Affordable Health Insurance | iCanBenefit.com

Association Group Insurance	starting at:
Complete Choice Select	$169.95
Entry Level Health Plans
Easy Choice	$89.95
My Choice	$29.95
Major Medical & Combination Plans
Major Medical	Request Quote
Total Complete Choice	Request Quote
Total Easy Choice	Request Quote

Monthly Fees
	1500	3500	6500
Individual:	$169.95	$239.95	$279.95
Couple:	$239.95	$339.95	$429.95
Single Parent:	$219.95	$309.95	$379.95
Family:	$289.95	$409.95	$549.95

Enrollment Fee:	$100

Monthly Fees
Individual:	$89.00
Single Parent:	$119.00
Couple:	$119.00
Family	$149.00

Enrollment Fee:	$ 75.00

Monthly Fees
Individual:	$29.95
Couple:	$34.95
Single Parent:	$34.95
Family:	$39.95

Enrollment Fee:	$ 15.00

Indiana Complete Choice Select Program Details
Complete Choice memberships include all the benefits of Basic Choice, along with unlimited telephonic doctor visits, an annual comprehensive wellness panel, personal health advocate support, and many other additional money saving lifestyle benefits. Plus, the program gives you limited indemnity medical benefits for doctor visits, preventative care, lab and diagnostic services, and surgery, along with a generic prescription plan, accidental medical expense benefits and AD&D benefits, as well as many additional features that assist with routine and unexpected medical needs

Doctor's Office Visits
Outpatient doctor's office visits (including chiropractic office consultations) are covered at the indicated amount per visit at the indicated maximum per person during each Calendar Year
1100 - n/a
3300 - $75 per visit $150 max per Calendar Year
6600 - $75 per visit $225 max per Calendar Year

Preventative Care
covers routine exams, medical treatment and wellness injections
1100 - n/a
3300 - $50 per visit $50 max per Calendar Year
6600 - $100 per visit $150 max per Calendar Year

Outpatient Diagnostic Benefits
covers outpatient diagnostic tests including:
1100 - $50 per visit $200 total max per Calendar Year
3300 - $500 total max per Calendar Year:
6600 - $1000 total max per Calendar Year:
Lab Work/ Blood Tests
1100 - $50 per visit $200 total max per Calendar Year
3300 - $20 per test/ 3 tests $60 max per Calendar Year
6600 - $35 per test/ 6 tests $210 max per Calendar Year
X-Rays
1100 - $50 per visit $200 total max per Calendar Year
3300 - $70 per x-ray/ 2 x-rays $140 max per Calendar Year
6600 - $75 per x-ray / 4 x-rays $300 per Calendar Year

Advanced Studies

1100 - $50 per visit $200 total max per Calendar Year
3300 - $300 max per Calendar Year
6600 - $490 max per Calendar Year
Anigogram/Arteriogram
1100 - $50 per visit $200 total max per Calendar Year
3300 - $270/test
6600 - $400/test
EEG
1100 - $50 per visit $200 total max per Calendar Year
3300 - $50/test
6600 - $80/test
Myelogram
1100 - $50 per visit $200 total max per Calendar Year
3300 - $90/test
6600 - $130/test
CT
1100 - $50 per visit $200 total max per Calendar Year
3300 - $170/test
6600 - $260/test
MRI Scans
1100 - $50 per visit $200 total max per Calendar Year
3300 - $220/test
6600 - $330/test
PET
1100 - $50 per visit $200 total max per Calendar Year
3300 - $300/test
6600 - $490/test

Hospitalization
Covers per diem hospitalization, covered at the indicated amount per day at the indicated maximum per person during each Calendar Year, including stays for:
1100 - $250 per day Up to 10days/ $2,500 max
3300 - $500 per day Up to 10 days/$5,000 max
6600 - $1,000 per day Up to 10 days/$10,000 max
Mental Illness
1100 - $50 per day/ 10 day max
3300 - $50 per day / 10 day max
6600 - $300 per day / 10 day max
Substance Abuse Treatment
1100 - $50 per day / 10 day max
3300 - $50 per day / 10 day max
6600 - $300 per day / 10 day max
Skilled Nursing Facility
1100 - $50 per day / 10 day max
3300 - $50 per day / 10 day max
6600 - $300 per day / 10 day max

Inpatient Miscallaneous Hospital Expense
Covers miscellaneous hospital expenses such as: Lab Work Blood Test X-Rays Diagnostic Studies Medication Crutches Bandages Etc.
1100 - n/a
3300 - n/a
6600 - $150 per day 10 day max $1,500 max per Calendar Year

Surgery
Covers surgical costs according to a Surgical Schedule up to the following maximum amounts
1100 - $1,500 maximum per surgery
3300 - $3,000 maxiumum per surgery
6600 - $5,000 maximum per surgery

Anesthesia
Covers anesthesia at 25% of amount paid by surgical coverage
1100 - Limited to $375 per surgery
3300 - Limited to $750 per surgery
6600 - Limited to $1,250 per surgery

Outpatient Surgical Facility

1100 - n/a
3300 - n/a
6600 - $150 per surgery $300 max per Calendar Year

Durable Medical Equipment
Canes Crutches Walkers Wheelchairs Respiratory Equipment Splints Nebulizers Neck Braces Slings Etc.
1100 - $50 per Calendar Year
3300 - $50 per Calendar Year
6600 - $100 per Calendar Year

Emergency Room
Covers ER visits for illness which do not result in hospital confinement
1100 - $75 per visit $300 max per Calendar Year
3300 - $75 per visit $300 max per Calendar Year
6600 - $75 per visit $300 max per Calendar Year

Accident Medical Expense
this benefit is underwritten by Guarantee Trust Life Insurance Company
1100 - $1,500 per Calendar Year $100 deductible per incident
3300 - $2,500 per Calendar Year $100 deductible per incident
6600 - $5,000 per Calendar Year $100 deductible per incident

Accidental Death & Dismemberment
this benefit is underwritten by Guarantee Trust Life Insurance Company
1100 - $5,000 (loss of life)
3300 - $5,000 (loss of life)
6600 - $10,000 (loss of life)

Generic Prescription Drug Coverage
$50 annual deductible
1100 - Co-pay: $15 or 50% whichever is greater Max of $75 per month and $150 per family per month
3300 - Co-pay: $15 or 50% whichever is greater Max of $125 per month and $250 per family per month
6600 - Co-pay: $15 or 50% whichever is greater Max of $250 per month and $500 per family per month

Dining Discounts
50% Savings With more than 30,000 merchant locations offering up to 50% savings on dining, you are sure to find deals at your favorite local restaurants. Take the opportunity to explore some new taste treats. Feel like Italian tonight? You are covered. How about Asian? That, too. We have plenty of local restaurants available to our members. Pick your category, enter your location and print out your savings offer. Ongoing 20% Savings To make a good deal even better, many of our participating merchants also offer ongoing 20% savings. Find a restaurant you really like and go back again and again to receive up to 20% of your total bill, excluding tax, tip and alcohol. Simply take your membership card to the restaurant and save 20% every time! Discounts cannot be used on major holidays, such as Christmas Eve/Day, New Years Eve/Day, Valentine’s Day, Easter, etc. Discounts may not be used in conjunction with other promotions or offers and awards programs. Offer valid through expiration date printed on your coupon obtained online.

Events and Attractions
Members can save on a wide variety of activities while on vacation! Whether its golfing, bowling, live events, or museums there is something fun for everyone to enjoy. You can also enjoy discounted rates on special events, sporting events, and several amusement parks including Universal Orlando Resort and great savings at Planet Hollywood!

Condo Vacations
Enjoy the comforts of home at resort destinations within the US or around the world! Enjoy great savings on condominiums. As a member, you can stay in beautiful one and two bedroom or studio condominiums at resorts in locations like Orlando, Ft. Lauderdale, Palm Springs, Hilton Head, Virginia Beach, St. Lucia, Mexico and many more. Members enjoy preferred rates through several of the nations largest resort rental companies like Florida Vacation Station, CondoDirect and Westgate Resorts.

