Voluntary Benefits

Disclosures

Trustmark Hospital StayPay – Group

Trustmark Hopsital StayPay® – Group insurance marketing pieces and presentations provide a brief description of benefits under HII 520 C and HII 520 C MET. This hospital indemnity insurance certificate provides limited benefits that are the result of a covered accident or covered sickness. It is not a substitute for medical expense insurance, major medical expense insurance or a health benefit plan alternative. It does not provide comprehensive medical coverage. It is also not a Medicare Supplement policy, nor is it a policy of worker’s compensation. Please refer to your certificate and outline of coverage, if applicable, for complete information. Limitations on pre-existing conditions may apply. Benefits, definitions, exclusions, form numbers and limitations may vary by state. For costs and coverage detail, including exclusions, limitations and terms, see your agent or write the company. Underwriting conditions may vary, and determine eligibility for the offer of insurance.

Exclusions
No benefits will be paid for losses that are caused by or occur as the result of any of the following:
  • A Pre-existing Condition as described and limited in this Certificate;
  • Involvement in a war or act of war, declared or undeclared;
  • Commission of or attempt to engage in criminal activity, whether convicted or not, or an illegal occupation;
  • Participation in a riot;
  • Riding in or driving any vehicle in a race, stunt show, or speed test;
  • Engaging in recreational activities involving a high degree of risk, which involve speed, height, a high level of physical exertion, or highly specialized gear;
  • Professional or semi-professional sports;
  • Recreationally operating, learning to operate, or serving as a crew member of a recreational aircraft, or jumping or falling from any aircraft, including those that are not motor driven;
  • Having cosmetic Surgery, cosmetic dental treatment, or other elective procedures that are not Medically Necessary (not including organ donation);
  • Tubal ligation, vasectomy or infertility treatment;
  • Treatment in a government hospital;
  • Any treatment or Surgery considered Investigational or Experimental by the American Medical Association, the Health Care Finance Administration, or the Federal Drug Administration;
  • Care or treatment received outside of the covered geographical area, except as provided under Geographical Limitation;
  • A newborn child’s routine nursery or well-baby care during the initial Confinement in a Hospital following birth;
  • Normal Childbirth within 9 months of the Effective Date.
Pre-existing Condition Limitation
No benefit will be paid for any loss incurred during the first 12 months after the Covered Person’s Effective Date which is caused by, related to, or resulting from a Pre-existing Condition.

Geographical Limitation
If a Covered Person requires Appropriate Care due to a Covered Accident or Covered Sickness that begins while outside the covered geographical area, benefit eligibility will be limited to 14 days.  After the 14-day period, the Covered Person will not be eligible for additional benefits until the Covered Person returns to the covered geographical areas. Covered geographical areas are the United States and its territories.