Secure Lite STM - Underwritten by Standard Security Life Insurance Company of NY Rated A- Excellent by AM Best

The Secure Lite STM Short term health insurance plan is designed to provide low cost medical coverage on a temporary basis.  Ideal if your between jobs, lay off, a college student or recent graduate, in a waiting period, while between permanent health plans or as a low cost short term health insurance alternative to COBRA or traditional health coverage. Secure Lite STM Short term coverage is available for as little as 30 days and you can keep it for up to 6 months.  You can also choose the exact number of days and save more when choosing the single payment option. Compare all of the short term health insurance plans to find the plan that fits your needs with the lowest cost..

Secure Lite STM - How are benefits covered?

Secure Lite STM pays benefits for each covered person in the following manner (subject to specific benefit limits):
1. You are responsible for eligible expenses until the deductible is satisfied. Choose from four options: $500, $1,000, $2,500 or $5,000 (maximum of 3 deductibles per family)
2. For most covered services, SecureLite STM then pays 80% or 50% of the next $10,000 of covered expenses
3. After this, SecureLite STM pays 100% of covered expenses up to your Coverage Period maximum of $750,000*
*Certain conditions have limited maximum benefits; see “What medical expenses are covered?” and “What Services are not covered?” Refer to your coverage document for specific terms and conditions.

Who qualifies for the Secure Lite STM plan?

Secure Lite STM Short-Term Medical is to those under the age of 65, their spouses under 65 and eligible dependents under age 26 who can answer 'no' to the health questions on the application. Child-only coverage is available for ages 2 through 18.

What medical expenses are covered?

After satisfying the deductible amount you’ve selected, Secure Lite STM will pay the coinsurance you’ve selected for covered expenses, up to a maximum of $750,000 per insured person per coverage period.*
The Benefits are limited to the usual, reasonable and customary charge for a covered expense in addition to any specific limits.

Physician Office Visit: Up to $25 per visit up to four visits per coverage period. After the office visit, the balance of the charge is subject to the plan deductible and coinsurance up to $1,000 per coverage period.

In-Hospital Regular Care Charges: Up to $1,000 per day; includes daily room and board and all miscellaneous charges**

In-Hospital Intensive or Critical Care Charges: 3 times the average semi-private room rate up to $1,250 per day; includes daily room and board and all miscellaneous charges**

Outpatient Hospital Surgery & Ambulatory Surgical Center Charges: Up to $1,000 per day includes cost of operating room and all miscellaneous charges**

Outpatient Emergency Room: Up to $500 per day includes the emergency room physician charge, 24-hour surveillance and all miscellaneous charges**

In-Hospital Physician Visits: Up to $500 maximum per hospital stay

Surgeon and Anesthesiologist: Up to $2,500 per procedure up to $5,000 maximum per Coverage Period

Outpatient or Physician Office Miscellaneous Charges:** Up to $1,000 per Coverage Period

Ambulance Services: Up to $250 per trip

Organ Transplants: Up to $150,000 lifetime maximum

Acquired Immune Deficiency Syndrome (AIDS): Up to $10,000 lifetime maximum***

Mammography are covered subject to deductibles, coinsurance and any specific limits****

Pap Smear and Screens (includes PSA) are covered subject to deductibles, coinsurance and any specific limits****

*Benefits for gall bladder surgery are limited to a $2,500 per Coverage Period per insured person. Benefits for injury or disorders of the knees are limited to a $2,500 per Coverage Period per insured person. Benefits may vary by state.
**Miscellaneous charges where indicated includes: X-rays, scans, laboratory, blood,therapy, oxygen, casts, splints, medicines, injections, chemotherapy and medical supplies.
***The AIDS maximum of $10,000 per Coverage Period does not apply to Policies/Certificates of Insurance issued to residents of AZ, CA, CO, DC, ID, IN, MD, ME, MO, NH, NC or ND. In KS the maximum per Coverage Period is $75,000.
****Benefits are covered subject to coinsurance and any specific limits including outpatient or doctor’s office miscellaneous limits.

Lab Card Select Discount Lab Services?