Hotel Discounts
Save at thousands of hotels in popular destinations worldwide. Enjoy access to savings at participating hotels such as Radisson, Sheraton, Days Inn, OMNI, Quality, Best Western and many more! Members may access all three Hotel Programs (see below for information on Hotel Chain Savings Program, Direct to Hotel Savings Program, and Guaranteed Best Rate Program). Each program has unique guidelines to follow. Hotel Program details are: Hotel Chain Savings Program Members can save up to 20% at participating hotels at popular hotel chains by calling the toll-free number as listed and providing the agent with the ID code as indicated. Advance reservations are required. Discounts vary by chain. Blackout dates and other restrictions may apply. At check-in, no card is required, just the confirmation number given at time of booking. Instructions on how to find participating hotel chains can be found by logging in at the top of this page. Direct to Hotel Savings Program Members receive up to 50% savings off the rack rate at over 4,000 participating hotels worldwide. Members can find participating hotels by logging in at the top of this page. Members should call the telephone number noted for the hotel listing on the website in advance, and identify him/herself as an Entertainment Member when requesting the Entertainment rate. Note: Some restrictions may apply. Discounts are based on Program room availability - if traveling during peak season, holiday weeks or special events, the discount may not be available every night of your stay. Only one room can be discounted per membership card and the card is non-transferable. At check-in, members need to present their membership card with the Entertainment logo along with their confirmation number. Guaranteed Best Rate Program Members receive the guaranteed best rate, plus they may qualify for a rebate of $100-$200. The rebate is based upon the number of consecutive nights, with a minimum of two (2) nights and only available for those who pay in full at the time of booking. The Rate is guaranteed at the time of reservation to be the best rate for the room type at the same hotel on the dates booked. The network of hotels participating consists of 35,000 hotels worldwide. Rooms are subject to availability.

Car Rental Discounts
When you travel, you can access great savings with the most trusted names in the car rental business. Members enjoy savings of 5-25% on car and RV rentals. They may take advantage of savings through Alamo, Avis, Budget, National, Hertz and Enterprise. Save on rates from economy size all the way up to the finest luxury vehicles.

Nationwide Shopping
Members can access direct discount savings on thousands of local and national retailers throughout the country. Savings for everything from apparel and electronics to toys and office supplies all at top merchant names are available at your fingertips. It's as simple as printing out the offer and bringing it on your next trip to the store. Or, just click-through to purchase online! Online Shopping Members will have access to hundreds of offers in our Top Web Deals category, which allows you to save time and money on great national online retailers. For more details on how to use and access your benefits, members may simply follow the link at the bottom of this page. Simply select Shopping or Top Web Deals and start saving!

Recreational Activities
Members and their families can enjoy great discounts on recreational activities, including a visit to the museum or attendance at live events, such as sporting events. If you would rather participate, then we have great discounts for you, too! Local offers include, but are not limited to, bowling, laser tag, miniature golf, ice skating, roller skating and many more. All are easy to access through the member search. In addition, Members can also access significant savings at golf courses and movie theaters.

Golfing Discounts
Members can save up to 50% on some of the country’s top golf courses. Whether traveling across the country for a golf weekend escape or playing nine holes at a local course, we have your golf needs covered. Sample savings include: 2-for-1 Green Fees; 2-for-1 Bucket of Balls; 50% Off Discount; and Ongoing 20% off Savings! Log in to access your golf discounts today.

Movie Discounts
You can enjoy discounted movie tickets at major movie theater chains throughout the country. Simply search for the available theater of your choice, you can access printable, box office redemption discounts, as well as tickets that can be ordered by mail. If you prefer to stay home, as a member you'll have access to discounts at local movie rental locations. (Movie rental discounts can be found under the Shopping category) Terms: Certain Terms and Conditions may apply to specific theaters. Please be sure to check applicable limitations online before you purchase your tickets. A shipping and handling fee will apply for all mail orders.

Identity Theft Package
Our combination of three powerful identity theft services gives you and any covered dependents protection to help detect identity fraud before it actually occurs, services to help you restore your identity if it is stolen and insurance coverage to help you with any costs associated with restoring your identity as a result of identity fraud. Identity Monitoring Through Identity Monitoring, activities associated with a person’s identity are monitored across multiple data sources to detect the type of fraudulent activity that takes place prior to the theft of any individual’s identity. Monitored data sources include: Credit Bureau Data DMV Records Bankruptcy Lien and Judgment Filings Utility Records Public Records Private Contributory Databases As identity fraud usually precedes identity theft, this type of proactive alert system is critical to mitigating the extensive and expensive damages perpetrated after an identity is stolen and manipulated. Identity Theft Resolution Program Identity Theft is a rapidly growing crime that can happen to you any time and any place, resulting in extensive damages that are very expensive and difficult to repair on your own. If you are an HCCUA Member and discover that you or a covered dependent are a victim of this crime; you have the peace of mind of knowing that there are ID Theft Specialists who treat every Identify Theft as an emergency and are always prepared to help you when you need it. Once you report an incident, qualified paralegals will: Consult with you to determine the severity of the theft Prepare and overnight a customized, pre-completed state specific “ID Recovery Kit™” Contact all three credit reporting agencies and obtain a free credit report Place fraud alerts on your credit records and obtain a list of creditors involved with the fraud Notify local authorities of the incident and help you obtain necessary reports Notify the appropriate bank or agency if other forms of identification (such as an ATM card, driver’s license, social security card, or passport) were stolen or are missing, so that appropriate action can be taken and new forms issued If your credit cards are misplaced or stolen, qualified paralegals will: Contact each credit card company while you are on the phone Cancel your affected credit cards Request new replacement cards Place fraud alerts with all three major credit bureaus Assist you with interpreting your credit reports Provide daily credit monitoring from all three bureaus for six months to help prevent any further fraud Identity Theft Insurance Each member will also receive up to $25,000 worth of insurance coverage* underwritten by a nationally recognized Insurance Carrier with an “A” or better AM Best Rating. This coverage will help members offset some of the costs of restoring their identity to its original status, including: Lost wages: $500.00 per week, for 4 weeks maximum Re-filing of loans Defense cost for certain civil law suits: Reasonable and necessary fees and expenses incurred in the United States by the insured with insurer’s consent for an attorney appointed by them for: (a)Defending any civil suit brought against the insured by a creditor, collection agency or other entity acting on behalf of a creditor for non- payment of goods or services or default on a loan solely as a result of a stolen identity event. (b) Removing any civil judgment wrongfully entered against the insured solely as a result of a stolen identity event. Reimbursement of fees: Reasonable and necessary costs incurred in the United States by the insured for: (a) Re-filing applications for loans, grants or other credit instruments that are rejected solely as a result of a stolen identity event. (b) Notarizing affidavits or other similar documents, long distance telephone calls and postage solely as a result of the insured’s efforts to report a stolen identity event and/or amend or rectify records as to the insured’s true name or identity as a result of a stolen identity event. (c) Up to six credit reports from established credit bureaus (with no more than two reports from any one credit bureau) dated within 12 months after the insured’s discovery of a stolen identity event. *Identity Theft Insurance not available in the state of New York

Pet Care Savings
HCCUA has partnered with Pet Assure® so you can start saving on your pet care needs immediately! Remember, your Pet Assure® Benefits cover all of the pets in your household. 10%-30% off on pet supplies and specialty items from thousands of participating merchants and service providers! 25% off all medical services each and every time you visit a participating veterinarian from Pet Assure’s® network!* Our Pet Club has participating practices in all 50 states, Washington DC, and Puerto Rico so you are protected right at home or while you are away. With Pet Club, you receive your discount right in the vets office. There are no hassles like claim forms or deductibles and remember, no pet will ever be excluded! You can enroll any pet, any age, and in any health condition even those with pre-existing conditions. Free enrollment in 24/7 Pet Assistance Locator Service (PALS Tag). This recovery service has reunited thousands of lost pets with their families. Anyone who finds your lost pet simply calls the 24/7 Pet Assistance Locator Service. We go right to work calling you at your home, office, cell phone and every other emergency contact you have provided until your pet is safely returned. Log in at the top of the page to access this benefit. *Food and flea products you take home, non-medical boarding and grooming, and any outside services (such as lab work) are at the veterinarian's discretion to discount or not, but may be available at a discount from another participating retailer.

Floral Savings
Looking for a great way to say “I Love You”, “Happy Anniversary”, “Happy Birthday” or “Just Because”? Save up to 25% on your purchase of flowers, gift baskets, balloon bouquets, plants and more! Take advantage of great floral savings at thousands of participating florists nationwide, including: 1-800-Flowers.com Blooms Today Florist.com Ftd.com Pro Flowers USAFlorist.com From You Flowers Hallmark Flowers & Gifts For instructions on how to access this benefit, please log in at the top of the page on HCCUA.ORG.

Local Services
Not enough hours in the day to get all of your errands done? We can assist in easing the pain by providing significant cost savings on a variety of local services that you use every day. From discounts on your health and beauty needs to major construction on your home and everything in between, we can be your source for savings.

