Hospital Indemnity Plan

Citi Benefits Handbook

Although Citi offers you the opportunity to enroll in comprehensive medical coverage, there are still expenses associate with a hospital stay that the plan may not cover. These include copays, coinsurance, prescription drug copays and other non-medical expenses such as childcare, mortgage payments and utility bills.

Through the Hospital Indemnity Plan, you can receive a lump sum cash payment if you or a covered family member is admitted to the hospital.

What's Covered


Inpatient Stay*	Benefit**
The initial day of your stay in a hospital	A lump sum benefit of: $1,000
Benefit begins on day 1 of your stay in a non-ICU room of a hospital	A daily benefit of: $250
Benefit begins on day 1 of your stay in an ICU room of a hospital	A daily benefit of: $500
The hospital stay after the birth of a newborn. Outpatient birth is not covered	A lump sum benefit of: $200
The initial day of your stay in an observation unit as a result of an illness or accidental injury	A lump sum benefit of:$100
Benefit for each day of your stay in a hospital or treatment facility for the treatment of substance abuse at a non-employer designated facility	A daily benefit of: $125
Benefit for each day of your stay in a hospital or mental disorder treatment facility for the treatment of mental disorders	A daily benefit of: $100
Benefit for each day of your stay in a rehabilitation unit immediately after your hospital stay due to an illness or accidental injury	A daily benefit of: $50

* Limited to a combined maximum of 30 days per plan year.

**Daily benefits begin on day one and count toward the calendar year maximum.

Waiver of Premium

If you miss 30 continuous days of work as a result of a hospital stay, your Hospital Indemnity coverage premium will be waived beginning on the first pay period that occurs after the 30th day of your absence, through the next six months of coverage. You must remain employed to qualify for a waiver of premium. This waiver of premium benefit does not apply to your covered dependents.

Exclusions and Limitations

Benefits will not be paid for any stay or other service for an illness or accidental injury related to:

Certain competitive or recreational activities, including but not limited to: ballooning, bungee jumping, parachuting, and skydiving;

Any semi-professional or professional competitive athletic contest, including officiating or coaching, for which you receive payment;

Act of war or rioting;

Operating, learning to operate or serving as a pilot or crew member of any aircraft, whether motorized or not;

Assault, felony, illegal occupation, or other criminal act;

Care provided by a spouse, parent, child, sibling or other household member;

Cosmetic services and plastic surgery, with certain exceptions;

Custodial care;

Hospice services, except as specifically provided under the plan;

Self-harm, suicide, except when resulting from a diagnosed disorder;

Violating any cellular device use laws of the state in which the accident occurred, while operating a motor vehicle;

Care or services received outside the United States or its territories;

Experimental or investigational drugs, devices, treatments or procedures;

Education, training or retraining services or testing;

Accidental injury sustained while intoxicated or under the influence of any drug intoxicant;

Exams except as specifically provided under the plan;

Dental and orthodontic are and treatment;

Family planning services;

Any care, prescription drugs and medicines related to infertility;

Nutritional supplements, including but not limited to: food items, infant formulas and vitamins;

Outpatient cognitive rehabilitation, physical therapy, occupational therapy or speech therapy for any reason; and

Vision-related care.