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HCC Life STM
US residents - Up to 12 months
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HCC Life STM provides affordable temporary health insurance to protect you and your family. You
should consider purchasing HCC Life STM if you are concerned about protecting yourself from the
potentially high medical costs associated with an unexpected accident or injury.
With HCC Life STM you're in control. You get to choose your deductible, coinsurance, maximum
coverage amount, and the exact length of coverage. You also have the freedom to receive treatment
from doctors and hospitals of your choice without incurring out-of-network penalties. HCC Life STM
gives you peace of mind by relieving some of your financial worry in the event of an unexpected
medical condition.
HCC Life STM is appropriate for:
• Individuals transitioning between jobs
• College students or recent graduates
• New employees waiting for group coverage to begin
• Individuals not yet eligible for Medicare coverage
• Individuals waiting on approval of major medical coverage
• Individuals no longer eligible on parents' plan due to age or status
• Individuals looking for an affordable substitute for COBRA
Plan benefits are subject to the deductible and coinsurance. After you satisfy your deductible, HCC
Life STM will begin paying eligible expenses according to the coinsurance you select and up to the
coverage period maximum that you choose. Benefits are based on usual and customary charges of
the geographical area in which charges are incurred
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Length of Coverage
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Up to 6 or 12 months*
Purchase in full or make monthly payments
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Deductible
Amount you pay toward covered
expenses before the plan pays benefits
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$250, $500, $1,000, $2,500, $5,000, or $7,500
A maximum of 3 deductibles is required per family
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Coinsurance
Percentage of eligible expenses the
plan pays after the deductible
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80% or 50% of the next $5,000 of
eligible expenses
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Coverage Period Maximum
The maximum amount the plan pays
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$1 million or $2 million
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* Plans over 6 months not available in all states
The deductible is waived when you receive care at an urgent care center, and instead you pay a $50
co-payment, after which coinsurance applies. An urgent care center means a facility separate from a
hospital emergency department where patients can be immediately treated for injury or sickness on a
walk-in basis without an appointment.
• Inpatient and outpatient charges made by a hospital, including inpatient prescription drugs
• Charges incurred at an urgent care center after a $50 co-pay
• Charges made by a physician, surgeon, radiologist, anesthesiologist, and any other medical
specialist to whom the physician has referred the case
• Charges made for dressings, sutures, casts or other supplies prescribed by the attending
physician or specialist, but excluding nebulizers, oxygen tanks, diabetic supplies and all devices
for repeat use at home
• Charges for diagnostic testing using radiology, ultrasonographic or laboratory services
• Charges for oxygen and other gases and anesthetics and their administration
• Charges made by a licensed extended care facility upon direct transfer from an acute care
hospital
• Emergency local ambulance transport in connection with injury or sickness resulting in inpatient
hospitalization
• Expenses related to complications of pregnancy
• Charges for physical therapy that is prescribed in advance by a physician in relation to a covered
injury or sickness
Limits apply to all benefits. Please see the certificate for a complete listing of benefits, limits, and
exclusions.
HCC Life STM does not cover: pre-existing conditions* (including those not inquired about on the
enrollment form); preventive or wellness doctor visits; dental or optical treatments; routine physical
exams; normal pregnancy or childbirth; well child care; interscholastic and intercollegiate sports
injuries; over-the-counter medications and outpatient prescription drugs; and expenses incurred
outside the United States, its possessions or territories, or Canada.
The following conditions are also excluded: varicose veins, substance abuse and alcoholism, chronic
fatigue or pain disorders, and allergies, except for emergency treatment of allergic reactions.
Expenses during the first 6 months after the effective date are excluded for (subject to all other
coverage provisions, including the pre-existing condition limitation): a. Total or partial hysterectomy,
unless it is medically necessary due to a diagnosis of carcinoma; b. Tonsillectomy; c. Adenoidectomy;
d. Repair of deviated nasal septum or any type of surgery involving the sinus; e. Myringotomy; f.
Tympanotomy; g. Herniorraphy; or h. Cholecystectomy.
*Pre-existing conditions refers to conditions for which you received medical treatment, diagnosis, care,
or advice within a specific number of months immediately preceding your effective date. The "pre-ex"
period will vary depending on the state in which HCC Life STM is purchased. This exclusion does not
apply to a newborn or newly adopted child who is added to coverage.
