Compass Accident Insurance - Labcorp Benefits Enrollment System

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Compass Accident InsuranceEnrollment at a glanceAffordable insurance that can help you pay for the out-of-pocket costs you mayexperience after an accident.For the employees of: LabCorp ReliaStar Life Insurance Company, a member of the Voya family of companies

Have you ever dislocated a joint or gotten a deep cut? How about something more severe, like a concussion orbroken bone? Most of us have experienced an accident that needed medical attention as least once in our lives. AccidentInsurance can help relieve some of the financial stress that goes along with an accidental injury.What is Accident Insurance?Accident Insurance pays you benefits for specific injuries and events resulting from a covered accident that occurs on orafter your coverage effective date. The benefit amount depends on the type of injury and care received. You have theoption to elect Accident Insurance to meet your needs. Accident Insurance is a limited benefit policy. It is not healthinsurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.Other features of Accident Insurance include: Guaranteed issue: No medical questions or tests are required for coverage. Flexible: You can use the benefit payments for any purpose you like. Payroll deductions: Premiums are paid through convenient payroll deductions. Portable: If you leave your current employer, you can take your coverage with you.How can Accident Insurance help?Below are a few examples of how your Accident Insurance benefits could be used: Medical expenses, such as deductibles and copays Home healthcare costs Lost income due to lost time at work Everyday expenses like utilities and groceriesWho is eligible for Accident Insurance? You—all active employees working 20 hours per week***.Your spouse*—If you have coverage on yourself, you may enroll your spouse, as long as your spouse is not coveredunder your employer’s plan as an employee. Your spouse will be covered for the same Accident benefits as you are.Your children**—If you have coverage on yourself; your natural children, stepchildren, adopted children or childrenfor whom you are a legal guardian; are eligible to be covered under your employer’s plan, up to the age of 26. Yourchildren will be covered for the same Accident benefits as you are and one premium amount covers all of your eligiblechildren. If both you and your spouse are covered under this policy as an employee; then only one, but not both, maycover the same children for Accident Insurance. If the parent who is covering the children stops being insured as anemployee, then the other parent may apply for children’s coverage.*The use of “spouse” in this document means a person insured as a spouse as described in the applicable rider. This may include domestic partners orcivil union partners as defined by the employer’s plan. Please contact your employer for more information.**The definition of “child” may vary by state. Please contact your employer for more information.***16 hours for healthcare industries ReliaStar Life Insurance Company, a member of the Voya family of companies

What accident benefits are available?The following list is a summary of the benefits provided by Accident Insurance. You may be required to seek care for yourinjury within a set amount of time. Note that there may be some variations by state. For a list of standard exclusions andlimitations, go to the end of this document. For a complete description of your available benefits, exclusions andlimitations, see your certificate of insurance and any riders.EventBasic PlanEnhanced Plan 800 125 400 500 1,200 175 6001,000 100 200 200 400 75 150 11,500 17,000 500 750 120 180 60 100 100 240 1,000 90 200 200 360 1,500 60 60 90 120 30 45Prosthetic device (one)Prosthetic device (two or more)Major diagnostic exam 500 800 100 750 1,200 240Outpatient surgery (1 per accident)X-ray 150 50 225 100 1,000 1,250 4,500 7,500 10,000 15,00025% of the burn benefit 250 crown, 60extraction 60 22525% of the burn benefit 350 crown, 90extraction 100 350Accident hospital careSurgery open abdominal, thoracicSurgery exploratory or without repairBlood, plasma, plateletsHospital admissionHospital confinementper day, up to 365 daysCritical care unit confinementper day, up to 15 daysRehabilitation facility confinementper day, up to 90 daysComa duration of 14 or more daysTransportationper trip, up to 3 per accidentLodging per day, up to 30 daysAccident careInitial doctor visitUrgent care facility treatmentEmergency room treatmentGround ambulanceAir ambulanceFollow-up doctor treatmentMedical equipmentPhysical or occupational therapy up to 6 peraccidentCommon injuriesBurns second degree, at least 36% of the bodyBurns 3rd degree, at least 9 but less than 35square inches of the bodyBurns 3rd degree, 35 or more square inches ofthe bodySkin graftsEmergency dental workEye injury removal of foreign objectEye injury surgery ReliaStar Life Insurance Company, a member of the Voya family of companies

