Aflac

Group Hospital
Indemnity
INSURANCE

Even a small trip to the hospital can

have a major impact on your finances.

Here’s a way to help make your visit a

little more affordable.

AGC1902066 R2 EXP 8/22

AFLAC GROUP HOSPITAL INDEMNITY
Policy Series C80000 HI G

The plan that can help with

expenses and protect your savings.
Does your major medical insurance cover all of your bills?

Even a minor trip to the hospital can present you with unexpected expenses and medical bills. And even
with major medical insurance, your plan may only pay a portion of your entire stay.

That’s how the Aflac Group Hospital Indemnity plan can help.

It provides financial assistance to enhance your current coverage. It may help avoid dipping into savings or
having to borrow to address out-of-pocket-expenses major medical insurance was never intended to cover.
Like transportation and meals for family members, help with child care, or time away from
work, for instance.

The Aflac Group Hospital Indemnity plan benefits include

the following:
• Hospital Confinement Benefit
• Hospital Admission Benefit
• Hospital Intensive Care Benefit and more

How it works

The The The Aflac Group Hospital Indemnity

The insured The insured plan pays
Aflac Group has a high physician is released
admits the

$1,100
Hospital Indemnity fever and after two
plan is selected. goes to the insured into days.
emergency the hospital.
room.

Amount payable was generated based on benefit amounts for: Hospital Admission ($1,000) and Hospital Confinement ($50 per day).

Please contact your local Benefit Navigator at Wellstar for more information.
The plan has limitations and exclusions that may affect benefits payable. This brochure is for illustrative purposes only. Refer to your
certificate for complete details, definitions, limitations, and exclusions.
 BENEFIT
AMOUNT

H O S PI TA L A DMIS SIO N BE N E F I T per confinement (once per covered sickness or accident per calendar year for each insured)
Payable when an insured is admitted to a hospital and confined as an inpatient because of a covered accidental
injury or covered sickness. We will not pay benefits for confinement to an observation unit, or for emergency room
treatment or outpatient treatment. $1,000
We will not pay benefits for admission of a newborn child following his birth; however, we will pay for a newborn’s
admission to a Hospital Intensive Care Unit if, following birth, he is confined as an inpatient as a result of a covered
accidental injury or covered sickness (including congenital defects, birth abnormalities, and/or premature birth).

H O S PI TA L C O N F IN EM E N T per day (maximum of 31 days per confinement for each covered sickness or accident for each insured)
Payable for each day that an insured is confined to a hospital as an inpatient as the result of a covered accidental
injury or covered sickness. If we pay benefits for confinement and the insured becomes confined again within six
$50
months because of the same or related condition, we will treat this confinement as the same period of confinement.
This benefit is payable for only one hospital confinement at a time even if caused by more than one covered
accidental injury, more than one covered sickness, or a covered accidental injury and a covered sickness.

H O S PI TA L IN T E N SI V E CA R E BE N E F I T per day (maximum of 10 days per confinement for each covered sickness or accident
for each insured)
Payable for each day when an insured is confined in a Hospital Intensive Care Unit because of a covered accidental
injury or covered sickness. We will pay benefits for only one confinement in a Hospital's Intensive Care Unit at a time. $100
Once benefits are paid, if an insured becomes confined to a Hospital's Intensive Care Unit again within six months
because of the same or related condition, we will treat this confinement as the same period of confinement.
This benefit is payable in addition to the Hospital Confinement Benefit.

S U C CE S S O R IN S U R ED BE N E F I T
If spouse coverage is in force at the time of the employee’s death, the surviving spouse may elect to continue coverage. Coverage
would continue according to the existing plan and would also include any dependent child coverage in force at the time.

In order to receive benefits for accidental injuries due to a covered accident, an insured must be admitted within six months of the date of
the covered accident (in Washington, twelve months).

EMP LOY ER FAC I L I T Y R IDER

HOSPITAL ADMISSION (once per confinement)

$500
Once per covered sickness or accident per calendar year.

HOSPITAL CONFINEMENT (per day)

$50
Maximum confinement period: 31 days per covered sickness or covered accident.

HOSPITAL INTENSIVE CARE (per day)

$100
Maximum confinement period: 10 days per covered sickness or covered accident.

