Supplemental Health Protection Plan

allstate gap coverageSupplemental Health (Hospital Indemnity) insurance from Allstate Benefits can help provide a financial safety net, with cash benefits that help fill gaps left by major medical coverage associated with a hospital stay because of injury or illness. Benefits can be used for out-of-pocket expenses such as copays, deductibles and treatment.

Allstate GAP Coverage complements existing medical coverage with benefits that can help pay for out-of-pocket expenses.  These benefits are paid directly to the insured, unless assigned to the provider.

Benefits are paid for out-of-pocket expenses for deductible, coinsurance and copayments you or each covered family member incur for a hospital confinement due to injury or sickness.

Value to Employees

  • Empowers employees to make their own health care decisions and have control of their finances
  • Guaranteed Issue allows employees to enroll during open enrollment without proof of good health (for many benefits)
  • Wellness programs promote early detection and prevention
  • Benefits are easy to understand and utilize

Value to Employers

  • Mitigates impact of health care reform with improved plan design and cost reallocation
  • Promotes consumerism, health care accountability and financial responsibility among employees
  • Provides medical plan savings and “bends the cost curve” by promoting wellness and prevention
  • May curtail unscheduled absences and 401(k) plan raiding to pay for unexpected medical expenses
  • Helps employee retention and engagement by providing the financial support to pay out-of-pocket expenses

 

Why GAP Coverage?

 

Approximately $712 each month is spent on out-of-pocket medical expenses*

Most Americans don’t have three months of savings to help cover out-of-pocket medical costs**

Nearly 2 million people will face bankruptcy due to unpaid medical bills this year***

* http://www.dukehealth.org/health_library/news/medical-bills-force-cancer-patients-to-skimp-on-care-and-necessities
** MetLife 2012 Survey
***http://www.cnbc.com/id/100840148

Key Features

  • Includes benefits for hospital confinement and hospital intensive care
  • Coverage available for spouse and child(ren)
  • Benefits paid regardless of any other coverage
  • Benefits paid directly to the insured unless assigned elsewhere

Benefits

  • Inpatient Hospital Stays
  • Inpatient surgeries
  • Physician’s hospital charges

  • The Hospital Confinement Insurance can be enhanced through the addition of the Outpatient Benefit
  • This benefit pays for outpatient out-of-pocket expenses for deductibles, coinsurance and non-office visit copayments due to injury or sickness.

GAP Claim Example

This is an example only, and may not reflect the employee’s experience

Acute Critical Illness Claim Example

John wakes up in the hospital. He doesn’t remember how he got there, but a doctor explains that he suffered a heart attack and his family called 911.

According to the American Heart Association the average cost of an inpatient hospital stay for a patient with a heart condition is $20,785.  With John’s plan he is responsible for a $3,000 deductible and $3,550 coinsurance payment, which would be a total of $6,550 out of pocket for his medical costs.  With Allstate Benefits Critical Illness Insurance benefit he could receive $10,000 to cover these expenses.

*This is an example of the total benefits that might be paid. The example shown may vary from the coverage offering. Individual experience may also vary.

Group Accident Claim Example

Cindy broke her foot playing soccer. After spending a few hours in the emergency room, she has two follow-up visits and several physical therapy sessions.

According to the U.S. Department of Health & Human Services the Average medical expense for a broken foot in the United States is $7,700.  With Cindy’s plan she would be responsible for $3,000 deductible, and $940 coinsurance resulting in $3,940 out of pocket expenses.  With GAP Coverage Cindy could receive $1,680 as an Accident Insurance Cash Benefit.

*This is an example of the total benefits that might be paid. The example shown may vary from the coverage offering. Individual experience may also vary.

 

*These policies have exclusions and limitations, may have reductions of benefits at specific ages, and may not be available for sale in all states. For costs and complete details contact your Allstate Benefits Representative.

*This coverage does not constitute comprehensive health insurance coverage (often referred to as “major medical coverage”) and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.