Equitable Financial Life Insurance Fixed Indemnity Policy Overview
This document outlines the details of a fixed indemnity insurance policy, clarifying its limitations compared to comprehensive health insurance.
Page 1 Group name: Betenbough Homes, LLC Equitable Financial Life Insurance Company of America 2999 NORTH 44 STREET, SUITE 250 TH PHOENIX, ARIZONA 85018 (866) 274-9887 https://equitable.com/employee-benefits IMPORTANT: This is a fixed indemnity policy, NOT health insurance This fixed indemnity policy may pay you a limited dollar amount if you’re sick or hospitalized. You’re still responsible for paying the cost of your care. The payment you get isn’t based on the size of your medical bill. There might be a limit on how much this policy will pay each year. This policy isn’t a substitute for comprehensive health insurance. Since this policy isn’t health insurance, it doesn’t have to include most Federal consumer protections that apply to health insurance. Looking for comprehensive health insurance? or call (TTY: 1-855-889-4325) to find Visit HealthCare.gov 1-800-318-2596 health coverage options. To find out if you can get health insurance through your job, or a family member’s job, contact the employer. Questions about this policy? For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioner’s website (naic.org) under “Insurance Departments.” If you have this policy through your job, or a family member’s job, contact the employer.
Page 2 Group name: Betenbough Homes, LLC Policy number: 024883 Form created: 08/28/2025 Benefit plan and features Class definition: Class 1 – All Active Full Time Employees Included Benefits Benefit Amount First Day Hospital $500, once per year First Day Hospital Intensive Care Unit (ICU) Confinement $1,000, once per year Daily Hospital Confinement $100, up to 365 days per year Daily Hospital ICU Confinement $200, up to 60 days per year Daily Hospital Rehabilitation Unit $50, up to 60 days per year Annual Wellness Screening $50, once per year per insured Admission and Confinement benefits are not additive.
Page 3 • CA15-3 (blood test for breast cancer) • Breast Cancer Screening (clinical breast exam, mammography, MRI, thermography, ultrasound) • CA 125 (blood test for ovarian cancer) • Colorectal Cancer Screening (fecal occult blood test, colonoscopy, sigmoidoscopy) • CEA (blood test for colon cancer) • Lipid panel(cholesterol, triglycerides, HDL, LDL) • Pap smear • Prostate Cancer Screening (digital rectal exam, PSA blood test) Qualifying exams and screenings for Wellness Screening Benefit • Skin Cancer Screening • Diabetes tests (fasting blood glucose test, hemoglobin A1c) • Cardiac exercise stress test • Electrocardiogram (ECG)-resting or stress • Chest x-ray • Hemoccult stool analysis • Serum protein electrophoresis • Carotid Doppler • Echocardiogram • Immunizations • Interscholastic Sports Physical Exam Coverage Details Coverage Basis 24-Hour Age Reduction None Maternity Waiting period No Waiting Period Pre-Existing Condition Limitation None Annual Maximum Payout Unlimited Lifetime Maximum Payout Unlimited Portability To age 70 Understanding your benefits Commonly Used Terms Accident An event that an average person would consider sudden and unforeseeable and which causes injury to an insured. Illnesses of any kind are not considered an accident. Common carrier A phrase referring to commercial airplanes, trains, buses, subways, ferries, etc. Open reduction Surgical treatment or repair of an injury. Closed reduction Non-surgical treatment or repair of an injury. Frequently Asked Questions When can I enroll? You can enroll when you are initially eligible for benefits and any subsequent annual enrollment or life status change. • • • • • • • • • • • • • • • • • • •
Page 4 Do benefits have to be used for medical expenses? You decide how to use your benefit payment: • Out-of-pocket medical costs, including deductibles and co-pays • Rehab costs • Rent or mortgage payments • Groceries • Utility or credit card bills • Childcare • Other financial support What is hospital indemnity insurance? Group hospital indemnity insurance provides cash benefits for stays in a hospital and some related therapies. Our plan pays higher benefits for more serious hospitalizations. Why should I buy hospital indemnity? Hospital indemnity insurance helps cover unexpected expenses related to a hospitalization, which can be costly. While major medical insurance covers the majority of costs of a hospitalization, there are typically still out-of-pocket costs, such as deductibles or co-pays, in addition to added expenses outside the hospital due to your or a family member’s hospitalization. What is a wellness benefit? Insureds are eligible to receive an annual benefit amount when they undergo any eligible exam or screening from the covered list. How do I learn more about my benefits? Go to www.equitable.com/employeebenefits and log on to EB360® to view your account details. If I have additional questions, who can I talk to? Please don’t hesitate to contact us at Phone Number (866) 274-9887. • • • • • • •