Take advantage of high-quality, low-cost laboratory testing (save up to 40%) by utilizing Lab Card Select. Simply visit a Lab Card Select provider or instruct your physician to send you lab work to a Lab Card Select provider. A complete list of Lab Card Select providers can be found at www.labcardselect.com (be sure to select “Lab Card Select”Network).

Private Health Care Systems (PHCS) PPO Network?

In addition to your insurance plan, you’ll also enjoy discounts provided through nationwide access to one of the premier PPOs through Private HealthCare Systems (PHCS). PHCS provides you with the opportunity to reduce your expenses for provider and facility services. The program is voluntary, so there is no penalty for not using a PHCS participating provider; but you can reduce your out-of-pocket medical expenses by using the program. Simply call PHCS at 1-800-678-7427 or visit PHCS on the web at www.phcs.com to verify that your doctor or hospital is part of the PHCS Healthy Directions Network. At the time of service present your Short Term Medical Insurance Identification Card with the PHCS logo on it and your provider will bill you at the reduced network rate for services if applicable.*
*PHCS and Lab Card Select are not affiliated with the Standard Security Life Insurance Company of New York nor are they a part of the Secure Lite STM insurance plan.

Is there a pre-existing condition limitation?

Secure Lite will not provide benefits for any loss caused by or resulting from a pre-existing condition. A pre-existing condition is any medical condition or sickness for which medical advice, care, diagnosis, treatment, consultation or medication was recommended or received from a doctor within five years immediately preceding the covered persons effective date of coverage; or symptoms existed within the 5-years immediately prior to the covered persons effective date of coverage which would cause a reasonable person to seek diagnosis, care or treatment. The pre-existing condition limitation may vary by state.

What is the usual, reasonable and customary charge?

Usual, Reasonable and Customary means with respect to fees or charges, fees for medical services or supplies which are usually charged by the provider for the service or supply given and the average charge for the service or supply in the locality in which the service or supply is received; whichever is less, or with respect to treatment or medical services, treatment which is reasonable in relationship to the service or supply given and the severity of the condition. In reaching a determination as to what amount should be considered as Usual, Reasonable and Customary for services and supplies; we may use and subscribe to a standard industry reference source that collects data and makes it available to its member companies.

What are my payment options?

Choose from two convenient payment options.

• You can pay for coverage in monthly payments for up to 6 months at a time. We accept monthly payments by check, money order, credit card or automatic bank withdrawal. If you select this option, and your need for insurance ends before your coverage period ends, you can cancel at any time throughwritten notification to our Policy Service Department.

• The single payment option is ideal if you know the exact number of days coverage is needed. This option has a special reduced rate and you only pay for the coverage you need through one, single payment. You can pay in full for any number of days, from a minimum of 30 days to a maximum of 180 days of coverage by check, money order or credit card or ACH online.

Your subsequent monthly credit card/ach premium deductions will occur based upon the effective date of coverage. If your coverage effective date is the 1st - 14th, your premium will be deducted on the 1st of the month. If your coverage effective date is the 15th - 31st, your premium will be deducted on the 15th of the month.

How can I save money and maximize my benefits?

Through the STM plan, you have access to discounted medical services through two national Preferred Provider Networks (PPOs): ACS and MultiPlan. The network providers have agreed to provide their services at a negotiated fee and pass these discounts on to you. While you have the flexibility to choose any health care provider, the discounts available through network providers for covered services will help to lower your out-of-pocket cost. The discount will be reflected in your final bill and you will not owe the network providers for the difference between their retail rate and the negotiated fee. You will still be responsible for paying your share of the covered expenses, including any deductible, copay and coinsurance. Your coinsurance amount will be based upon the negotiated fee.
Using a network provider is voluntary. If you are unable to find a network provider, we will attempt to negotiate a discount for you from your provider. While we can’t guarantee the outcome, if we successfully obtain a discount it will be passed on to you.
To search for a health care provider or facility, please visit the Web sites listed below. At the time of services, simply present your identification card to the network provider.
• ACS is a comprehensive network of 2,500 ancillary service providers at over 25,000 sites, representing providers of outpatient services, including lab and diagnostic testing, except physicians. www.anci-care.com
• MultiPlan is one of the nation’s largest networks with more than 500,000 members in 50 states, including physicians, and inpatient and outpatient facilities. www.multiplan.com or 888-342-7427.
ACS and MultiPlan are not affiliated with Standard Security Life Insurance Company of New York, nor are they part of this insurance plan.

