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Hospital Indemnity Coverage
Hospital Indemnity Coverage through Voya pays cash benefits directly to you if you have a covered
stay in a hospital or critical care unit (ICU). You can use the benefits from this policy to help pay for
your medical expenses such as deductibles and copays, travel cost, food and lodging, or everyday
expenses such as groceries and utilities.
• Benefits are payable for pregnancy as long as the hospitalization occurs on or after your
effective date of coverage
• Coverage is guaranteed issue; no medical questions
SUMMARY OF BENEFITS*
Hospital Admission $600 max one time per confinement
Critical Care Unit (CCU) Admission $1,200 max one time per confinement
Hospital Confinement Benefit $100 per day, max 30 days per confinement
Critical Care Unit Benefit $200 per day, max 30 days per confinement
Observation Unit Daily Benefit $300 per day, max 1 day per calendar year
*This is a summary. Refer to plan documents for details.
WEEKLY PAYROLL DEDUCTION BI-WEEKLY PAYROLL DEDUCTION
Employee Only $1.44 $2.88
Employee + Spouse $3.91 $7.82
Employee + Child(ren) $2.30 $5.99
Employee + Family $5.46 $10.92
30 • 2021 BUILDERS FIRSTSOURCE MID-YEAR BENEFITS GUIDE 2021 BUILDERS FIRSTSOURCE MID-YEAR BENEFITS GUIDE • 31
