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Q: Who is the State of South Dakota’s Hospital Indemnity Insurance Carrier?
A: The State of South Dakota’s Hospital Indemnity Insurance Carrier is Voya Financial/ReliaStar.
Q: What is Hospital Indemnity Insurance Coverage?
A: Hospital Indemnity Insurance Coverage pays you and/or a covered family member a daily benefit for each full day of hospitalization due to an illness or injury - up to a total of 180 days, beginning with the first day of a hospital stay. Care must be medically necessary, ordered by a physician, and take place in a hospital.
Q: How long can I receive payments?
A: You can receive benefits for up to 180 days per plan year. There is no lifetime maximum. The payments end with earlier of your death, or the last full day of medically necessary confinement.
Q: Define “Confinement."
A: Confinement is defined as the pre-authorized admission to a hospital by a physician due to an injury or illness. To be an eligible benefit the confinement must be medically necessary, ordered by a physician and take place in a hospital. Self inflicted injuries do not meet the definition of eligible reasons for confinement.
Q: What ‘confinement’ facilities are excluded from the definition of hospital?
A: Nursing homes, extended care facilities, homes for the aged, rehabilitation centers, primarily custodial care facilities or a place primarily for the treatment of alcoholism or substance abuse are excluded.
Q: How much is the benefit I receive?
A: You receive (Hospital: $200 per day | Critical Care Unit: $400 per day | Rehabilitation Facility: $100) per day of confinement, starting with the first full day of confinement. This amount is in addition to any other payments you may receive.
Q: When would benefits (payments to you) begin?
A: You may receive benefits following the first full day of hospital confinement. There is no waiting or elimination period.
Q: Who’s eligible to sign up for Hospital Indemnity Insurance Protection?
A: You are eligible for coverage if you are an active State employee working a minimum of 20 hours per week. Spouse and dependent children are also eligible. (Spouses 70 years of age or older cannot be added to the plan, however if your spouse was added before turning 70, he/she can remain on the the plan.)
Q: When would the coverage be effective?
A: Coverage will begin on the 1st or 15th of the month following the payroll cycle in which contributions are first withheld. New employees must apply for coverage within 30 days of the date of active employment. Otherwise coverage may be applied for during an Annual Enrollment Period, or following a qualified Family Status change.
Q: Am I guaranteed coverage?
Q: Are the benefits taxable?
Q: Are there any other benefits to this program?
A: Yes, for example benefits may also be available if the member is hospitalized as an inpatient in an observation room for which they are charged a fee. Confinement in a hospital for pregnancy is also covered.
Q: How do I apply for the State Hospital Indemnity Insurance coverage?
A: Contact your HR Representative to enroll.
Q: When can I apply for Hospital Indemnity Insurance (HIP) Coverage?
A: New Hires may enroll in the State HIP plan within the first 30 days from date of hire. Current employees can apply for HIP during the open enrollment period only. Existing employees with a Family Status Change may enroll in the State HIP during the 60 days following a qualifying Family Status Change.
Q: Does the State of South Dakota pay for a portion of my benefit?
A: No. Employees are solely responsible for the premiums.
Q: Can I purchase additional coverage, over the per day amounts or beyond the 180 days per year maximum benefit payment period?
A: No. However individual contracts may be available through your personal insurance agent.
Q: Is this an individual contract?
A: No. Individual contracts for more coverage may be available from your personal agent.
Q: Is this an individual contract?
A: No. The State of South Dakota contract with VOYA Life Insurance Company is a group contract. This means there is one master contract held by the State of South Dakota. Because this is written on a group basis, the underwriting is much more liberal than most individual contracts, and pricing is usually much better.
Q: Can I take the Hospital Indemnity Insurance coverage with me when I retire or leave State employment?
A: No. This contract is NOT eligible for COBRA coverage.
Q: Will the rates ever change?
A: It is possible for rates to change, but they will never change based on your age.
Q: Can I be declined coverage?
A: No, this contract is guaranteed issue and you cannot be declined based on current health conditions.
Additional questions or concerns:
You may contact VOYA Insurance Company's local representative, Risty Benefits, Inc at 866-237-9411 or email email@example.com.
As Plan Administrator, VOYA Insurance Company has final authority to make determinations on eligibility, enrollment and issues not specifically addressed in the Hospital Indemnity Insurance coverage information provided on this document and the information provided on this website. The contract between VOYA Insurance Company and the South Dakota State Employee Health Plan is the binding document and in case of any discrepancies the contract would rule.