Adult Wellness Testing (Not Available in HI,NY,NJ,RI)
Blood tests, as part of your annual "wellness" routine, can help spot a wide variety of health problems, and early detection and treatment can save money, prevent further health problems, and even save lives. Serious medical conditions such as Heart Disease, Cancer, Diabetes, Thyroid Disease and more can go undetected for 2 years or more without causing noticeable symptoms. So, every year, the Member and spouse (if applicable) can get a Comprehensive Wellness Profile through major clinical labs (such as Lab Corp) with no additional charge or co-payment. This includes more than 50 individual blood tests and provides a thorough biochemical assessment and results on all major organs of the body. The tests performed as part of the Comprehensive Wellness Profile include: Complete Blood Count (CBC) Thyroid Profile w/TSH Lipid Profile (cholesterol, HDL, LDL, the risk ratio, triglycerides) Liver Panel Kidney Panel Bone and Minerals Glucose (Diabetes) Fluids and Electrolytes

Health Advocacy Services
You now have your own advocate to help you and your whole family navigate the healthcare system! You get access to your own healthcare advocate who can help you and your whole family(including your spouse, dependants, parents, and in-laws) navigate the healthcare system and deal with the clinical and administrative issues you have to face to meet your medical, hospital, vision, dental, pharmacy and other healthcare needs. Clinical Services Finding top-rated doctors, hospitals, and medical institutions Helping with complex medical conditions Researching treatments and locating providers Assisting with obtaining second opinions Scheduling appointments with specialists Administrative Services Dealing with insurance companies Resolving insurance claim problems and disputes Helping you manage your healthcare costs Negotiating medical bill reductions Getting billing mistakes corrected Locating financial assistance programs Health Coaching Helping prepare patients for appointments Answering questions and providing information Aiding you in better understanding medical conditions Enabling you to become more active in your own healthcare Assisting with making arrangements for special needs Information & Service Support Assisting with in-home-care and eldercare issues and arrangements Providing information needed for making informed healthcare decision Helping you complete qualification applications Identifying, arranging and coordinating health and wellness services Help with arranging transportation service Locating support groups and educational services Thsi Healthcare Advocacy Service is FREE OF CHARGE for all members in our Complete Choice Enhanced and Easy Choice Progarms and is available for all other members for an additional $20 per month.

Financial Education & Credit Counseling
This benefit provides you and your family with personalized financial and credit counseling services 365 days per year! We provide access to counseling and financial education through a variety of delivery methods including telephone, online tools and live chat sessions.

Professional Tax Preparation, Advice & Audit Assistance
A comprehensive tax program providing free tax return preparation, deeply discounted tax schedule preparation and unlimited, toll-free, tax related advice during normal business hours. Unlimited personal and sole-proprietor small business federal taxation advice by toll–free phone/fax/email Free tax return preparation (1040EZ, 1040A, and 1040) and discounted preparation of from schedules* Review of prior year's tax return Member portal with information on tax tips, tax law changes, tax organization, IRS audits, IRS notifications,and on–line member advice IRS audit assistance Tax planning $25 discount on other tax services at all Jackson Hewitt locations This Tax preparation, advice & audit assistance service is FREE OF CHARGE for all members in our Complete Choice Enhanced Programs and is available for all other members for a one–time annual free of $120

Indiana Easy Choice Program Details
Easy Choice membership provides individuals and their families with all of the benefits of Basic Choice, along with additional telephonic visits, an annual comprehensive wellness panel, personal health advocate support, and a health discount program from OptumHealthâ„ Allies. Plus, Easy Choice includes accident medical expense benefits and a generic prescription drug plan!

Medical Care
Save on primary care and specialty practitioners (15-35%), physical therapy/rehabilitation (15-25%), diagnostics (20-60%), urgent care centers (5-20%), hospitals/outpatient surgery (5-20%) Hospital Discounts are not available in Maryland or other states where prohibited by law.

Dental
Save 10-35% on general dentistry, pediatric dentistry, orthodontics, periodontics, endodontics, prosthodontics, oral and maxillofacial surgery, and cosmetic dentistry.

Vision
Save on eye examinations (pay no more than $40 for an annual eye exam), eyeglass lenses (20%), frames (20%), patient options (tints, scratch resistant coatings, UV protection - 20-40%), mail order contacts (15%), laser vision correction (15% off standard pricing & 5% off promotional offers).

Alternative Care
Save 20% on acupuncture/acupressure, chiropractic, massage therapy, & naturopathy.

Advanced Studies

1100 - $1,000 max per calendar year
3300 - $1,000 max per Calendar Year
6600 - $2,000 max per Calendar Year
Angiogram/Arteriogram
1100 - $270/test
3300 - $400/test
6600 - $400/test
EEG
1100 - $50/test
3300 - $80/test
6600 - $80/test
Myelogram
1100 - $90/test
3300 - $130/test
6600 - $130/test
CT
1100 - $170/test
3300 - $260/test
6600 - $260/test
MRI Scans
1100 - $220/test
3300 - $330/test
6600 - $330/test
PET
1100 - $400/test
3300 - $600/test
6600 - $600/test

Surgery
And you also have benefits for inpatient and outpatient surgery as well as anesthesia coverage paid at schedule’s amounts for specific procedures up to:
1100 - $1,250 per person per calendar year / $1k surgery and $250 anesthesia
3300 - $3750 per person per calendar year / $3k surgery and $750 anesthesia
6600 - $7500 per person per calendar year/ $6k surgery and $1,500 anesthesia

Outpatient Diagnostic Benefits
Covers outpatient diagnostic tests including:
1100 - $1,200 total max per Calendar Year:
3300 - $1,305 total max per Calendar Year:
6600 - $2,610 total max per Calendar Year:
Lab Work/Blood Tests
1100 - $20 per visit 3 visits $60 max per Calendar Year
3300 - $35 per visit 3 visits $105 max per Calendar Year
6600 - $35 per visit 6 visits $210 max per Calendar Year
X-Rays
1100 - $70 per visit 2 visits $140 max per Calendar Year
3300 - $100 per visit 2 visits $200 max per Calendar Year
6600 - $100 per visit 4 visits $400 max per Calendar Year

Accidental Death & Dismemberment

1100 - $10,000 (loss of life)
3300 - $10,000 (loss of life)
6600 - $10,000 (loss of life)

Generic Prescription Drug Coverage
Limited to $200 per insured per month and $2,400 per insured per year.
1100 - Co-Pay: $15 or 50% whichever is greater $50 annual deductible
3300 - Co-Pay: $15 or 50% whichever is greater $50 annual deductible
6600 - Co-Pay: $15 or 50% whichever is greater $50 annual deductible

Hospitalization
Covers per diem hospitalization, covered at the indicated amount per day at the indicated maximum per person during each Calendar Year, including stays for:
1100 - $200 first day $100 each additional day Up to 10 days $1,100 max
3300 - $600 first day $300 each additional day Up to 10 days $3,300 max
6600 - $1,200 first day $600 each additional day Up to 10 days $6,600 max
Mental and Nervous Disorders
1100 - $50 per day 10 day max
3300 - $150 per day 10 day max
6600 - $300 per day 10 day max
Substance Abuse & Chemical Dependency
1100 - $50 per day 10 day max
3300 - $150 per day 10 day max
6600 - $300 per day 10 day max
Skilled Nursing Facility
1100 - $50 per day 10 day max
3300 - $150 per day 10 day max
6600 - $300 per day 10 day max

Accident Medical Expense
This benefit is underwritten by Guarantee Trust Life Insurance Company
1100 - $5,000 per incident
3300 - $5,000 per incident
6600 - $5,000 per incident

Durable Medical Equipment
Covers durable medical equipment such as: Canes Crutches Walkers Wheelchairs Respiratory Equipment Splints Nebulizers Neck Braces Slings Etc.
1100 - $50 per Calendar Year
3300 - $100 per Calendar Year
6600 - $100 per Calendar Year

Wellness Benefit
Covers routine exams and related lab and x-ray tests
1100 - $50 per visit $150 max per Calendar Year
3300 - $75 per visit $150 max per Calendar Year
6600 - $100 per visit $150 max per Calendar Year

Emergency Room
This benefit is payable in addition to other benefits which may apply as the result of an injury due to illness. Treatment must be performed within 72 hours of the accident.
1100 - $75 per visit $300 max per Calendar Year
3300 - $75 per visit $300 max per Calendar Year
6600 - $75 per visit $300 max per Calendar Year

Anesthesia
Covers anesthesia at 25% of amount paid by surgical coverage
1100 - Limited to $250 per surgery
3300 - Limited to $750 per surgery
6600 - Limited to $1,500 per surgery

Inpatient Miscellaneous Hospital Expense
Covers miscellaneous hospital expenses such as: Lab Work Blood Tests X-Rays Diagnostic Studies Medication Crutches Bandages Etc.
1100 - n/a
3300 - $75 per day 10 day max $750 max perCalendar Year
6600 - $150 per day 10 day max $1,500 max per Calendar Year

