An affordable limited benefit program for Benjamin Moore Associates and contractors.

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MedAfford+ Program

This program helps full-time and part-time employees cut down on
out of pocket health related costs.

The insurance portion of this program is a basic group hospital
indemnity insurance coverage with no pre-existing exclusion
(except pregnancy) and pays regardless of any existing
insurance coverage.

Other features include:

• All plans have access to a network of over 300,000 physicians, 4,000 hospitals and 50,000 ancillary facilities where the member gets significantly reduced rates.
• Benefits are payable whether you go in or out of the network.
• In addition to insured benefits, this program provides all plans with a dental, vision and prescription drug discount program as well as a 24-hour nurse hot line.

PLAN BENEFITS
Insurance Benefits (CAIC Hospital Indemnity):

• Physician's office visitsHospital confinement • Ambulance • Surgical • Anesthesia
• Wellness • Diagnostic test • Outpatient surgery • Well baby benefit • Outpatient
  diagnostic lab.

Non-insurance saving programs:

• Dental utilizing the Aetna Dental Access™ reduced-fee-network
• Vision savings program
• Prescription drug reduced-fee network
• E-Doc and 24-hour Nurse Line

THIS IS NOT BASIC HEALTH INSURANCE OR MAJOR MEDICAL COVERAGE AND IS NOT DESIGNED AS A SUBSTITUTE FOR BASIC HEALTH INSURANCE OR MAJOR MEDICAL COVERAGE. HOSPITAL INDEMNITY PLANS ARE EXEMPT FROM COORDINATION OF BENEFITS PROVISIONS.

HOSPITAL INDEMNITY INSURANCE PLAN OPTIONS
Underwritten by Continental American Insurance Company

COVERAGE	500 PLAN
PHYSICIAN OFFICE VISIT EMERGENCY ROOM ILLNESS Primary or Specialist Chiropractic care Covers any ER visit as a result of a Maximum 6 visits per certificate year per person	$50 per visit $300 certificate year maximum
OUTPATIENT DIAGNOSTIC LAB Per certificate year, per covered person Hospital confinement is not required Lab (glucose, urinalysis, CBC, blood tests)	$75 Lab per visit (up to 3)
OUTPATIENT DIAGNOSTIC TEST Per certificate year, per covered person Hospital confinement is not required X-Ray (chest. broken bones) Advanced Studies (CT Scan, MRI)	$50 X-Ray per visit Advanced Studies $1,250 per certificate maximum per covered member
WELLNESS BENEFIT Routine exams, medical treatment, injections, mammograms, well child care Cancer Screening and PSA	$50 per certificate year
ACCIDENT COVERAGE Charges must be incurred within ninety (90) days of the date of the accidental injury Non-Occupational Only Covers: Medical, dental or surgical treatment supplies	Up to $500 per occurrence
DAILY HOSPITAL CONFINEMENT Up to 30 days per certificate year due to a covered accident or sickness Must be admitted as an inpatient Mental or Substance Abuse limited to 30 days per certificate year	$1000 First day $500 each additional day Max of 30 days per certificate year
INTENSIVE CARE CONFINEMENT Up to 30 days per certificate year if you are confined in a hospital intensive care or critical care unit as a result of a covered accident or sickness	$1500 First day $500 each additional day $15,000 maximum per certificate year for ICU, CCU benefit
SURGICAL SCHEDULE Inpatient or outpatient Maximum benefit paid by schedule See schedule of operations	$2,500 per certificate maximum scheduled amount for the most procedure during surgical session
ANESTHESIA BENEFIT 25% of the amount paid under the surgical benefit	$250 certificate year maximum per insured member
AMBULANCE Payable once per accident	$100
OUTPATIENT SURGERY FACILITY	$100 maximum per

NON-INSURED DISCOUNT PROGRAMS INCLUDED IN ALL PLANS

• DENTAL (utilizing Aetna Dental Access™) NETWORK**: average discounts range from 15% to 50%.
  
• VISION: discounts are 10% to 50%, with average savings of 28% to 39%.
  
• PRESCRIPTION DRUGS: save an average of 46% on generic and 15% on brand-name drugs.
  
• E-DOC: simply e-mail your questions about personal and family health issues and concerns to a board certified physician or licensed psychologist with complete confidentiality. You will receive a personalized response to your specific question within 24 hours-most replies arrive within 2-4 hours.
  
• NURSE-LINE: you can call and speak to a registered nurse 24 hour a day, 7 days a week.

PROGRAM'S MONTHLY COST	BASIC AGES 18-64	ENHANCED AGES 18-64	DELUXE AGES 18-64
Member	$110.89	$156.13	$187.57
Member & spouse	$183.96	$275.19	$337.70
Member & Dependent Children	$148.93	$154.18	$255.89
Family	$222.00	$333.24	$399.86
Rates include insurance and non-insurance products. For a complete breakdown of fees, please contact your agent.

TERM LIFE OPTION AVAILABLE FOR ALL PLANS (MEMBERS AGE 18-64)

COVERS	AMOUNT	COVERAGE FOR	MONTHLY COST
Member	$10,000	Member Only	$4.70
Spouse	$5,000	Member & Spouse	$8.00
Child(ren)	$2,500	Member & Family/Child	$8.00

* This benefit is paid in addition to the Hospital Confinement and Hospital Admission Benefit.
** Not available in the state of Vermont