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What’s covered? Your plan covers several types of accidental injuries, including: Fractures Second- and third-degree burns Lacerations Dislocations Eye injuries Torn ligaments The plan also pays a benefit for the following services if they’re related to a covered injury. Emergency care Follow-up care Hospitalization and and diagnostics Physical therapy surgical procedures Ambulance rides Doctor visits Hospital admission Emergency room admission Chiropractic visits ICU X-rays Medical equipment Surgery Prosthetic devices Rehabilitation This is a brief description of available benefits. For a complete SPOUSE AND CHILD description of coverage, please refer to your enrollment COVERAGE materials or contact your benefits representative. Spouse and dependent benefits may be available. Please refer to your enrollment materials for specific details. Accident Insurance 2

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