Torn knee cartilage 150 225 500 20 40 160 800 30 60 240 320 500 480 800 275 425 550 825 800 1,225 150 10,750 16,0002Closed/open reduction 2,550/ 5,100 225 16,000 24,0002Closed/open reduction 3,850/ 7,700 1,600/ 3,200 2,400/ 4,800 1,000/ 2,000 1,500/ 3,000 1,000/ 2,000 750/ 1,500 750/ 1,500 175/ 350 1,600/ 3,200 1,100/ 2,200 1,100/ 2,200 275/ 550 750/ 1,500 750/ 1,500 750/ 1,50025% of the closedreduction amount3Closed/open reduction 2,000/ 4,000 1,500/ 3,000 1,200/ 2,400 1,100/ 2,200 1,100/ 2,200 1,100/ 2,20025% of the closedreduction amount3Closed/open reduction 3,000/ 6,000 2,500/ 5,000 1,800/ 3,600 1,200/ 2,400 1,200/ 2,400 1,400/ 2,800 1,800/ 3,600 1,800/ 3,600 2,100/ 4,200 1,200/ 2,400 1,800/ 3,600Finger, toeVertebral body 160/ 320 2,240/ 4,480 240/ 480 3,360/ 6,720Vertebral processesPelvis except coccyxCoccyxBones of face except noseNose 960/ 1,920 2,250/ 4,500 200/ 400 800/ 1,600 400/ 800 1,440/ 2,880 3,200/ 6,400 400/ 800 1,200/ 2,400 600/ 1,200surgery with no repair or if cartilage is shavedTorn knee cartilage surgical repair1Laceration treated no sutures1Laceration sutures up to 2”1Laceration sutures 2” – 6”1Laceration sutures over 6”Ruptured disk surgical repairTendon/ligament/rotator cuffexploratory arthroscopic surgery with no repairTendon/ligament/rotator cuffone, surgical repairTendon/ligament/rotator cufftwo or more, surgical repairConcussionParalysis - paraplegiaParalysis - quadriplegiaDislocationsHip jointKneeAnkle or foot bone(s)other than toesShoulderElbowWristFinger/toeHand bone(s) other than fingersLower jawCollarbonePartial dislocationsFracturesHipLegAnkleKneecapFoot excluding toes, heelUpper armForearm, hand, wristexcept fingers ReliaStar Life Insurance Company, a member of the Voya family of companies

Upper jawLower jawCollarboneRib or ribsSkull – simple except bones of faceSkull – depressed 1,000/ 2,000 960/ 1,920 960/ 1,920 300/ 600 1,000/ 2,000 1,500/ 3,000 1,440/ 2,880 1,440/ 2,880 400/ 800 1,400/ 2,800 2,000/ 4,000 3,000/ 6,000 240/ 480 1,200/ 2,40025% of the closedreduction amount 360/ 720 1,800/ 3,60025% of the closedreduction amountexcept bones of faceSternumShoulder bladeChip fractures1Laceration benefits are a total of all lacerations per accident.Closed Reduction of Dislocation Non-surgical reduction of a completely separated joint. Open Reduction of Dislocation Surgicalreduction of a completely separated joint.3Closed Reduction of Fracture Non-surgical. Open Reduction of Fracture Surgical.2Meet MichelleMichelle works full-time while raising two energetic children and playing in a summer softball league. While sliding intohome base, she broke her ankle and tore her ACL. Fortunately, the accident didn’t break Michelle’s bank account - andthe family vacation was saved.Benefits paid by Michelle’s Accident Insurance 400 300Accident InsuranceBasic Benefit 100 150Accident InsuranceEnhanced Benefit 200 340 1,000 550 825 1,500 150 125 300 3,775 1,200 60 60 180 2,300 1,800 120 90 270 3,645Out-of-Pocket CostsUrgent care facility treatmentX-ray and MRITendon/ligament/rotator cuffsurgeryBroken ankle, closed reductionMedical equipmentFollow-up doctor visitPhysical therapy (6 sessions)TotalThis is an example of how coverage could work. The amounts shown are an example only. Actual costs/results may vary.What does my Accident Insurance include?The benefits listed below are included with your Accident Insurance coverage. For a list of standard exclusions andlimitations, please refer to the end of this document. For a complete description of your available benefits, exclusions andlimitations, see your certificate of insurance and any riders. Sports Accident Benefit: If your accident occurs while participating in an organized sporting activity as defined inthe certificate, the Accident Hospital Care, Accident Care or Common Injuries benefit will be increased by 25%, toa maximum additional benefit of 1000.o If your spouse and/or children are covered for Accident Insurance, their coverage includes this benefit.o This benefit only applies to the events in the table above. It does not apply to any of the additionalbenefits/coverage outlined in this section. ReliaStar Life Insurance Company, a member of the Voya family of companies