Outpatient Surgical Facility
pays amount shown if a Covered Person undergoes surgery in an outpatient facility at the direction of a doctor for a covered injury or sickness
1100 - n/a
3300 - $75 per surgery $150 max per Calendar Year
6600 - $150 per surgery $300 max per Calendar Year

Doctor’s Office Visits
Outpatient doctor’s office visits are covered at the indicated amount per visit at the indicated maximum per person during each Calendar Year
1100 - $60 per visit 5 visits $300 max
3300 - $75 per visit 4 visits $300 max
6600 - $75 per visit 4 visits $300 max

Roadside Assistance

A full-time, nationwide premium roadside assistance plan to give you peace of mind that is always just a toll-free phone call away, with coverage that includes:

Towing
Jump starts / flat tire changes
Lost key/lockout assistance
Fuel delivery
Minor on-site repairs
Legal defense reimbursement
Emergency trip interruption
Theft reward
Hit and run reward
Trip planning

24-Hour Toll-Free Dispatch Service

General Membership Emergency Road Service and Towing Benefit – up to $100
Premium Membership Emergency Road Service and Towing Benefit – up to $150

Dispatch service for:

On-site emergency road service such as jump starts, gas delivery and flat tire changes up to your benefit limit
Towing at no cost back to the service provider we send or to any destination you choose up to your benefit limit

Lock-Out Benefit

General Membership Lock-Out Benefit – up to $100
Premium Membership Lock-Out Benefit – up to $150

Trip Interruption

General Membership Trip Interruption – up to $750
Premium Membership Trip Interruption – up to $1,500

Vehicle Theft Reward

General Membership Vehicle Theft Reward Benefit – up to $5,000
Premium Membership Vehicle Theft Reward Benefit – up to $10,000

Hit-And-Run Reward

General Membership Hit-And-Run Reward Benefit – up to $5,000
Premium Membership Hit-And-Run Reward Benefit – up to $10,000

Reimbursement Legal Defense

General Membership Reimbursement Legal Defense Benefit – up to $750
Premium Membership Reimbursement Legal Defense Benefit – up to $1,500

The Legal Defense benefit provides payment for attorney fees – up to the benefit limit – to defend you in court if you are charged with certain moving violations of motor vehicle laws while driving an eligible vehicle. You may choose any attorney (other than yourself or a family member) to represent you. We cannot provide an attorney for you. For states other than New York, we will reimburse you up to the following benefit limits. For New York state residents, we must by law make the reimbursement payment directly to your attorney.

Offense or Action	General Benefit Limit	Premium Benefit Limit
A moving motor vehicle law violation*	$50	$75
Appeal of that offense	$50	$75
Reckless driving	$150	$200
Appeal of that offense	$150	$200
Manslaughter	$400	$550
Appeal of that offense	$350	$450

*Other than reckless driving and/or manslaughter

Personalized TRIP-PLAN Service
We’ll send you a personalized TRIP-PLAN package for any driving trip you may take in the U.S. and Canada. We’ll include route maps and information on points of interest, hotels/motels or even campground information (if you request it).

Dining Discounts

50% Savings

With more than 30,000 merchant locations offering up to 50% savings on dining, you are sure to find deals at your favorite local restaurants. Take the opportunity to explore some new taste treats. Feel like Italian tonight? You are covered. How about Asian? That, too. We have plenty of local restaurants available to our members. Pick your category, enter your location and print out your savings offer.

Ongoing 20% Savings

To make a good deal even better, many of our participating merchants also offer ongoing 20% savings. Find a restaurant you really like and go back again and again to receive up to 20% of your total bill, excluding tax, tip and alcohol. Simply take your membership card to the restaurant and save 20% every time!

Discounts cannot be used on major holidays, such as Christmas Eve/Day, New Years Eve/Day, Valentine’s Day, Easter, etc. Discounts may not be used in conjunction with other promotions or offers and awards programs. Offer valid through expiration date printed on your coupon obtained online.

Events and Attractions
Members can save on a wide variety of activities while on vacation! Whether its golfing, bowling, live events, or museums there is something fun for everyone to enjoy. You can also enjoy discounted rates on special events, sporting events, and several amusement parks including Universal Orlando Resort and great savings at Planet Hollywood!

Condo Vacations

Enjoy the comforts of home at resort destinations within the US or around the world! Enjoy great savings on condominiums. As a member, you can stay in beautiful one and two bedroom or studio condominiums at resorts in locations like Orlando, Ft. Lauderdale, Palm Springs, Hilton Head, Virginia Beach, St. Lucia, Mexico and many more. Members enjoy preferred rates through several of the nations largest resort rental companies like Florida Vacation Station, CondoDirect and Westgate Resorts.

Hotel Discounts

Save at thousands of hotels in popular destinations worldwide. Enjoy access to savings at participating hotels such as Radisson, Sheraton, Days Inn, OMNI, Quality, Best Western and many more!

Members may access all three Hotel Programs (see below for information on Hotel Chain Savings Program, Direct to Hotel Savings Program, and Guaranteed Best Rate Program). Each program has unique guidelines to follow. Hotel Program details are:

Hotel Chain Savings Program

Members can save up to 20% at participating hotels at popular hotel chains by calling the toll-free number as listed and providing the agent with the ID code as indicated. Advance reservations are required. Discounts vary by chain. Blackout dates and other restrictions may apply. At check-in, no card is required, just the confirmation number given at time of booking. Instructions on how to find participating hotel chains can be found by logging in at the top of this page.

Direct to Hotel Savings Program

Members receive up to 50% savings off the rack rate at over 4,000 participating hotels worldwide. Members can find participating hotels by logging in at the top of this page. Members should call the telephone number noted for the hotel listing on the website in advance, and identify him/herself as an Entertainment Member when requesting the Entertainment rate. Note: Some restrictions may apply. Discounts are based on Program room availability - if traveling during peak season, holiday weeks or special events, the discount may not be available every night of your stay. Only one room can be discounted per membership card and the card is non-transferable. At check-in, members need to present their membership card with the Entertainment logo along with their confirmation number.

Guaranteed Best Rate Program

Members receive the guaranteed best rate, plus they may qualify for a rebate of $100-$200. The rebate is based upon the number of consecutive nights, with a minimum of two (2) nights and only available for those who pay in full at the time of booking. The Rate is guaranteed at the time of reservation to be the best rate for the room type at the same hotel on the dates booked. The network of hotels participating consists of 35,000 hotels worldwide. Rooms are subject to availability.

Car Rental Discounts
When you travel, you can access great savings with the most trusted names in the car rental business. Members enjoy savings of 5-25% on car and RV rentals. They may take advantage of savings through Alamo, Avis, Budget, National, Hertz and Enterprise. Save on rates from economy size all the way up to the finest luxury vehicles.

Nationwide Shopping

Members can access direct discount savings on thousands of local and national retailers throughout the country. Savings for everything from apparel and electronics to toys and office supplies all at top merchant names are available at your fingertips. It's as simple as printing out the offer and bringing it on your next trip to the store. Or, just click-through to purchase online!

Online Shopping

Members will have access to hundreds of offers in our Top Web Deals category, which allows you to save time and money on great national online retailers. For more details on how to use and access your benefits, members may simply follow the link at the bottom of this page. Simply select Shopping or Top Web Deals and start saving!

Recreational Activities

Members and their families can enjoy great discounts on recreational activities, including a visit to the museum or attendance at live events, such as sporting events.

If you would rather participate, then we have great discounts for you, too! Local offers include, but are not limited to, bowling, laser tag, miniature golf, ice skating, roller skating and many more. All are easy to access through the member search.

In addition, Members can also access significant savings at golf courses and movie theaters.

Golfing Discounts
Members can save up to 50% on some of the country’s top golf courses. Whether traveling across the country for a golf weekend escape or playing nine holes at a local course, we have your golf needs covered. Sample savings include: 2-for-1 Green Fees; 2-for-1 Bucket of Balls; 50% Off Discount; and Ongoing 20% off Savings! Log in to access your golf discounts today.

Movie Discounts

You can enjoy discounted movie tickets at major movie theater chains throughout the country. Simply search for the available theater of your choice, you can access printable, box office redemption discounts, as well as tickets that can be ordered by mail. If you prefer to stay home, as a member you'll have access to discounts at local movie rental locations. (Movie rental discounts can be found under the Shopping category)

Terms: Certain Terms and Conditions may apply to specific theaters. Please be sure to check applicable limitations online before you purchase your tickets. A shipping and handling fee will apply for all mail orders.

