinement in a Hospital separated by less than 90 days and due to the same or related causes are considered part of the same period of Confinement.

Pre-Existing Conditions Limitation:

During the two years of coverage, losses incurred for Pre-Existing Conditions are not covered. A Pre-Existing Condition means any Injury or Sickness, diagnosed or undiagnosed, for which you have received medical care within the 12-month period prior to your coverage effective date or the date of an increase in coverage. During that time, benefits for all other Injuries or Sickness will be paid under the policy provisions. You are urged to consider this limitation before dropping any coverage you may have until the waiting period is over.

This limited health benefit plan (1) does not constitute major medical coverage, and (2) does not satisfy the individual mandate of the Affordable Care Act (ACA) because the coverage does not meet the requirements of minimum essential coverage

Medicare Replacement Notice

Definitions

Confined or Confinement

Confined or Confinement means being an Inpatient in a Hospital due to Sickness or Injury. With respect to the Skilled Nursing Facility Benefit, Confined or Confinement means being an Inpatient in a Skilled Nursing Facility due to Sickness or Injury.

Hospital

Hospital means an institution which: operates pursuant to law; primarily and continuously provides medical care and treatment of sick and injured persons on an Inpatient basis; operates facilities for medical and surgical diagnosis and treatment by or under the supervision of a staff of legally qualified physicians; and provides 24 hour a day nursing service by or under the supervision of registered graduate nurses.

Hospital will also mean a Sanatoria operated by or certified by the First Church of Christ, Scientist, Boston, Massachusetts.

Hospital does not mean any institution or part thereof which is used primarily as: a nursing home, convalescent home, or Skilled Nursing Facility; a place for rest, custodial care, or for the aged; a clinic; a place for the treatment of mental illness, alcoholism, or drug addiction.

Total Disability

Total Disability means: a disability which wholly and continuously prevents a person from performing the material and substantial duties of his or her regular occupation, if Gainfully Employed Full-time; or a disability which the Covered Person's Physician certifies wholly and continuously prevents him or her from engaging in substantially all of the normal activities of a person of like age and sex in good health, if not Gainfully Employed Full-time.

The Total Disability must be due to the same or related medical condition as that which caused the Qualifying Hospital Confinement.

Member's Termination:

Your coverage under the Policy will cease on the first to occur of: a) the date the Policy is cancelled; b) the Premium Due Date that the required premium for your coverage is not paid, subject to the Grace Period provision; or c) the Premium Due Date following the date we or the Policyholder cancel coverage for a class of person to which you belong.

Dependent Termination:

Your dependent's coverage under the Policy will cease on the first to occur of:

  1. the date the Policy is cancelled;
  2. the Premium Due Date that the required premium for the dependent's coverage is not paid, subject to the Grace Period provision;
  3. in the case of a Covered Spouse, the date the Spouse is legally separated or divorced from you;
  4. in the case of a Covered Child, the date the child no longer qualifies as an Eligible Child unless continued under the Incapacitated Child Continuation provision;
  5. the Premium Due Date following the date we or the Policyholder cancel coverage for a Class of Person to which he or she belongs;
  6. the date you are no longer covered by the Policy.

A.G.I.A., Inc. is the Plan Administrator that administers the insurance plan on behalf of the Hartford Life and Accident Insurance Company for the benefit of the Group Policyholder.  NASW Assurance Services, Inc. is compensated for the placement of insurance and for the services it provides to customers on behalf of the insurance company, in addition to other compensation it may receive.  This is a participating group policy under which dividends and/or experience credits may be paid to NASW Assurance Services, Inc. Compensation is paid to or retained by the Group Policyholder NASW Assurance Services, Inc. and NASW directly or indirectly for services associated with this insurance program.

This policy provides limited benefits health insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Department of Financial Services.

Sponsored by:

This website explains the general purpose of the insurance described, but in no way changes or affects the Master Policy # AGP-5730 & AGP-5731 as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.

Underwritten by:
Hartford Life and Accident Insurance Company
Hartford, CT 06155
Policy Form # SRP-1151-A (HLA)(5730); Policy Form # SRP-1151-A (HLA)(5731)
Policy # AGP-5730 & AGP-5731

1The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company.

Read the full AGIA privacy policy.

Administered by:
Association Group Insurance Administrators
P.O. Box 26450, Phoenix, AZ 85068

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