Page 5 Important Information The following is a summary. A complete Limitations and exclusions: list of applicable exclusions and limitations are included in the policy and certificate. State variations may apply. Hospital Indemnity benefits may not be payable for any loss that is a result of, or is caused or contributed to by: war or any act of war, intoxication, participation in certain activities involving an increased risk of injury as listed in the policy and certificate (ex: mountain climbing, sky diving), participating in a felony or illegal activity, suicide or intentionally self-inflicted injury, while incarcerated, voluntary drug use unless administered by and used as instructed by a physician or for over-the-counter drugs in accordance with manufacturer's instructions, substance abuse, any mental/nervous disorder, elective procedures (except for sterilization, tubal ligation or vasectomy, and reversal thereof, or gender change, if recommended by a physician), and treatment or services provided by any government agency or program for which there is not normally any charge except for treatment provided by or through a Veteran's Home or Hospital. The policy has limitations and exclusions. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. This coverage does not constitute comprehensive health insurance coverage (often referred to as "major medical coverage") and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. Hospital indemnity insurance This policy provides limited benefits: is a limited benefit policy. It does NOT provide basic hospital, basic medical or major medical insurance, and does not satisfy the requirement for minimum essential coverage under the Affordable Care Act. THIS POLICY IS NOT A MEDICARE SUPPLEMENT PLAN. The certificate has exclusions and limitations for certain conditions that may affect any benefits payable. For costs and complete details of the coverage, please see the actual policy or contact your insurance broker. Benefits payable are subject to all terms and conditions of the certificate. Policy form MOEBP22 HI; AXEBP22 HI and state variations. Availability is subject to state approvals. Hospital does not include certain facilities such as nursing homes, convalescent care, or extended care facilities. Equitable policy strictly prohibits doing business with any person or entity involved with marijuana production, distribution or other ancillary operations. Marijuana-related businesses also include the marketing of marijuana-related products and services, persons and businesses that service and receive income from the marijuana industry, and business involving hemp and hemp-related ingredients. Equitable is the brand name of the retirement Legal disclosures: and protection subsidiaries of Equitable Holdings, Inc., including Equitable Financial Life Insurance Company (Equitable Financial) (NY, NY), Equitable Financial Life Insurance Company of America (Equitable America), an AZ stock company with an administrative office located in Charlotte, NC, and Equitable Distributors, LLC. Equitable Advisors is the brand name of Equitable Advisors, LLC (member FINRA, SIPC) (Equitable Financial Advisors in MI and TN). All group insurance products are issued either by Equitable Financial or Equitable America, which have sole responsibility for their respective insurance and backed solely by their claims-paying obligations. Some products are not available in all states. Equitable policy strictly prohibits doing business with any person or entity involved with marijuana production, distribution or other ancillary operations. Marijuana related businesses also include the marketing of marijuana related products and services, persons and businesses that service and receive income from the marijuana industry, and business involving hemp and hemp related ingredients. ©2023 Equitable Holdings, Inc. All rights reserved. (6/23) | EB360® is a registered mark of Equitable Holdings, Inc., NY, NY.
