Sample Benefit Enrollment Guide

Company Name Aetna Accident and Critical Illness

Company Name offers supplemental Accident and Critical Illness through Aetna. Accident and

Critical Illness coverage provides financial protection for you and your family if the unexpected

occurs.

Accident

You will receive a cash benefit based on the type of injury you sustain or the type of treatment

you need. Examples of covered injuries and expenses include:

Initial Care

Benefit Amount

Surgical Care

Benefit Amount

Torn Knee Cartilage

$750

$150 (3 visits per plan year) $150 (3 visits per plan year)

Initial Treatment—ER

Ruptured Disc

$750

Medical Imaging (MRI, CT Scan, etc.)

Fracture, Dislocation & Other Injury

Benefit Amount

Hospital Care

Benefit Amount

Inpatient Stay—Initial Day Inpatient Hospital Daily Benefit

Dislocation Benefit: Hip—Closed Fracture Benefit: Clavicle—Closed Burn—3rd Degree (>10%)

$1,000

$3,000

$200

$600

$18,000

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