Doctor & Therapist Visits By Email Or Phone

The Doctor will see you now!
MDLiveCare is the newest and most advanced healthcare delivery system in America, providing members with phone and e-mail access to board-certified physicians 24 hours a day, 7 days a week, 365 days a year. Individuals and families can connect instantly with a network of U.S. based, state-licensed, physicians for information, diagnoses, and treatment recommendations. Physicians may also prescribe medication when appropriate for common, non-emergency conditions. MDLiveCare redefines traditional healthcare delivery by harnessing the power of digital telephony and the Internet. The result: Americans nationwide can now experience real-time, quality physician care – anytime, anywhere, and for anyone.

Physician inquiries are UNLIMITED and FREE OF CHARGE for all HCCUA Members!

Unless otherwise noted, members will receive two annual doctor consultations free of charge, and can purchase additional consultations for $35 each.

For Members in our Complete Choice Enhanced 3300 and 6600 Programs, doctor consultations are unlimited and free of charge.

For Members in our Easy Choice Program, the number of free consultations depends on the plan type:

Individual	4 free consultations
Single Parent or Couple	8 free consultations
Family	12 free consultations

Why use MDLiveCare?

On-demand healthcare - Wherever and whenever you need, as often as you need. 24/7/365 Access.
Save Money - Save hundreds or thousands of dollars by avoiding unnecessary doctors' office or ER visits.
Save time - Avoid waiting for an appointment or sitting in the doctor's office.
Our network of physicians - U.S. based, licensed, board-certified, and experienced.

When to use MDLiveCare

Your Primary Care physician is not available
Requesting prescription medication or a refill*
After normal business hours, nights, weekends
For non-emergency medical issues & questions
Traveling and need medical advice

Using MDLiveCare
You can talk to a doctor over the phone or ask questions and get advice privately using secure E-mail.

Common Conditions we Treat

Acid reflux
Acne
Allergies
Asthma
Birth control
Family planning
Bladder infection
Bronchitis
Cellulites
Cold & Flu
Congestive heart failure
Constipation
Diarrhea
Diabetes
Erectile dysfunction
Gout
Hair Loss

Headache
Heart problems
Heartburn
Hemorrhoids
High blood pressure
Infections
Joint ache & pains
Nausea
Pneumonia (mild)
Rashes
Shingles
Sinus conditions
Sore throat
Stable herpes
Thyroid conditions
Urinary tract infection
Yeast infection

Pediatric Care (Ages 2yrs and up)
- Cold & Flu
- Constipation
- Ear infection
- Fever
- Nausea
- Pink eye
- Stomach viruses
- Vomiting

Mental Health
- Anxiety
- Addictions
- Depression
- Marriage and Family
- Eating Disorders
- Life Coaching
- Substance Abuse
- Smoking Cessation

Prescriptions
MDLiveCare is integrated with SureScripts for the delivery of electronic prescriptions to the pharmacy of your choice. With over 57,000 pharmacies to choose, your prescriptions are sent instantly to the pharmacy of your choice as soon as your consultation is over. If for any reason your pharmacy is unable to receive e-prescriptions, a traditional prescription is generated for our physicians to sign and fax. The prescription is fully compliant and includes all required information.

Prescription Policy
Physicians providing consultations for MDLiveCare members offer prescriptions for a wide range of products that deliver direct medicinal value. These include, but are not limited to, drug classes such as antibiotics and antihistamines. Convenience prescriptions for maintenance medicines may also be obtained in cases where a member is in transition to a new insurance plan or doctor.

It is important to note that MDLiveCare is not a drug fulfillment warehouse. Prescriptions will only be issued when indicated and approved by a physician. In the event a physician does prescribe medication, he/she will usually limit the supply to no more than thirty days. Patients with chronic illnesses should visit their primary care physicians or other specialists for extended care. MDLiveCare physicians do not issue prescriptions for substances controlled by the DEA, for non-therapeutic use, and/or those which may be harmful (potential for abuse or addiction). For a current list of DEA controlled substances, visit: http://www.deadiversion.usdoj.gov/schedules

Prescribed Diagnostic Tests
Your physician might request tests to assist with your healthcare. Diagnostic tests help physicians detect diseases earlier, prescribe therapies, and monitor results. MDLiveCare has a strategic alliance with LabCorp to provide this service. Choose from over 2,000 locations nationwide at your convenience.

LabCorp provides leading-edge medical laboratory tests and services through a national network of primary clinical laboratories and specialized Centers of Excellence.Important Notice: MDLiveCare is not health insurance and does not replace your primary care physician. MDLiveCare physicians do not prescribe controlled medications. If you have an emergency, please dial 911. All our services are HIPAA-Compliant.

Legal Care Solution

HCCUA has selected Legal Club of America® Corporation to provide its members with the most comprehensive discount legal care solution for individuals and their eligible family members. Members have unlimited access to a proprietary network of plan attorneys in all 50 states. These attorneys have contracted with Legal Club to provide members with free and discounted legal care.

Free Legal Referral Services:

The following nine (9) services are available at no charge from your plan attorney:

Initial phone and face-to-face consultations for each new legal matter (no time limit)
Review of independent legal documents (6 page maximum per document, no limit to the number of new independent documents)
Plan attorneys will prepare a free Simple Will for you and your family, and update the Will annually
A state specific, web based, free Living Will form is available to Members. This form can be completed by a plan attorney for free
Plan attorneys will help Members represent themselves in small claims court
Assistance in solving problems with government programs, such as INS and welfare
When deemed appropriate by your plan attorney, he or she will write initial letters on your behalf (one letter per legal matter, with no limit on the number of new legal matters)
When deemed appropriate by your plan attorney, he or she will make initial phone calls on your behalf (one call per legal matter, with no limit on the number of new legal matters)

Deeply Discounted Legal Referral Services :

The following are eight (8) commonly used legal services for which plan attorneys have agreed to charge a one-time, deeply discounted fee (Court costs and filing fees are additional):

Legal Services	Member Rate	Non-Member Rate
Traffic Ticket Defense	$89.00	$199.00
Name Change	$155.00	$365.00
Simple Will with Minors Trust	$250.00	$530.00
Chapter 7 Bankruptcy	$750.00	$1,500.00
Non-Support (Spouse/Child)	$275.00	$1,490.00
Simple Divorce	$275.00	$1,100.00
Regular Incorporation	$295.00	$585.00
Personal Real Estate Closing	$250.00	$675.00

Guaranteed Low Hourly Rate: After the free letters, calls, and consultations take place, members and their attorneys will have to decide what course of action to take next. In some cases, members will have no choice and litigation will ensue. This is when Legal Club plan attorneys charge a capped hourly rate. Plan attorneys will either charge $125.00 per hour, or when appropriate, give members a 40% discount off their usual and customary hourly rate.

Retainers: In the case of extended legal care, plan attorneys may ask you for a retainer. Any retainer sought will be computed by multiplying the number of hours a plan attorney believes a case will take, by the appropriate discounted hourly plan rate. Any unused portion of the retainer will be returned to you.

Contingency Fee Discounts: The contingency fee discount will be a 10% reduction of the state maximum rate or the attorney’s usual rate, whichever is lower.

Definitions

“Bankruptcy Chapter 7” includes preparation of the petition, documents, and schedules. Filing fees, court appearances and costs are additional. Attorneys may charge one fixed rate, which would include the basic fixed fee plus costs, court time, and expenses.

“Divorce (Simple)” is when the plan member’s spouse is not represented by separate counsel, there are no minor children under age 18, marital assets are less than $70,000, and all issues are agreed to without aid of counsel. This does not include court appearances, the filing or preparation of documents affecting property or costs, or separation agreements.

“Incorporation (Regular)” includes preparation of the incorporation documents, (articles of incorporation, by laws, and the minutes). This does not include filing fees, costs, or the corporate kit. Any extended work for the new corporation is not eligible for family plan discounts. Not-for-profit organizations, LLC’s and LLP’s are not included in this definition. Plan attorneys can assist members choosing to set these entities up at the reduced hourly rate of $125.00 or, when appropriate, 40% of their usual and customary hourly rate.

“Name Change Plan” attorneys will assist you and your family in obtaining a name change when it is not contested or challenged by another party. This includes preparation of the petition, attendance at the hearing, and preparation and review of the final judgment document. This fee does not include additional court appearances, filing fees, or the attorneys travel time to and from the courthouse.

“Non-Support (Spouse/Child)” The discounted fee for you and your family includes the preparation for and the attendance at a single hearing for judgments or contempt citations for non-payment of alimony and child support maintenance. Additionally, the plan attorney will provide one hour of collection efforts after the hearing, which may include an initial phone call made and/or a collection letter written on the member’s behalf. Preparation does not include obtaining discovery evidence, extended court time, and extended collections work. All extended legal care will be provided at the deeply discounted rate of $125.00 or, when appropriate, 40% of their usual and customary hourly rate.

