You may know CaliforniaChoice as the most flexible health insurance option for small businesses in California. It offers you and your employees more choices than any other program in the state.
Starting this month, CaliforniaChoice also offers its members access to supplemental health insurance benefits through MetLife. Depending on whether your broker offers other supplemental health coverage, you may be able to choose from several options. These include Accident Insurance, Critical Illness Insurance, Hospital Indemnity Insurance, and Legal Plans.
Accident Insurance
Accidents happen every day. If they are serious enough, they can lead to treatment in a doctor’s office, urgent care, or hospital emergency room. They may also result in expenses not covered by your medical insurance.
Here’s an example: Kathy’s daughter, Molly, plays soccer. During a recent game, Molly collided with an opposing player. Molly was knocked unconscious and taken to the local emergency room for treatment. The ER doctor diagnosed a concussion and a broken tooth. She ordered a CT scan, too. After a thorough evaluation, Molly was released to her primary care physician for follow-up care. She also received treatment from her dentist for a broken tooth with a crown.
Here’s a summary of the benefits Kathy and her daughter, Molly, received:
Benefits Paid by MetLife Policy(Accident Insurance, High Plan) |
|
| Covered Event | Benefit Amount |
| Ambulance (ground) | $300.00 |
| Emergency care (in ER) | $100.00 |
| Physician follow-up (2 @ $75.00) | $150.00 |
| Medical testing | $100.00 |
| Concussion | $400.00 |
| Broken tooth (repaired by crown) | $200.00 |
| Total payout: $1,250.00 | |
This is a hypothetical example for illustrative purposes only. Covered services/treatments must be a result of a covered accident or sickness as defined in the group policy/certificate. Refer to the Outline of Coverage for details. Benefit amount is based on sample MetLife plan design. Actual plan design and benefits may vary.
Why Accident Insurance Matters
MetLife’s Accident Insurance includes coverage for more than 150 different injuries. It also includes an array of medical services and treatments. Plus, when you have MetLife Accident Insurance, payments are made directly to you, not to providers like your hospital or doctor. When your employees have the financial support they need it can mean less worry when an accident happens.
Talk to a Broker to Learn More
To learn more about CaliforniaChoice and its supplemental insurance offerings, talk to your broker. If you don’t already have a broker, you can search for one here.
Limitations and Exclusions
MetLife’s Accident Insurance is a limited benefit group insurance policy. It is not intended to be a substitute for Medical insurance. Certain states may require the insured to have Medical coverage to enroll for Accident coverage. The policy or its provisions may vary or be unavailable in some states. There are benefit reductions that begin at age 65, if applicable.
Policies offered by MetLife may include waiting periods and contain certain exclusions, limitations, and terms for keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12-AX or contact MetLife.
Benefits are underwritten by Metropolitan Life Insurance Company, New York, NY. “Hospital” does not include nursing homes, convalescent care, or extended care facilities. Refer to MetLife’s Disclosure Statement or Outline of Coverage/Disclosure Document for full details.