When does my coverage start?

Your coverage will begin as early as the day following online submission. You can request a later effective date, but no more than 60 days after the application date. All coverage is subject to approval of your application and payment of the first premium.

How long will STM coverage last?

HPA’s Secure Lite STM is specifically designed to fill temporary insurance needs and coverage stops at the end of the period applied for. Depending on the payment option you select, SecureLite STM offers coverage for one to 6 months.**

Can I continue coverage?

If your need for temporary health insurance continues, you may apply for another Secure Lite STM plan.* Your application is subject to eligibility, underwriting requirements and state availability of the coverage. The next coverage period is not continuous and any condition incurred during the last coverage period will be excluded as a pre-existing condition.
*Some states may restrict re-application to another STM coverage period.

When does coverage terminate?

Coverage ends on the earliest of the date the premium is not paid when due; or you cease to be a member of the association;* or the group master policy terminates; or you enter full-time active duty in the Armed Forces; or you become eligible for Medicare; or the elected coverage period expires; or Standard Security Life Insurance Company of New York determines fraud or misrepresentation has been made in filing a claim for benefits. A dependent’s coverage ends on the earliest of the date your coverage terminates; or the dependent becomes eligible for Medicare; or the dependent ceases to be eligible. *Applies only to states where association membership is required.

Is there an extension of benefits after the plan terminates?

If a member, or insured dependent is receiving benefits for a hospital confinement on the date that the certificate of insurance terminates (for other than nonpayment of premium), benefits will continue in accordance with the terms of the certificate of insurance for as long as that confinement remains. However, in no event will coverage continue beyond the end of 90 days following the date the coverage terminates when the insured becomes eligible for other coverage for the same conditions or the maximum benefits have been reached. Benefits payable are subject to a new deductible amount and satisfaction of coinsurance limit.

Is there a free-look period?

If you are not completely satisfied with this coverage, and you have not filed a claim, you may return the Certificate of Insurance within 10 days and receive a premium refund. Enrollment and Administrative fees are non-refundable.

Do I need pre-certification?

You must notify the pre-certification service 10 days prior to a non-emergency hospital admission or surgery and 48 hours (or as soon as reasonably possible) following an emergency admission to the hospital for pre-certification of admission. Failure to pre-certify will result in a benefit reduction of 50%. Pre-certification is not a guarantee of benefits.

What is the enhancement series*?

In addition to offering you an association-endorsed short-term medical plan, CA provides additional consumer benefits and services you can use to stay healthy and reduce your medical expenses. These benefits include:

• *The Communicating for America (CA) Healthy Lifestyle Enhancement Series is not an insurance benefit, nor is it affiliated with Standard Security Life Insurance Company of New York, nor is it a part of the STM insurance plan. The Enhancement Series is not available to residents in the states where the CA membership is not required.
  

Who is the Association?

Communicating for America, Inc.*** (CA) provides many discounts to its members. Your enrollment as a member of CA is completed upon receipt of the association annual dues. Your membership information will be mailed shortly thereafter.
***CA is not affiliated with Standard Security Life Insurance Company of New York, nor is it a part of the insurance coverage. CA is a 501c5 non-profit association headquartered in Fergus Falls, Minn., with an office in D.C., providing members valued benefits and savings since 1972. CA membership does not apply to residents of the following states: ID, IN, KS, LA, ME, MD, MN, MT, ND, NH, NV or SD.

Who is the Insurance Company?

The Secure Lite is insured by Standard Security Life Insurance Company of New York (Standard Security), a member of the IHC Group. Standard Security is rated A- (Excellent) by A.M. Best Company, a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet their obligations to their insureds. Standard Security has chosen Health Plan Administrators, Inc. (HPA), also a member of the IHC Group, to provide service for your Secure Lite STM plan.
The IHC Group is an insurance organization comprised of Independence Holding Company (NYSE: IHC) and its operating subsidiaries. The IHC Group has been providing life, health and stop-loss insurance solutions for over 25 years. For more information on Independence Holding Company and the IHC Group,