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Message Fixed Indemnity Insurance-Brought to You bySGIC – The Peace of Mind PeopleCreated for Members of MyHealth & Wellness AssociaonFIC2024NA
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SGIC InsuranceSGIC is an independently owned and operated American insurance company that specializes in accident and health insurance plans. SGIC's vision is to provide peace of mind through a more personal approach to the difficult to navigate health insurance market.**Plans are not available everywhere and are subject to eligibility.B++GOODAM Best RatingRe-insured by ZurichAA-SUPERIORAM Best RatingClearwater, Florida Headquarters and all operations are located in Clearwater, FL30 Years A&H products have been developed and supported by 30 years of insurance and healthcare experienceAgile Operations Ability to move quickly in response to market needs and regulation changesPartnership Working together to build products that fit the needs of the marketUS Based Customer Service Answer 90% of calls in 30 seconds or lessUS Based Claims Administration Clean claim turnaround in 2-3 daysSGICInsurance.com3
MedRedMedWhiteMedBlueAll American MedPlansCoverage Made for YouAll American MedPlans are designed for individuals and families seeking coverage tailored to their unique needs, including: Self-employed professionals and gig workers. Families managing healthcare on a budget. Those without access to employer-sponsored insurance. Anyone desiring flexibility in their choice of doctors and facilities.Coverage in ActionAll American MedPlans offers coverage you can count on, with real benefits for real situations: Hospital stays, doctor visits, preventive care, and more. Enhanced support with optional riders, like maternity, emergency room, or medical bill relief. Prescription savings through our innovative RX program. US-based call center prioritizing your peace of mind and making health insurance approachable.4
Why All American MedPlans?*Coverage is subject to a 12-month Pre-exisng condions exclusion. Coverage limits and a deducble may apply. TAll American Med Plans are not required to comply with certain federal market requirements, principally those contained in the Aordable Care Act (ACA). Review Your Cercate carefully to be sure You are aware of and understand any exclusions and limitaons regarding coverage of pre-exisng condions or health benets. Your coverage may also have lifeme and/or annual limits on health benets.Flexibility Multiple plan designs with a range of deductibles and plan benefit options.Any Choice of Doctors or Medical Facilities Seek medical treatment where You desire. A National PPO Network is also provided to help your benefits go farther.Predictable Benefits Plans offer set benefit amounts for specific health related services or treatments, which can make budgeting easier.Budget Friendly There are multiple plans and coverage options offered, allowing you to select what's best for your health insurance budget and needs.Peace of Mind Peace of mind and security. A personal approach to navigate the difficult health insurance market.Anytime Enrollment Members can enroll at any time – no qualifying event needed.5
All American MedPlans BenefitsDeducbles & Maximums MedRed MedWhite MedBlueCoverage Period Maximum $100,000 $250,000 $500,000 $1,000,000 $100,000 $250,000 $500,000 $1,000,000 $100,000 $250,000 $500,000 $1,000,000Lifeme Maximum $5,000,000 $5,000,000 $5,000,000Deducble Opons $0 $2,500 $5,000 $7,500 $10,000 $0 $2,500 $5,000 $7,500 $10,000 $0 $2,500 $5,000 $7,500 $10,000Family Deducble 3X 3X 3XInpaent Facility Fees Indemnity Benets*MedRed MedWhite MedBlueHospital Connement 1-4 Days per person, per year$6,000 $4,000 $2,000 5-9 Days per person, per year$5,000 $3,000 $1,500 10+ Days per person, per year$4,000 $2,000 $1,000Maximum Days per person, per year301251201Intensive Care Unit (ICU) $6,000 30 Days $4,000 30 Days $2,000 30 DaysMental Health or Substance Abuse $150 14 Days $100 7 Days $50 5 DaysRehab and/or Skilled Nursing or Hospice $1,000 7 Days $500 5 Days $250 3 DaysInpaent Professional Services Indemnity Benets*MedRed MedWhite MedBlueInpaent Physician Care $150 5 Days $100 4 Days $50 3 DaysInpaent Surgery $8,000 3 Days $6,000 2 Days $4,000 1 DayInpaent Assistant Surgeon 20% 20% 20%Inpaent Anesthesia 30% 30% 30%Outpaent Benets MedRed MedWhite MedBluePhysician Oce Visit $175 10 Days $125 7 Days $75 4 DaysChiropractic Care $75 5 Days $50 3 Days $25 2 Days*Subject to the deducble1. 31 days in Texas.6
All American MedPlans Benefits Outpaent Benets Cont’d MedRed MedWhite MedBlueMental Illness/Alcohol/Substance Abuse $150 5 Days $100 3 Days $50 2 DaysSurgery* $5,000 3 Days $3,500 2 Days $2,000 1 DayAssistant Surgeon*20% 20% 20%Anesthesia*30% 30% 30%Physicians Office Surgery $300 3 Days $200 2 Days $100 1 DayOutpatient Surgery Facility Fee* $1,500 3 Days $1,000 2 Days $500 1 DayPrevenve Care MedRed MedWhite MedBlueMammography/Pap Smear 1 per year $250 $250 $250Colonoscopy 1 per year $750 $500 $250 Wellness Care $150 2 Days $125 1 Day $100 1 DayEmergency & Urgent Care Outpaent ServicesMedRed MedWhite MedBlueUrgent Care $250 6 Days $200 4 Days $150 2 DaysEmergency Room* $500 2 Days $400 2 Days $300 1 DayGround/Water Ambulance* $500 2 Days $500 1 Day $500 1 DayAir Ambulance* 1 per year $1,500 $1,500 $1,500 Addional Outpaent Services MedRed MedWhite MedBlueAdvanced Diagnosc Tesng $600 5 Days $400 4 Days $200 3 DaysRadiaon/Chemo/Dialysis/Immunotheraphy*$500 5 Days $500 4 Days $500 1 DayX-Ray/Lab $200 5 Days $100 4 Days $50 1 DayInjecon $25 2 Days $25 1 Day $25 1 Day*Subject to the deducble7