“Plan/Participating Attorneys” are licensed and qualified to practice law in your state, are required by the company to maintain professional liability insurance, and have contracted with Legal Club of America® to provide legal services to plan members for the law areas that they handle and the cases that they accept.

“Residential Real Estate Closing” The discounted fee for a residential real estate closing includes a free initial consultation and the review of the member’s purchase or sales agreement. Additionally, the plan attorney will provide one hour of representation at the closing for the purchase or sale of residential real estate. Additional hours will be billed at the low hourly rate of $125.00 or, when appropriate, 40% of their usual and customary hourly rate. All research including Title insurance, liens, deeds, property judgments, flood, hazard, or mortgage insurance, and fees associated with filing real estate documents in your state are not included in the definition or covered by this discounted rate. Additional work will always be done at the deeply discounted rate of $125.00 or, when appropriate, 40% of their usual and customary hourly rate.

“Simple Will (No Charge Will)” A will distributing personal property, not involving trusts, specific bequests, real estate, tax matters, guardianships, living wills, health care proxies or partitions.

“Simple Will with Minor’s Trust” The discounted fee includes the preparation of a simple will with a minor’s trust for the surviving minor children of the plan member. This document will contain information related to minor children (specifically: name, DOB, SS#), real estate, specific bequests, and information pertaining to the appointed guardian of the estate of our member. This fee does not cover extensive information regarding retirement plans, investments and their tax treatment, other kinds of trusts, complex tax matters, or estate planning. Counsel for these additional areas of law will be provided at the deeply discounted rate of $125.00 or, when appropriate, 40% of their usual and customary hourly rate.

“Traffic Defense” The discounted fee applies to first time non-criminal traffic infractions including but not limited to: violation of traffic control device, failure to stop at a stop sign, improper change of lane, illegal turns, improper or unsafe equipment, expired tag, no proof of insurance, unlawful speed, improper passing, failure to use turn signal, failure to yield the right of way, and safety belt violations. The special privileged rate applies to each individual non-criminal traffic infraction. The discounted fee includes the preparation of any necessary court documents and attendance at a single court hearing to settle a single, first time, misdemeanor traffic infraction. The discounted fee does not include court costs, fines imposed by the presiding judge, additional scheduled hearings or other traffic matters that the court deems to be criminal in nature.

Miscellaneous Information

Participating attorneys are bound by their state’s professional code of ethics. They will advise you if they have a conflict of interest in taking your case. Plan attorneys have the inherent right to decline a case if in their professional opinion they believe it is the right thing to do. If this occurs, you may be referred to another attorney on the plan by calling Legal Club’s Member Services Department for assistance.
Attorney fees are paid directly to your plan attorney. Participating attorneys are not employees of Legal Club of America® and have no financial obligation to the company.
Legal Club of America® and Legal Care Direct™ are not liable to indemnify or reimburse any plan member or participating attorney for any attorney fees or costs generated by the plan member.
Legal Club of America® and Legal Club Financial, its subsidiaries, State Bar Associations, and other regulatory agencies do not guarantee the quality or quantity of legal services that are provided by plan attorneys. However, all participating attorneys are required to provide certificates of liability insurance, and background checks are performed, not less than annually, to verify that they are in good standing.
The plan attorneys in their attorney/client relationship have the sole responsibility for providing legal services to the plan member.
Legal Club Financial is not a law firm, insurance carrier or a provider of legal services.
The term “guarantee” as used in this guidebook refers to the guarantee that Legal Club will use its best effort to locate and refer its members to an attorney that will abide by the fee schedule outlined herein. If Legal Club can not find such an attorney for a member, the member’s only recourse is a refund of the most recent month’s membership fee.
Court filing fees, expert witness fees, court costs, court reporter fees, transcript expenses, photocopying costs, postage, telephone toll charges and any other incidental expenses incurred by the plan member are excluded from discounted rates under any of the pricing formulas described herein.

Exclusions

The following matters are excluded from your plan privileges:

Legal matters involving the laws of jurisdictions outside the United States or its subdivisions.
Legal matters where the plan member has already retained participating counsel at their usual rates prior to enrollment in the Legal Club.
Frivolous legal matters as determined by the plan attorney in accordance with the professional code of ethics in their state.
Any action involving Legal Club of America®, Legal Care Direct™, Legal Club Financial, plan attorneys, affiliated companies or any of their company’s or affiliated company’s directors, officers, employees or agents in any matter in which they have interests adverse to the plan member’s.
Legal matters against the plan sponsor, employer, directors, officers, agents, or employees, where Legal Care Direct™ membership was gained through the sponsor or employer’s efforts.
In matters where the plan member and eligible family member have adverse interests, only the original plan member is eligible for plan discounts and not the family member unless both parties provide written authorization and consent otherwise

Identity Theft Package

Our combination of three powerful identity theft services gives you and any covered dependents protection to help detect identity fraud before it actually occurs, services to help you restore your identity if it is stolen and insurance coverage to help you with any costs associated with restoring your identity as a result of identity fraud.

Identity Monitoring

Through Identity Monitoring, activities associated with a person’s identity are monitored across multiple data sources to detect the type of fraudulent activity that takes place prior to the theft of any individual’s identity.

Monitored data sources include:

Credit Bureau Data
DMV Records
Bankruptcy Lien and Judgment Filings
Utility Records
Public Records
Private Contributory Databases

As identity fraud usually precedes identity theft, this type of proactive alert system is critical to mitigating the extensive and expensive damages perpetrated after an identity is stolen and manipulated.

Identity Theft Resolution Program

Identity Theft is a rapidly growing crime that can happen to you any time and any place, resulting in extensive damages that are very expensive and difficult to repair on your own. If you are an HCCUA Member and discover that you or a covered dependent are a victim of this crime; you have the peace of mind of knowing that there are ID Theft Specialists who treat every Identify Theft as an emergency and are always prepared to help you when you need it.

Once you report an incident, qualified paralegals will:

Consult with you to determine the severity of the theft
Prepare and overnight a customized, pre-completed state specific “ID Recovery Kit™”
Contact all three credit reporting agencies and obtain a free credit report
Place fraud alerts on your credit records and obtain a list of creditors involved with the fraud
Notify local authorities of the incident and help you obtain necessary reports
Notify the appropriate bank or agency if other forms of identification (such as an ATM card, driver’s license, social security card, or passport) were stolen or are missing, so that appropriate action can be taken and new forms issued

If your credit cards are misplaced or stolen, qualified paralegals will:

Contact each credit card company while you are on the phone
Cancel your affected credit cards
Request new replacement cards
Place fraud alerts with all three major credit bureaus
Assist you with interpreting your credit reports
Provide daily credit monitoring from all three bureaus for six months to help prevent any further fraud

Identity Theft Insurance

Each member will also receive up to $25,000 worth of insurance coverage* underwritten by a nationally recognized Insurance Carrier with an “A” or better AM Best Rating. This coverage will help members offset some of the costs of restoring their identity to its original status, including:

Lost wages: $500.00 per week, for 4 weeks maximum
Re-filing of loans
Defense cost for certain civil law suits: Reasonable and necessary fees and expenses incurred in the United States by the insured with insurer’s consent for an attorney appointed by them for:

(a)Defending any civil suit brought against the insured by a creditor, collection agency or other entity acting on behalf of a creditor for non- payment of goods or services or default on a loan solely as a result of a stolen identity event.
(b) Removing any civil judgment wrongfully entered against the insured solely as a result of a stolen identity event.

Reimbursement of fees: Reasonable and necessary costs incurred in the United States by the insured for:

(a) Re-filing applications for loans, grants or other credit instruments that are rejected solely as a result of a stolen identity event.
(b) Notarizing affidavits or other similar documents, long distance telephone calls and postage solely as a result of the insured’s efforts to report a stolen identity event and/or amend or rectify records as to the insured’s true name or identity as a result of a stolen identity event.
(c) Up to six credit reports from established credit bureaus (with no more than two reports from any one credit bureau) dated within 12 months after the insured’s discovery of a stolen identity event.

*Identity Theft Insurance not available in the state of New York

Pet Care Savings

HCCUA has partnered with Pet Assure® so you can start saving on your pet care needs immediately! Remember, your Pet Assure® Benefits cover all of the pets in your household.

10%-30% off on pet supplies and specialty items from thousands of participating merchants and service providers!

