What is Hospital Fixed Indemnity Insurance?

Hospital Fixed Indemnity Insurance pays a fixed cash amount for Your Covered Hospital expenses regardless of any other insurance. Any costs incurred in excess of the fixed cash amount for medical care or medical care not listed in the Schedule of Benefits, are the responsibility of the Insured. Please review the plan benefits, benefit amounts, limitations and exclusions to determine if they meet your needs.

Hospital Fixed Indemnity Insurance is NOT a major medical or comprehensive medical healthcare plan.

Is Hospital Fixed Indemnity Insurance major medical insurance?

No, Hospital Fixed Indemnity Insurance is not major medical and is not intended to replace other medical coverage.

Who is eligible for coverage?

To be eligible for the American Bar Association Hospital Fixed Indemnity Insurance, you must be an active member of the American Bar Association and:

  • Over the age of 18, unless a dependent of a member
  • Under age 80
  • Reside in a qualified state of the United States.

As an active member of the American Bar Association you also have the option enroll your eligible dependents.

Who are my eligible dependents?

Eligible Dependent means:

  • Lawful spouse, if not legally separated or divorced, or Domestic Partner or Civil Union Partner.
  • Proof of Domestic Partner relationship in the form of a signed and completed AFFIDAVIT OF DOMESTIC PARTNERSHIP will be required.
  • Unmarried Children under age 26 may vary by state.

The age limitations will not apply to an Insured Person’s unmarried Child who is incapable of self-support due to a mental or physical incapacity. Proof of such incapacity must be furnished to the Company immediately upon enrollment or within 31 days of the Child reaching the age limitation. Thereafter proof will be required whenever reasonably necessary, but not more often than once a year after the 2-year period following the age limitation.

(Definition of Eligible Dependent may vary by state)

Can I or my dependents be enrolled more than once?

No. At any one time each Covered Person may have only one Certificate issued by Us having coverage similar to that described in the Certificate.

When would my coverage be effective?

Provided the proper premium payment is made, coverage will become effective at 12:01 am on the first of the month following the date of acceptance of your enrollment form.

When would coverage end?

Your Insurance will end on the earliest of:

  1. The date You are no longer a member of the American Bar Association.
  2. The date You report for full-time active duty in any Armed Forces. This does not include Reserve or National Guard duty for training;
  3. The end of the period for which the last premium contribution is made; or
  4. The date the Policy is terminated; or
  5. The date the Insured Person requests, in writing, that his/her coverage be terminated

Your Dependent’s coverage will end on the earliest of:

  1. The date the Policy terminates; or
  2. The date the Your coverage ends; or
  3. The date the Dependent is no longer a Dependent; or
  4. The last day of the period for which premiums have been paid.
  5. The date You report for full-time active duty in any Armed Forces. This does not include Reserve or National Guard duty for training

What is a Pre-existing condition and are they covered?

Pre-existing condition means a disease or physical condition for which medical advice or treatment was recommended or received by the Covered Person during the 12 months prior to the Covered Person’s Effective Date of coverage.
Pre-existing Conditions will not be covered for a period of the first 12 months after the Covered Person’s Effective Date of coverage (applies to Hospital, ICU and Surgery benefits only).
(Definition of Pre-existing coverage as well as indicated time frames may vary by state)

What is a Waiting Period and does this coverage include a Waiting Period?

Waiting Period means the consecutive number of days after the Certificate Effective Date before benefits are payable for Covered Expenses due to Sickness.
There is a 30-day Waiting Period due to Sickness. There is no Waiting Period due to Injury.

Can I use any medical provider for this Hospital Fixed Indemnity plan?

Yes. Hospital Fixed Indemnity Insurance is not a major medical plan and does not include a medical network.

How do I file a Hospital Fixed Indemnity Claim?

To file a Hospital Fixed Indemnity Insurance Claim, simply download the CLAIM FORM and mail to Coordinated Benefit Plans (CBP), P.O. Box 23802, Tampa FL 33623 with all necessary supporting documentation.