We will pay the additional applicable benefit amount when an insured is admitted, confined, or receives treatment at an employer facility.
LIMITATIONS AND E XCLUSIONS Dependent Children are your or your spouse’s natural children, step-children, grandchildren
State references within this brochure refer to the state of your group and not your resident state. who are in your legal custody and residing with you, foster children, children subject to legal
All limitations and exclusions that apply to the plan also apply to the riders unless amended by the guardianship, legally adopted children (in Texas, adopted children), or children placed for adoption.
riders. (In Florida, coverage may be provided for the children of custodial and non-custodial parents.)
Newborn children are automatically covered from the moment of birth for 60 days. Newly adopted
EXCLUSIONS children are automatically covered for 60 days also. See certificate for details. Dependent children
We will not pay for loss due to: must be younger than age 26 (and in Louisiana and Illinois, unmarried). See certificate for details.
• War – voluntarily participating in war, any act of war, or military conflicts, declared or Doctor is a person who is duly qualified as a practitioner of the healing arts acting within the scope
undeclared, or voluntarily participating or serving in the military, armed forces, or an auxiliary of his license, and: is licensed to practice medicine; prescribe and administer drugs; or to perform
unit thereto, or contracting with any country or international authority. (We will return the surgery, or is a duly qualified medical practitioner according to the laws and regulations in the state
prorated premium for any period not covered by the certificate when the insured is in such in which treatment is made.
service.) War also includes voluntary participation in an insurrection, riot, civil commotion or civil
state of belligerence. War does not include acts of terrorism (except in Illinois). In Montana: For purposes of treatment, the insured has full freedom of choice in the selection of
any licensed physician, physician assistant, dentist, osteopath, chiropractor, optometrist, podiatrist,
− In Connecticut: a riot is not excluded.
licensed social worker, psychologist, licensed professional counselor, acupuncturist, naturopathic
− In Oklahoma: War, or any act of war, declared or undeclared, when serving in the military, physician, physical therapist, or advanced practice registered nurse.
armed forces, or an auxiliary unit thereto. (We will return the prorated premium for any
A Doctor does not include you or any of your Family Members. For the purposes of this definition,
period not covered by the certificate when the insured is in such service.) War does not
Family Member includes your spouse as well as the following members of your immediate family:
include acts of terrorism.
son, daughter, mother, father, sister, or brother. In Arizona, however, a doctor who is your family
• Suicide – committing or attempting to commit suicide, while sane or insane. member may treat you. In South Dakota, however, a doctor who is your family member may treat
− In Missouri, Montana, and Vermont: committing or attempting to commit suicide, while you if that doctor is the only doctor in the area and acts within the scope of his or her practice.
sane. Employer facility means a hospital, ambulatory surgical center, or doctor’s office designated by the
− In Minnesota: this exclusion does not apply. policyholder.
• Self-Inflicted Injuries – injuring or attempting to injure oneself intentionally. A Hospital is not a nursing home; an extended care facility; a skilled nursing facility; a rest home
− In Missouri: injuring or attempting to injure oneself intentionally which is obviously not an or home for the aged; a rehabilitation facility; a facility for the treatment of alcoholism or drug
attempted suicide. addiction (except in Vermont); an assisted living facility; or any facility not meeting the definition of
− In Vermont: injuring or attempting to injure oneself intentionally, while sane. a Hospital as defined in the certificate.
• Racing – riding in or driving any motor-driven vehicle in a race, stunt show or speed test in a A Hospital Intensive Care Unit is not any of the following step-down units: a progressive care unit;
professional or semi-professional capacity. a sub-acute intensive care unit; an intermediate care unit; a private monitored room; a surgical
• Illegal Occupation – voluntarily participating in, committing, or attempting to commit a felony or recovery room; an observation unit; or any facility not meeting the definition of a Hospital Intensive
illegal act or activity, or voluntarily working at, or being engaged in, an illegal occupation or job. Care Unit as defined in the certificate
− In Connecticut: voluntarily participating in, committing, or attempting to commit a felony. Sickness means an illness, infection, disease, or any other abnormal physical condition or
pregnancy that is not caused solely by, or the result of, any injury (In Maine, illness or disease of an
