Microsoft Word - 2024.25 Company Benefits Summary_Dean PPO

Voluntary Accident

Voluntary Accident coverage pays benefits when you or your covered family member(s) is injured, outside of work, because of an accident, like falling down the stairs or off a ladder, getting hurt playing sports. A list of covered injuries is listed below. There is no overall annual or lifetime limit. Refer to the plan certificate for detailed Voluntary Accident coverage information or visit www.principal.com .

INJURY

BENEFIT

Burns

Up to $5,000

Comas

$15,000

Concussions

$500

Dental or eye injuries

$500

Dislocations

Up to $7,500

Fractures

Up to $10,000

Injuries not specifically listed

$100

Internal injuries

$1,500

Knee cartilage / ruptured disc / tendon / ligament/ rotator cuff injuries with surgical repair

$1,500

COVERAGE LEVEL

MONTHLY PREMIUM

Employee Only

$9.07

Employee & Spouse

$15.37

Employee & Child(ren)

$16.20

Family

$25.93

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