Get help paying out-of-pocket hospital costs

The Union Plus Hospital Indemnity Insurance Plan is actually two different plans. One is for members ages 18-64. The other is for members 65-79.

You are eligible to enroll in the plan for your age bracket as long as you are a union member and a U.S. resident. 

Your spouse/domestic partner is eligible if they are over age 18, a U.S. resident not in active full time military service and not legally separated or divorced from you. Children under the age of 26 are also eligible. (See the Certificate of Insurance for full details).

Member and spouse/domestic partner may not duplicate coverage, and children can only be covered by one member.

These policies are guaranteed acceptance but do contain a Pre-Existing Condition Limitation.

Choose between three coverage plans that pay cash benefits directly to you to use however you need. Hospitalization must begin within 90 days after the illness or injury occurs. All plans will pay the daily cash benefit amount you select for each day of your hospitalization. 

As soon as coverage becomes effective, you will be paid the hospital confinement benefit amount that you select for the first day you or your covered dependent is hospitalized as an inpatient due to a covered illness or covered injury. 

If more than one type of confinement occurs for a covered person for the same day (regardless of the medical facility(ies)), only the highest confinement benefit is payable. 

You will be paid the daily hospital confinement benefit amount you select for each day you or your covered dependent is hospitalized as an inpatient due to a covered illness or covered injury. This benefit is not payable for any day for which a First Day Hospital Confinement benefit is payable.

You will be paid the daily ICU confinement benefit amount you select for each day you or your covered dependent is an ICU inpatient due to a covered illness or covered injury.

If you are enrolled in the plan for members over age 65, you will be paid the Post Confinement Release benefit amount after you or your covered dependent is released from an ICU, rehabilitation facility or skilled nursing facility after a covered stay of 10 days or more. This benefit is paid in addition to the daily hospital benefit. 

This benefit is not applicable for members enrolled in the plan for ages 18-64. 

If you are enrolled in the plan for members over age 65, you will be paid the Continuous Care Facility Confinement benefit amount after you or your covered dependent is confined to a continuous care facility. The Confinement must start within 30 days of a covered accident or illness. This benefit will cover up to 30 days per year. 

This benefit is not applicable for members enrolled in the plan for ages 18-64.

Once you receive your Certificate of Insurance you have a full 30 days to review it. If you’re not satisfied, simply return it within 30 days of receipt, premiums paid will be refunded, minus any claims paid. 

Your coverage is effective as of the first day of the month after the administrator receives your enrollment form and first premium payment.

All Coverage Effective Dates, changes in coverage effective dates, new dependent coverage effective dates and reinstatement of coverage effective dates for a member or a dependent will be deferred if on the date the member or a dependent is to become covered, he or she is confined or confined elsewhere. Such coverage will not start until the first day of the month on or next following the day after: 1) the member or the dependent is no longer confined or confined elsewhere; and 2) the member or the dependent has engaged in all of the normal and customary activities of a person of like age, gender and good health for at least 15 consecutive days. In no event will dependent insurance become effective before a member becomes insured. 

Your coverage remains in effect if premiums are paid, the Master Policy is in force, and you remain a union member, until you reach age 85. Dependent coverage terminates when your coverage terminates, premiums are not paid, or they cease to be eligible dependents.

Confined or Confinement means the assignment to a bed in a medical facility for a period of at least 20 consecutive hours, or being held in a Hospital for 24 consecutive hours or more. Hospital does not include convalescent homes; convalescent, rest or nursing facilities; facilities affording primarily custodial, educational or rehabilitory care; facilities primarily for care of the aged/elderly, care of persons with substance abuse issues/disorders, or care of persons with mental and nervous disorders; or a distinct unit within a hospital that primarily treats or is dedicated to the care of persons with substance abuse issues/disorders or mental and nervous disorders. 

No benefits are payable under the Policy for any Illness or Injury that results from or is caused by a Covered Person’s: 1) suicide or attempted suicide, whether sane or insane, or intentional self-infliction; 2) voluntary intoxication (as defined by the law of the jurisdiction in which the Illness or Injury occurred) or while under the influence of any narcotic, drug or controlled substance, unless administered by or taken according to the instruction of a Physician or Medical Professional; 3) voluntary intoxication through use of poison, gas or fumes, whether by ingestion, injection, inhalation or absorption; 4) voluntary commission of or attempt to commit a felony, voluntary participation in illegal activities (except for misdemeanor violations), voluntary Participation in a Riot, or voluntary engagement in an illegal occupation; 5) incarceration or imprisonment following conviction for a crime; 6) travel in or descent from any vehicle or device for aviation or aerial navigation, except as a fare-paying passenger in a commercial aircraft (other than a charter airline) on a regularly scheduled passenger flight; 7) ride in or on any motor vehicle or aircraft engaged in acrobatic tricks/stunts (for motor vehicles), acrobatic/stunt flying (for aircraft), endurance tests, off-road activities (for motor vehicles), or racing; 8) participation in any organized sport in a professional or semi-professional capacity; 9) travel or activity outside the United States or Canada; 10) active duty service or training in the military (naval force, air force or National Guard/Reserves or equivalent) for service/training extending beyond 31 days of any state, country or international organization, unless specifically allowed by a provision of the Certificate; or 11) involvement in any declared or undeclared war or act of war (not including acts of terrorism), while serving in the military or an auxiliary unit attached to the military, or working in an area of war whether voluntarily or as required by an employer. If You notify Us of active duty service or training outside the continental United States, Hawaii, Puerto Rico or Alaska, We will refund any premiums paid for any period for which no coverage is provided as a result of the exclusion. 

In addition, We will not pay for any benefits under the Policy, unless required by law for: 1) elective abortion or complications thereof; 2) artificial insemination, in vitro fertilization, test tube fertilization; 3) sterilization, tubal ligation or vasectomy, and reversal thereof; 4) aroma therapeutic, herbal therapeutic, or homeopathic services; 5) any Mental and Nervous Disorder, unless specifically allowed by a provision of the Certificate; 6) Substance Abuse, unless specifically allowed by a provision of the Certificate; 7) medical mishap or negligence on the part of any Physician, Medical Professional, or Therapist, including malpractice; 8) Confinement, Treatment, supplies or services provided by, through or, on behalf of any government agency or program; unless payment is required by a Covered person; 9) Custodial Care, unless specifically allowed by a benefit provision in the Certificate or any rider attached to the Policy (if applicable); 10) elective or cosmetic surgery or procedures, except for reconstructive surgery: a) incidental to or following surgery for disease, infection or trauma of the involved body part; or b) due to Congenital Anomaly or disease of a Dependent Child which has resulted in a functional defect; 11) dental care or Treatment, except for: a) Treatment due to an Injury to sound natural teeth within 12 months of the Accident; and 12) Treatment necessary due to congenital disease or anomaly. Congenital Anomalies of newborn and newly adopted children are not excluded if otherwise covered under the terms of the Policy. 

Pre-existing condition means any illness or injury for which a covered person received treatment in the 12 months prior to your coverage effective date or date of an increase in coverage. 

The plan does not pay benefits for any covered illness or covered injury that results from, or is caused or contributed to by, a pre-existing condition until 12 months after a covered person is continuously insured under the Policy. A pre-existing condition limitation of 12 months will also apply to any benefit amount increase or the addition of any benefit under the Policy. If a covered person becomes confined as the result of a pre-existing condition prior to completing this 12-month limitation period, benefits will only be payable for any day of confinement that extends after the end of the limitation period.