25% off all medical services each and every time you visit a participating veterinarian from Pet Assure’s® network!* Our Pet Club has participating practices in all 50 states, Washington DC, and Puerto Rico so you are protected right at home or while you are away. With Pet Club, you receive your discount right in the vets office. There are no hassles like claim forms or deductibles and remember, no pet will ever be excluded! You can enroll any pet, any age, and in any health condition even those with pre-existing conditions.

Free enrollment in 24/7 Pet Assistance Locator Service (PALS Tag). This recovery service has reunited thousands of lost pets with their families. Anyone who finds your lost pet simply calls the 24/7 Pet Assistance Locator Service. We go right to work calling you at your home, office, cell phone and every other emergency contact you have provided until your pet is safely returned.

Log in at the top of the page to access this benefit.

*Food and flea products you take home, non-medical boarding and grooming, and any outside services (such as lab work) are at the veterinarian's discretion to discount or not, but may be available at a discount from another participating retailer.

Floral Savings

Looking for a great way to say “I Love You”, “Happy Anniversary”, “Happy Birthday” or “Just Because”? Save up to 25% on your purchase of flowers, gift baskets, balloon bouquets, plants and more! Take advantage of great floral savings at thousands of participating florists nationwide, including:

1-800-Flowers.com
Blooms Today
Florist.com
Ftd.com
Pro Flowers
USAFlorist.com
From You Flowers
Hallmark Flowers & Gifts

For instructions on how to access this benefit, please log in at the top of the page on HCCUA.ORG.

Local Services
Not enough hours in the day to get all of your errands done? We can assist in easing the pain by providing significant cost savings on a variety of local services that you use every day. From discounts on your health and beauty needs to major construction on your home and everything in between, we can be your source for savings.

Adult Wellness Testing (Not Available in HI,NY,NJ,RI)

Blood tests, as part of your annual "wellness" routine, can help spot a wide variety of health problems, and early detection and treatment can save money, prevent further health problems, and even save lives. Serious medical conditions such as Heart Disease, Cancer, Diabetes, Thyroid Disease and more can go undetected for 2 years or more without causing noticeable symptoms. So, every year, the Member and spouse (if applicable) can get a Comprehensive Wellness Profile through major clinical labs (such as Lab Corp) with no additional charge or co-payment. This includes more than 50 individual blood tests and provides a thorough biochemical assessment and results on all major organs of the body.

The tests performed as part of the Comprehensive Wellness Profile include:

Complete Blood Count (CBC)
Thyroid Profile w/TSH
Lipid Profile (cholesterol, HDL, LDL, the risk ratio, triglycerides)
Liver Panel
Kidney Panel
Bone and Minerals
Glucose (Diabetes)
Fluids and Electrolytes

Health Advocacy Services

You now have your own advocate to help you and your whole family navigate the healthcare system!

You get access to your own healthcare advocate who can help you and your whole family(including your spouse, dependants, parents, and in-laws) navigate the healthcare system and deal with the clinical and administrative issues you have to face to meet your medical, hospital, vision, dental, pharmacy and other healthcare needs.

Finding top-rated doctors, hospitals, and medical institutions
Helping with complex medical conditions
Researching treatments and locating providers
Assisting with obtaining second opinions
Scheduling appointments with specialists

Dealing with insurance companies
Resolving insurance claim problems and disputes
Helping you manage your healthcare costs
Negotiating medical bill reductions
Getting billing mistakes corrected
Locating financial assistance programs

Helping prepare patients for appointments
Answering questions and providing information
Aiding you in better understanding medical conditions
Enabling you to become more active in your own healthcare
Assisting with making arrangements for special needs

Assisting with in-home-care and eldercare issues and arrangements
Providing information needed for making informed healthcare decision
Helping you complete qualification applications
Identifying, arranging and coordinating health and wellness services
Help with arranging transportation service
Locating support groups and educational services

Thsi Healthcare Advocacy Service is FREE OF CHARGE for all members in our Complete Choice Enhanced and Easy Choice Progarms and is available for all other members for an additional $20 per month.

Financial Education & Credit Counseling
This benefit provides you and your family with personalized financial and credit counseling services 365 days per year! We provide access to counseling and financial education through a variety of delivery methods including telephone, online tools and live chat sessions.

Professional Tax Preparation, Advice & Audit Assistance

A comprehensive tax program providing free tax return preparation, deeply discounted tax schedule preparation and unlimited, toll-free, tax related advice during normal business hours.

Unlimited personal and sole-proprietor small business federal taxation advice by toll–free phone/fax/email
Free tax return preparation (1040EZ, 1040A, and 1040) and discounted preparation of from schedules*
Review of prior year's tax return
Member portal with information on tax tips, tax law changes, tax organization, IRS audits, IRS notifications,and on–line member advice
IRS audit assistance
Tax planning
$25 discount on other tax services at all Jackson Hewitt locations

This Tax preparation, advice & audit assistance service is FREE OF CHARGE for all members in our Complete Choice Enhanced Programs and is available for all other members for a one–time annual free of $120

Premium Roadside Assistance

A full-time, nationwide premium roadside assistance plan to give you peace of mind that is always just a toll-free phone call away, with coverage that includes:

Towing
Jump starts / flat tire changes
Lost key/lockout assistance
Fuel delivery
Minor on-site repairs
Legal defense reimbursement
Emergency trip interruption
Theft reward
Hit and run reward
Trip planning

24-Hour Toll-Free Dispatch Service

General Membership Emergency Road Service and Towing Benefit – up to $100
Premium Membership Emergency Road Service and Towing Benefit – up to $150

Dispatch service for:

On-site emergency road service such as jump starts, gas delivery and flat tire changes up to your benefit limit
Towing at no cost back to the service provider we send or to any destination you choose up to your benefit limit

Lock-Out Benefit

General Membership Lock-Out Benefit – up to $100
Premium Membership Lock-Out Benefit – up to $150

Trip Interruption

General Membership Trip Interruption – up to $750
Premium Membership Trip Interruption – up to $1,500

Vehicle Theft Reward

General Membership Vehicle Theft Reward Benefit – up to $5,000
Premium Membership Vehicle Theft Reward Benefit – up to $10,000

Hit-And-Run Reward

General Membership Hit-And-Run Reward Benefit – up to $5,000
Premium Membership Hit-And-Run Reward Benefit – up to $10,000

Reimbursement Legal Defense

General Membership Reimbursement Legal Defense Benefit – up to $750
Premium Membership Reimbursement Legal Defense Benefit – up to $1,500

The Legal Defense benefit provides payment for attorney fees – up to the benefit limit – to defend you in court if you are charged with certain moving violations of motor vehicle laws while driving an eligible vehicle. You may choose any attorney (other than yourself or a family member) to represent you. We cannot provide an attorney for you. For states other than New York, we will reimburse you up to the following benefit limits. For New York state residents, we must by law make the reimbursement payment directly to your attorney.

Offense or Action	General Benefit Limit	Premium Benefit Limit
A moving motor vehicle law violation*	$50	$75
Appeal of that offense	$50	$75
Reckless driving	$150	$200
Appeal of that offense	$150	$200
Manslaughter	$400	$550
Appeal of that offense	$350	$450

*Other than reckless driving and/or manslaughter

Personalized TRIP-PLAN Service
We’ll send you a personalized TRIP-PLAN package for any driving trip you may take in the U.S. and Canada. We’ll include route maps and information on points of interest, hotels/motels or even campground information (if you request it).

Hospital Stay

Reasonable and Customary Charges made by the Hospital for each day a Covered Person is Hospital Confined. Such charges will include:

(a) Room ccommodations (up to the average semi-private room rate). The average semi-private room rate includes any seperate charges such as room, nursing services, maintenance, utilities and similar items. If a Hospital has only private rooms, eligigble charges will be limited to 90% of the private room charge.

(b) Charges for an Intensive Care Unit, Coronary Care Unit and Neonatal Intensive Care Unit confinement up to three times the average semi-private room rate.

(c) Hospital charges for miscellaneous medical services and supplies that are necessary for the treatment of the Covered Person while Hospital Confined. These charges include: operating room, recovery room, anasthesia, surgical dressings, central supplies, casts and splints, Medicines or Drugs, x-ray photographs, laboratory service and oxygen, equipment and services, blood plasma, whole blood and blood derivatives. All charges must be incurred while a Covered Person is Hospital Confined. Eligible charges do not include: charges for take-home Medicines or Drugs (unless otherwise specifically provided by the Group Policy), personal and convenience items, or items that are not intended for use while Hospital Confined.

Surgery

Reasonable and Customary Charges by a Doctor for the primary surgery performed on a Covered Person while Hospital Confined or in a Same Day Surgery Facility.

This benefit includes routine care after the surgery. ANTEX will pay other surgical procedures, done during this same session, at 50% of the Reasonable and Customary allowance.