− In Illinois: committing or attempting to commit a felony or being engaged in an illegal
insured). A Covered Sickness is one that is not excluded by name, specific description, or any other
occupation.
provision in this plan. For a benefit to be payable, loss arising from the covered sickness must
− In Nebraska and Tennessee: voluntarily participating in, committing, or attempting to occur while the applicable insured’s coverage is in force (except in Montana).
commit a felony or voluntarily working at, or being engaged in, an illegal occupation or job.
Treatment is the consultation, care, or services provided by a doctor. This includes receiving any
− In Pennsylvania: committing or attempting to commit a felony, or being engaged in an diagnostic measures and taking prescribed drugs and medicines. Treatment does not include
illegal occupation. telemedicine services (except in Kansas).
− In South Dakota: voluntarily committing a felony.
You May Continue Your Coverage
• Sports – participating in any organized sport in a professional or semi-professional capacity. Your coverage may be continued with certain stipulations. See certificate for details.
• Custodial Care – this is non-medical care that helps individuals with the basic tasks of everyday Termination of Coverage
life, the preparation of special diets, and the self-administration of medication which does not Your insurance may terminate when the plan is terminated; the 31st day after the premium due
require the constant attention of medical personnel. date if the premium has not been paid; or the date you no longer belong to an eligible class. If your
• Treatment for being overweight, gastric bypass or stapling, intestinal bypass, and any related coverage terminates, we will provide benefits for valid claims that arose while your coverage was
procedures, including any resulting complications. in force. See certificate for details.
• Services performed by a family member. NOTICES
− In Arizona: this exclusion does not apply. If this coverage will replace any existing individual policy, please be aware that it may be in
− In South Dakota: this exclusion does not apply. your best interest to maintain your individual guaranteed-renewable policy.
• Services related to sex or gender change, sterilization, in vitro fertilization, vasectomy or Notice to Consumer: The coverages provided by Continental American Insurance
reversal of a vasectomy, or tubal ligation. Company (CAIC) represent supplemental benefits only. They do not constitute
− In Washington D.C. and Washington: Services related to sterilization, in vitro fertilization, comprehensive health insurance coverage and do not satisfy the requirement of
vasectomy or reversal of a vasectomy, or tubal ligation. minimum essential coverage under the Affordable Care Act. CAIC coverage is not
intended to replace or be issued in lieu of major medical coverage. It is designed to
• Elective Abortion – an abortion for any reason other than to preserve the life of the person upon
supplement a major medical program.
whom the abortion is performed.
− In Tennessee, or if the pregnancy was the result of rape or incest, or if the fetus is For more information, ask your insurance agent/producer, call 1.800.433.3036, or visit
non-viable. aflacgroupinsurance.com.
• Dental Services or Treatment.
• Cosmetic Surgery, except when due to: Continental American Insurance Company (CAIC ), a proud member of the Aflac family of insurers,
− Reconstructive surgery, when the service is related to or follows surgery resulting from is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not
a Covered Accidental Injury or a Covered Sickness, or is related to or results from a licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands.
congenital disease or anomaly of a covered dependent child. Continental American Insurance Company • Columbia, South Carolina
− Congenital defects in newborns. The certificate to which this sales material pertains may be written only in English; the certificate
prevails if interpretation of this material varies. This brochure is a brief description of coverage and
TERMS YOU NEED TO KNOW is not a contract. Benefits, terms, and conditions may vary by state. Read your certificate carefully
A Covered Accident is an accident that occurs on or after an insured’s effective date while coverage for exact terms and conditions. You’re welcome to request a full copy of the plan certificate through
is in force, and that is not specifically excluded by the plan. your employer or by reaching out to our Customer Service Center.
Dependent means your spouse or dependent children, as defined in the applicable rider, who have This brochure is subject to the terms, conditions, and limitations of Policy Series C80000. In
been accepted for coverage. Spouse is your legal wife, husband, or partner in a legally recognized Arkansas, C80100AR. In Oklahoma, C80100OK. In Oregon, C80100OR. In Pennsylvania, C80100PA.
union. Refer to your certificate for details. In Texas, C80100TX. In Virginia, C80100VA.