BENEFIT
Based on hours
worked the previous month |
LEVEL
I
1-90 Hrs Worked |
LEVEL
II
91-130 Hrs Worked |
LEVEL
III
131+ Hrs Worked |
| $5000 Employee Life Insurance Benefit |
X |
X |
X |
| Standard Dependent Life Benefit |
X |
X |
X |
| Daily Hospital Indemnity |
$200/$400 |
$300/$600 |
$300/$600 |
| Level I Accident Benefit |
$300
per/max |
$300
per/ max |
$300
per/ max |
| HMG Family Access Plan |
X |
X |
X |
| Survivor
Benefit |
X |
X |
X |
| Doctor’s
Office Visit Indemnity Benefit |
|
Up
to $35/visit |
Up
to $55/visit |
| Outpatient Diagnostic X-ray and Lab
Benefit |
|
Up
to $35/visit |
Up
to $45/visit |
| Vision Care Benefit |
|
|
X |