When coverage is purchased within 3 days of the effective date, you will only be entitled to receive
benefits for sicknesses that begin, by occurrence of symptoms and/or receipt of treatment, at least 72
hours following the effective date. This waiting period does not affect benefits for injuries.
This is a partial list of exclusions and limitations. Please see the certificate for detailed
information about these and other plan exclusions and limitations. Benefits, provisions,
limitations and exclusions may vary by state.
To purchase HCC Life STM, complete an enrollment form. If you do not have an enrollment form,
contact the distributor listed at the end of this brochure. HCC Life STM enrollment forms may be
submitted via mail, fax or online. Contact the distributor listed on the back of this brochure for
additional details.
If you apply online, your initial payment must be made by credit card (Visa, American Express,
Discover or MasterCard). If enrollment is by mail, you may submit premium via personal check or
credit card. Payment options include single up-front or monthly payments. If you choose to pay
monthly, a small administrative fee will apply to each payment; monthly premium payments are
payable by credit card only.
You are eligible to apply for HCC Life STM if you are age 2 through 64 and you meet the following
requirements:
• you are not pregnant, an expectant father, or planning on adopting;
• you will not be covered by other medical insurance at time of requested effective date;
• you are not a member of the armed forces of any country, state or international organization,
other than on reserve duty for 30 days or less; and
• you are able to answer “no” to the medical questions on the enrollment form
Your spouse under age 65 and dependents under age 19 are also eligible for coverage, provided they
meet the same requirements. Unmarried children under age 25 may also be included as a covered
dependent if enrolled full-time in an accredited school or college. Eligibility for children ages 19
through 25 may vary by state. In order to receive coverage, applicant may be required to enroll in the
Consumer Benefits of America Association.
For enrollment forms received online, by e-mail, or by fax, your coverage becomes effective at
12:01am* on the date following the date we receive your completed enrollment form provided payment
has been received. For enrollment forms submitted by mail, your effective date is 12:01am* on the
postmark date of your completed enrollment form or 12:01am* on the requested effective date,
whichever is later, provided payment has been received. Your requested effective date must be within
45 days from the date you signed the enrollment form.
*Times expressed are based on the geographical area where the certificate holder resides.
If you are not 100% satisfied with HCC Life STM, return the certificate along with a written request for
cancellation to HCC Life within 10 days of receipt with a written request for cancellation. Coverage will
be cancelled as of the effective date. No questions asked! After the 10 day free look, the premiums
will not be refunded. The administrative fee is non-refundable.
HCC Life STM is not renewable, but if your temporary insurance need continues beyond the coverage
period purchased, you may apply for a new plan as long as you have not had more than two HCC Life
STM plans during the past 12 months. Additional purchase may not be available in some states.
In most states, HCC Life STM is available only to members of the Consumer Benefits of America
Association. Membership in the association will entitle you to discounts of up to 40% off regular retail
prices on many short-term and long-term prescription drugs. Discounts are available from over 63,000
participating pharmacy providers nationwide or by mail service. When applicable, details about this
membership benefit accompany HCC Life STM insurance documents.
HCC Life STM is insured by HCC Life Insurance Company, which has been an industry leader in
medical stop loss and excess lines coverage for more than 30 years. HCC Life, an Indiana domiciled
insurer, has offices in Atlanta, Boston, Dallas, Indianapolis & Minneapolis and writes over $750 million
dollars in premium annually. HCC Life Insurance Company is rated 'A+' (Superior) for financial
strength by A.M. Best Company ratings services. All HCC Life products are backed by the financial
stability of our parent company, HCC Insurance Holdings, Inc. (NYSE: HCC).
HCC Life HealthCare Options, a division of HCC Life Insurance Company, offers HCC Life STM.
Headquartered in Indianapolis, Indiana, HCC Life HealthCare Options has a team of claims
specialists, medical professionals and service representatives available 24 hours a day, 7 days a week
to answer your questions and respond to your needs promptly and compassionately.
HCC Life Insurance Company respects individual privacy and values the confidence of its customers,
employees, consumers, business associates, and others. Please contact us or visit our website to
obtain a full version of our Privacy Policy.
HCC Life Insurance Company
251 N. Illinois Street, Suite 600
Indianapolis, IN 46204
Jagruti Khatri
4700 Dexter Dr, Suite 100
Plano, TX 75093
Phone: (866) INSU-BUY
Fax: (972) 767-4470
Website: InsuBuy.com
09/2009
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