Accident Insurance (Aflac)
Group Accident Insurance Fracture - once per covered accident, within 90 days of the accident Fracture
Open Reduction
Closed Reduction
Schedule
Employee Spouse Child Employee Spouse Child
Hip/Thigh
$6,000 $5,400 $4,800 $4,500 $3,600 $3,000 $3,000 $2,400 $2,400 $2,100 $2,100 $1,800 $1,200 $480
$6,000 $5,400 $4,800 $4,500 $3,600 $3,000 $3,000 $2,400 $2,400 $2,100 $2,100 $1,800 $1,200 $480
$6,000 $5,400 $4,800 $4,500 $3,600 $3,000 $3,000 $2,400 $2,400 $2,100 $2,100 $1,800 $1,200 $480
$3,000 $2,700 $2,400 $2,250 $1,800 $1,500 $1,500 $1,200 $1,200 $1,050 $1,050 $900
$3,000 $2,700 $2,400 $2,250 $1,800 $1,500 $1,500 $1,200 $1,200 $1,050 $1,050 $900
$3,000 $2,700 $2,400 $2,250 $1,800 $1,500 $1,500 $1,200 $1,200 $1,050 $1,050 $900
Vertebrae/Sternum
Pelvis
Skull (Depressed)
Leg
Forearm/Hand/Wrist Foot/Ankle/Kneecap
Shoulder Blade/Collar Bone
Lower Jaw Skull (Simple)
Upper Arm/Upper Jaw Facial Bones (except teeth) Vertebral Processes/Sacrum Coccyx/Rib/Finger/Toe
$600 $240
$600 $240
$600 $240
Outpatient Surgery and Anesthesia (per day) - within one year of the accident Performed in a Hospital or Ambulatory Surgical Center Maximum number of payments per covered accident: No Maximum Performed in a Doctor's Office, Urgent Care Facility or Emergency Room Maximum number of payments per covered accident: 2 Facilities Fee for Outpatient Surgery - within one year of the accident Payable once per each Outpatient Surgery and Anesthesia Benefit (in a hospital or ambulatory surgical center). Inpatient Surgery and Anesthesia (per day) - within one year of the accident Maximum number of payments per covered accident: No Maximum
$300
$300
$300
$35
$35
$35
$75
$75
$75
$750
$750
$750
Transportation - within six months of the accident Maximum number of payments per covered accident: 3 Minimum Required Distance (miles): 100 Plane
$350 $150
$350 $150
$350
Any ground transportation $150 (Surgical procedures may include, but are not limited to, surgical repair of: ruptured disc, tendons/ligaments, hernia, rotator cuff, torn knee cartilage, skin grafts, joint replacement, internal injuries requiring open abdominal or thoracic surgery, exploratory surgery (with or without repair), etc., unless otherwise noted due to an accidental injury.) Hospitalization Category - Mid Employee Spouse Child Hospital Admission (per confinement) - once per accident, within six months of the accident Maximum number of admissions per covered accident: 1 $900 $900 $900 Hospital Confinement (per day) - within 6 months of the accident Maximum days of confinement per covered accident: 365 $225 $225 $225 Hospital Intensive Care (per day) - within 6 months of the accident Maximum days of confinement per covered accident: 30 $300 $300 $300 Intermediate Intensive Care Step-Down Unit (per day) - within six months of the accident Maximum days of confinement per covered accident: 30 $150 $150 $150 Family Member Lodging (per day) - within six months of the accident Maximum days of lodging per covered accident: 30 $150 $150 $150 Minimum Required Distance (miles): 100
13 THRUSH AIRCRAFT 2023 BENEFITS GUIDE Page 4 of 14
GP-39730.PLAN-255321
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