A surgical procedure involving TMJ (Temporomandibular Joint Disorder) is limited to a Lifetime Maximum of $2,500 per Covered Person.

Assistant Surgeon

Reasonable and Customary Charges for surgical assistance performed on a Covered Person while Hospital Confined or in a Same Day Surgery Facility.

Eligible Assistant Surgeon expense is limited to 25% of the eligible charges allowance for the primary surgeon, when the assistance is rendered by a Doctor.

This benefit reduces to 20% when a Physician Assistant assists and to 15% if the assistance is by a Registered Nurse.

Second Surgical Opinion
Reasonable and Customary Charges for a Doctor providing a second surgical opinion regarding the advisability of surgery. If the initial and second surgical opinions conflict, ANTEX will pay benefits for a third surgical opinion. ANTEX does not subject charges for a second and third opinion to the Deductible Amount.

Anesthesia And Administration

Reasonable and Customary Charges by an anesthesiologist for the administration of anesthesia to a Covered Person who is undergoing surgery while Hospital Confined or in a Same Day Surgery Facility.

The anesthesiologist must be at the operation solely to render the anesthesia service. ANTEX will reduce eligible benefits by 50% if a nurse anesthetist, operating surgeon or assistant surgeon administers the anesthesia and any incidental fluids as part of a covered surgical procedure.

Charges include the reasonable cost of hospitalization and general anesthesia in order for a Covered Person to safely receive dental care if he or she is under 8 years of age or is developmentally disabled. This benefit does not apply to treatment rendered for temporal mandibular joint disorders (TMJ).

Doctor's Visits
Reasonable and Customary Charges by the primary attending Doctor for one visit per day while Hospital Confined.

Pathology
Reasonable and Customary Charges by a pathologist for the interpretation of diagnostic tests or studies while Hospital Confined or in a Same Day Surgery Facility.

Physiotherapy
Reasonable and Customary Charges for physical, speech or inhalation therapist services while Hospital Confined or in a Same Day Surgery Facility.

Post Confinement Therapy

Reasonable and Customary charges that a Hospital, or Hospital- based clinic, bills for the services and supplies it furnishes to a Covered Person who is not Hospital Confined.

The Covered Person must require Post Confinement Therapy for a Sickness or Injury that caused a Hospital Stay, or following surgery performed in a Hospital or Same Day Surgery Facility, that is normally covered by the Group Policy.

The following types of Therapy are eligible under this provision: Radiation therapy, including treatment planning; Chemotherapy, including treatment planning; Physical therapy; Speech therapy; and Occupational therapy.

Radiology
Reasonable and Customary Charges by a radiologist for the interpretation of diagnostic tests or studies while Hospital Confined or in a Same Day Surgery Facility.

Same Day Surgery Facility

Reasonable and Customary Charges for care received in a Same Day Surgery Facility.

Eligible charges will be the fees for the use of the facility and other miscellaneous charges made by the facility.

If the Covered Person stays in the Ambulatory Surgical Center for 18 or more hours, ANTEX will pay eligible charges up to the average semi-private room rate for the use of the facility.

The semi-private room rate will be consistent with Hospital charges in the area where the Ambulatory Surgical Center is located.

Organ Transplants

Maximum Benefit for Organ Transplants per Covered Person is $1,000,000.

The organ being transplanted must be the organ of primary disease and must be one of the following organs: heart, lung, liver, cornea, pancreas, kidney or bone marrow and/or stem cells harvested from bone marrow or peripheral blood.

(Stem cell or bone marrow transplants do not have to be the organ of primary disease).

We will pay benefits for the Eligible Expenses that result from charges related to, caused by, contributed to or resulting from an Organ Transplant. The Covered Person must incur the charges during the Transplant Period.

We will not pay for charges the Covered Person incurs outside the Transplant Period, except for anti-rejection Drug charges.

We will pay donor benefits: (a) Up to $15,000 in eligible charges; and (b) When You or a Covered Person is legally responsible for the charges.

Transplant Centers

We have contracted with certain specified transplant centers to provide Organ Transplants at a negotiated rate.

If a Covered Person utilizes a specified transplant center, ANTEX will waive the $1,000,000 Maximum Benefit for an Organ Transplant and the charges will instead be applied towards the Group Policy Maximum.

All other provisions of the Group Policy will continue to apply. You or a Covered Person may send a written request to ANTEX’s Case Management Department for a copy of the maximums.

Hospice Care Benefit

Reasonable and Customary Charges for Hospice Care provided by a Hospice agency up to the Maximum Benefit for Hospice Care shown in the Certificate Schedule.

We will not pay benefits under this provision and under another benefit provision of the Group Policy.

We only pay benefits for Hospice Care when: (a) The Hospice Care is provided to reduce or abate pain and not for cure; and (b) The Covered Person’s Doctor certifies that the Covered Person’s life expectancy is less than six months.

Mammogram
Reasonable and Customary Charges in excess of $25 for one annual screening mammogram per Calendar Year. We pay the benefit whether or not the Covered Person is Hospital Confined. We do not apply charges to the Deductible Amount or to any Co-Insurance Amount that is less than 100%.

Home Health Care

Reasonable and Customary Charges for Home Health Care up to $40 per visit.

There is a limit of one visit per day and 60 Home Health Care visits in each Calendar Year.

We count the following as one Home Health Care Visit:

(a) When a Home Health Care provider visits the home to evaluate the need for developing a Home Health Care plan; or
(b) Up to four consecutive hours of Home Health Care. The home Health Care must begin within 7 days of a prior Hospital Stay of at least 3 days.

The Home Health Care must be provided in lieu of a Hospital Stay.

The Home Health Care must be for treatment of the same Sickness or Injury for which the Covered Person was Hospital Confined.

Home Health Care includes the following eligible charges:

Registered Professional Nurse (R.N.) or Licensed Practical Nurse (L.P.N.) services/supplies; Qualified physiotherapist, speech therapist or inhalation therapist services/supplies; Medical social services worker services/ supplies. The services/supplies must be Medically Necessary to understand the emotional, social and environmental factors affecting the Covered Person’s Sickness;

Home health aide services/ supplies when under a R.N.’s direct supervision; Nutritional guidance when Medically Necessary; Oxygen and its administration.

Professional Ambulance Service
Reasonable and Customary Charges for transportation to the nearest Hospital qualified to treat Injuries or medical Emergencies.

Complications of Pregnancy

If a Covered Person suffers Complications of Pregnancy while covered under the Group Policy, eligible charges incurred for treatment of such Complications of Pregnancy will be considered for payment as if they had resulted from Sickness.

If an expense does not result solely from the treatment of the Complications of Pregnancy, then it will be deemed due to normal pregnancy and not covered under the Group Policy.

Foreign Emergency Treatment

We will pay for benefits for eligible charges resulting from charges for Emergency treatment that a Covered Person receives in a foreign country.

Benefits payable will be the lesser of:

(a) the actual charges for the services; or
(b) the eligible charges that We would have paid if the Covered Person had received the Emergency treatment where the Covered Person resides.

First Name
Last Name
Zip
Phone
E-mail
Date of birth
By submitting this information form, I acknowledge and expressly consent to be contacted by HCCUA and/or iCan, their affiliates and agents, via telephone and email.

Monthly Fees
	Plan Levels
	1500	3500	6500
Individual:	$169.95	$239.95	$279.95
Couple:	$239.95	$339.95	$429.95
Single Parent:	$219.95	$309.95	$379.95
Family:	$289.95	$409.95	$549.95

Enrollment Fee:	$100

Indiana Health Plans Overview

Association Group Insurance

Entry Level Health Plans

Major Medical & Combination Plans

Indiana Complete Choice Select

Doctor's Office Visits

Preventative Care

Outpatient Diagnostic Benefits

Advanced Studies

Hospitalization

Inpatient Miscallaneous Hospital Expense

Surgery

Anesthesia

Outpatient Surgical Facility

Durable Medical Equipment

Emergency Room

Accident Medical Expense

Accidental Death & Dismemberment

Generic Prescription Drug Coverage

Roadside Assistance

Dining Discounts

Events and Attractions

Condo Vacations

Hotel Discounts

Car Rental Discounts

Nationwide Shopping

Recreational Activities

Golfing Discounts

Movie Discounts

Doctor & Therapist Visits By Email Or Phone

Legal Care Solution

Identity Theft Package

Pet Care Savings

Floral Savings

Local Services

Adult Wellness Testing (Not Available in HI,NY,NJ,RI)

Health Advocacy Services

Financial Education & Credit Counseling

Professional Tax Preparation, Advice & Audit Assistance

Premium Roadside Assistance