What optional benefits are available?You may choose to include the optional benefits below with your Accident Insurance coverage. For a list of standardexclusions and limitations, please refer to the end of this document. For a complete description of your available benefits,exclusions and limitations, see your certificate of insurance and any riders. Spouse Accident Insurance: If you have coverage on yourself, you may enroll your spouse, as long as yourspouse is not covered under your employer’s plan as an employee.o Your spouse will be covered for the same Accident benefits as you are.o Guaranteed issue: No medical questions or tests are required for coverage. Children’s Accident Insurance: If you have coverage on yourself, your natural children, stepchildren, adoptedchildren or children for whom you are a legal guardian are eligible to be covered under your employer’s plan, upto the age of 26.o Your children will be covered for the same Accident benefits as you are.o Guaranteed issue: No medical questions or tests are required for coverage.o One premium amount covers all of your eligible children.o If both you and your spouse are covered under your employer’s plan as an employee, then only one, butnot both, may cover the same children for Accident Insurance. If the parent who is covering the childrenstops being insured as an employee, then the other parent may apply for children’s coverage.Are there additional non-insurance services available? Voya Travel Assistance: When traveling more than 100 miles from home, Voya Travel Assistance offersenhanced security for your leisure and business trips. You and your dependents can take advantage of four typesof services: pre-trip information, emergency personal services, medical assistance services and emergencytransportation services.Voya Travel Assistance services are provided by Europ Assistance USA, Bethesda, MD.How much does Accident Insurance cost?All employees pay the same rate, no matter their age. See the chart below for the premium amounts.Rates shown are guaranteed until January 1, 2022.The cost provided below includes Accident Insurance premium and a fee for Voya Travel Assistance. ReliaStar Life Insurance Company, a member of the Voya family of companies

Exclusions and Limitations*Exclusions for the Certificate, Spouse Accident Insurance, and Children’s Accident Insurance are listed below. (Thesemay vary by state.)Benefits are not payable for any loss caused in whole or directly by any of the following*: Participation or attempt to participate in a felony or illegal activity. An accident while the covered person is operating a motorized vehicle while intoxicated. Intoxication means thecovered person’s blood alcohol content meets or exceeds the legal presumption of intoxication under the laws ofthe state where the accident occurred. Suicide, attempted suicide or any intentionally self-inflicted injury, while sane or insane. War or any act of war, whether declared or undeclared, other than acts of terrorism. Loss sustained while on active duty as a member of the armed forces of any nation. We will refund, upon writtennotice of such service, any premium which has been accepted for any period not covered as a result of thisexclusion. Alcoholism, drug abuse, or misuse of alcohol or taking of drugs, other than under the direction of a doctor. Riding in or driving any motor-driven vehicle in a race, stunt show or speed test. Operating, or training to operate, or service as a crew member of, or jumping, parachuting or falling from, anyaircraft or hot air balloon, including those which are not motor-driven. Flying as a fare-paying passenger is notexcluded. Engaging in hang-gliding, bungee jumping, parachuting, sail gliding, parasailing, parakiting, kite surfing or anysimilar activities. Practicing for, or participating in, any semi-professional or professional competitive athletic contests for which anytype of compensation or remuneration is received. Any sickness or declining process caused by a sickness.*Definition and limitations/exclusions may vary by state.How do I enroll?You will be able to enroll for benefits October 8, 2018 – October 19, 2018. Watch for more details coming soon.Questions?For more information, please contact: Voya Employee Benefits Customer Service at (877) 236-7564This is a summary of benefits only. A complete description of benefits, limitations, exclusions and termination of coverage will beprovided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there isany discrepancy between this document and the group policy documents, the policy documents will govern. To keep coverage inforce, premiums are payable up to the date of coverage termination. Accident Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya family of companies. Policy Form #RL-ACC3-POL-16; Certificate Form #RLACC3-CERT-16; and Rider Forms: Spouse Accident Rider Form #RL-ACC3-SPR-16, Children's Accident Rider Form #RL-ACC3CHR-16. Form numbers, provisions and availability may vary by state.CN1030-38176-1018Laboratory Corporation of America, Group #70674-4, Acct #001 Date Prepared: 8/28/2018175128-11/01/2017 ReliaStar Life Insurance Company, a member of the Voya family of companies

Compass Accident Insurance . . Accident Insurance pays you benefits for specific injuries and events resulting from a covered accident that occurs on or after your coverage effective date. The benefit amount depends on the type of injury and care received. . employee, then the other parent may apply for children's coverage.