All eligible members in good standing under age 70 of the American Postal Workers Union and their families will be accepted for coverage.
You are eligible if:
Note: If you are insured for member/spouse coverage only, newborn children are covered up to 31 days old. To extend your newborn's coverage send notice of birth within 31 days and pay any required premium.
You may select a daily benefit of $200*, $100, $75 or $50, which will be paid for each day you and/or your insured spouse spends in the hospital (other than in an Intensive Care Unit) for a covered sickness or injury. Benefits begin the first day of hospitalization and are paid for up to 365 days of hospital confinement. While hospitalized, insured children receive 40% of your selected benefit ($80, $40, $30, or $20 per day).
*The member's or spouse's daily benefit amount will be limited to a maximum of $100 on the date the member or spouse attains age 70.
If two insured family members are hospitalized at the same time as a result of the same accident, the daily benefit is doubled for each hospitalized person for the first 7 days of hospitalization. This could mean daily benefits of up to $400 for a member or spouse or $160 for each insured child.
For each day you or your insured spouse are confined in a hospital intensive care unit, the daily benefit is increased by 50% for the first 7 days of hospitalization. Children are not eligible for this benefit.
Coverage will take effect on the payday the first premium is deducted from your paycheck, following the date of approval, unless you or any family member proposed for coverage are hospitalized. In that case coverage will begin on the day after such person is discharged.
Each insured member will receive a Certificate of Insurance evidencing coverage is provided under Group Policy G-29315-3/Face Form GMR.
Once you receive your certificate of insurance, if you're not 100% satisfied within the first 30 days, we'll send you a full refund of any premiums paid during that period and your certificate will be considered never issued. You will be under no further obligation.
Hospitalizations must begin while the covered person is being treated for a sickness or injury by a physician other than the member, a family member or a person residing in the member’s household. Benefits are not payable for hospitalizations due to war or military service; elective or cosmetic surgery; pregnancy (except complications of pregnancy are treated as any other illness), intentionally self-inflicted injury, whether sane or insane; or a pre-existing condition as indicated below. In addition benefits are not payable for confinements for which no charge is made that the covered person must pay.
A pre-existing condition is any injury or sickness for which a person has consulted a doctor, received any medical services or supplies, or taken any medication during the 12 months prior to becoming covered under this plan. These conditions will not be covered until this plan has been in force for at least 12 months. All new covered conditions that occur after the effective date of this plan will be covered immediately.
Successive periods of confinement will be considered as if they were one unless they are due to unrelated causes, or separated by at least 3 months.
Hospital means a licensed institution which is approved by the Joint Commission of Accreditation of Hospitals. Hospital does not mean an institution, or part of one, which is used mainly for the aged, the chronically ill, convalescents, drug addicts, alcoholics, a rest home, a nursing home, custodial, educational or rehabilitory care.
Intensive care Unit (ICU) means a cardiac unit or other unit or section of a hospital, which is reserved for critically ill patients, and which has: (a) specialized professional nursing care; and (b) special equipment and supplies on a standby basis. ICU does not include the following special units or such other specialized units: (a) step down ICU/CC Units; (b) telemetry units; or (c) semi-private rooms with separate charges for telemetry.
Your Hospital Indemnity Insurance Plan is renewable, provided the group policy remains in force. Earlier termination can only occur if you: (1) fail to pay a premium when due (2) retire or cease to be actively engaged full time of at least 20 hours per week for your employer or (3) are no longer a member of the APWU.
These are your affordable bi-weekly rates. You may select a daily benefit of $200, $100, $75 or $50. The rates for yourself, spouse and children are based on your age when you enter the plan. The rates do not increase as you get older.
Click Here to view the Hospital Indemnity Bi-Weekly Group Rates.
On the premium due date coinciding with or next following the date you or your spouse attains age 70, the person's daily benefit amount will be reduced to $100. Premiums do not reduce.
Call the following toll-free number
You must notify the Voluntary Benefits Plan of any address change, employment status change, change in union status, life status change (i.e., marriage, divorce, beneficiary or name change) or benefit changes requested. Notice must be in writing.
The insurance described in this brochure meets the minimum standards for limited benefit health insurance as defined by the New York State Insurance Department. It does NOT provide basic hospital, basic medical, major medical, nursing home and/or home care, or long term care insurance as defined by the New York State Insurance Department.
The Voluntary Benefits Plan P.O. Box 12009 Cheshire, CT 06410
Phone: 1-800-422-4492 Fax: 1-203-754-7847
New York Life Insurance Company 51 Madison Ave New York, NY 10010