For employees who do not participate in a District medical plan, the District provides a Hospital
Indemnity Benefit. The purpose of the Hospital Indemnity Plan is two-fold.....
- To provide a daily hospital benefit in the event you have an illness or
injury that requires
hospital confinement, AND
- To provide a $15,000 term life insurance benefit.
primary purpose of the Hospital Indemnity Plan is to provide a benefit for eligible
who for whatever reason have no health insurance, or for eligible employees who have their
health insurance provided by another source.
The Hospital Indemnity Benefit will pay a $250 daily benefit fo an inpatient
where charges are made by the hospital for room and board. The Hospital Indemnity Benefit is
supplemental plan and benefit is paid directly to the employee.
The benefit can be used to pay expenses associated with the hospital confinement
medical treatment, cover deductibles and coinsurance, or as an income replacement for lost
wages while recuperating.
The maximum benefit period is thirty (30) days. A new benefit period
will not begin unless it is
separated by fourteen (14) continuous days of non-confinement.
the Hospital Indemnity Benefit will pay a $10, 000 term life insurance benefit
through Met Life Insurance Company to your designated beneficiary in the
event of your death.
You are eligible and automatically covered as a District employee if you meet the following
- You are a fulltime regular employee of North East ISD and scheduled to
work at least
32 hours per week on a continuous basis, or
- You are a part-time regular employee of the District and scheduled to work
of 20 hours per week, on a continuous basis, and
currently enrolled as a participating member of any health plan offered
North East Independent School District.
is no monthly contribution due from the employee for this coverage. The District
contribute the monthly premium for the coverage to the NEISD Health Trust Fund.
How to file a claim
Upon release from a hospital confinement, you can request a Hospital Indemnity Plan Request
for Benefits form from the Employee Benefits Office.
Benefits are payable from the first day you are billed for room and board by the hospital.
Admissions through a hospital emergency room begin when you are admitted as an inpatient.
Eligible charges for room and board include charges for a private or semiprivate room, ward,
or an intensive care unit. When you are discharged from the hospital, request an itemized
statement documenting the room and board charges from the date of admission to the date
IMPORTANT INFORMATION: A Request for Benefits form must be completed
and submitted along with the hospital's itemized statement to the Employee
Benefits Office within ninety (90) days of the hospital discharge.
Request for Benefits forms will have the dates of hospital confinement
verified with the
hospital's business office. The number of days to be paid must be approved by the Medical
Auditor and Risk Management Director. Once the approval process is completed, you will
receive your Hospital Indemnity Benefit payment in your paycheck as supplemental salary.
All Hospital Indemnity Benefit payments are subject to federal income tax and will be reported
on your W2 as income. Hospital Indemnity Benefits do not qualify for Teacher Retirement
System (TRS) deposit.
If you fully meet the eligibility requirements for the Hospital Indemnity Benefit as outlined
above, your enrollment is automatic.
New employees will receive information about the Hospital Indemnity Benefit
new employee orientation meeting. If you choose not to enroll in one of the health plans
offered by the District within the first 31 days of employment, the Employee Benefits office will
file the beneficiary for the $15,000 term life insurance.
As for current employees who were previously enrolled in a NEISD health plan and later
canceled coverage, your enrollment in the Hospital Indemnity Benefit will become effective on
the first day of the month following cancellation of the other plan.
refer to your Hospital Indemnity Benefit Handbook for more information about