Pharmacy Solutions by Revive*SGIC is excited to offer a prescription membership service through Our partnership with Revive that will provide access to a variety of no-cost medications, pharmacy support, and discounts.How It Works$0 at the Pharmacy for Urgent Care PrescriptionsSee Your primary care physician or urgent care provider.If prescribed one of the program’s over 65 listed medications, go to one of the 70,000 participating retail pharmacies including Walgreens and CVS.Pharmacist ConsultationSpeak with one of their licensed, registered pharmacists at Your convenience to learn more about Your medications and options.$0 Home Delivery on Your Maintenance Medications through ManifestRx Pharmacy 425 Maintenance Medications 3 Month SupplyRX Savings CardSave up to 80% on all other medications at Your local pharmacy.*Revive is a non-insurance prescripon soluon and provider. Soluon is not dependent on injury or illness being covered by one of the plans and may be used for current or pre-exisng prescripons.Convenient and Comprehensive RX8
Rate LockWorried About Rising Insurance Costs?Say goodbye to the stress of annual premium increases with Our Rate Lock Rider. This included rider locks in Your insurance premium rate for two full terms, giving You peace of mind and budget stability.No surprises and no increases for 2 full terms as long as You do not make changes to your policy.Rate Lock Period: 2 Terms1What Happens After the Rate Lock Period? When the two-year Rate Lock Period ends, Your renewal premium will adjust to the current rates for Your plan and age. And the best part? You may have the option to lock in Your rates again for another two years! 2Protect Your Budget and Plan with ConfidenceLock in Your rate today and enjoy the assurance that Your insurance costs won’t rise unexpectedly. With the Rate Lock Rider, You're in control of Your premiums. Your Premium is Locked & Guaranteed for 2 YearsThe rate lock only applies to the insurance premium and not any membership or addional services purchased.Waiver of PremiumProtection When it Matters the MostStay focused on Your recovery. This benefit is designed to offer peace of mind during a challenging time, allowing You to focus on getting better while SGIC handles the premiums.Relief During Extended Hospitalization with the Waiver of Premium due to Hospital Confinement Indemnity Benefit. Premiums are waived for the covered person when faced with an extended stay in an ICU or hospital due to a Covered Illness or Injury. Starting from the 31st day of continuous confinement, this benefit ensures that Your coverage remains intact without the burden of ongoing premium payments. How It WorksWaiver of Premium Benet*3 months or unl the end of Your plan term, whichever comes rst.* Benet is subject to a 30-day waing period.If You or a covered loved one is confined to a hospital for greater than 30 days, Your premiums will be waived from that point forward for the covered person for up to 3 months Waived or the end of Your coverage term (whichever comes first) provided: The confinement occurs while Your coverage is active or within a Grace Period. The confinement begins before You reach 64 ½ years old. The stay is continuous without interruption and meets the required duration. The confinement begins during the current coverage term.9
MyHealth & Wellness AssociationMyHealth & Wellness Association (MWA) is delighted to provide its members with a dedicated platform aimed at advancing both physical and mental well-being. MWA achieves this by promoting a wide array of beneficial services, valuable information, and research through various channels dedicated to healthy living and longevity.MWA is fully dedicated to enhancing your experience as a member. Anticipate receiving valuable updates and resources through their digital network, and rest assured that they are continually exploring innovative ways to deliver added benefits.MyHealth & Wellness Associaon Membership is oponal in Texas and Michigan. These benets are applicable to your MWA Membership and are not provided under Your Fixed Indemnity Plan insured by SGIC. MWA and SGIC are separate organizaons. You are purchasing both a membership in MWA and the SGIC Fixed Indemnity Plan.HEALTH WELLNESS LIFESTYLE Telemedicine Fitness & Nutrion Allstate Identy Protecon Dental Vitamin Discounts Roadside Assistance Mental Health Chiropracc Discounts Safelite Vision Paent Billing Advocacy Emergency Travel Assist Hearing Care Giver Resource Pet Insurance DiscountsLearn about ALL of the benefits available to you through MyHealth & Wellness AssociationPlease don’t hesitate to contact Member Services at: 1-800-992-8044 or log into your member portal at https://myhealth-and-wellness.com/ for additional details.SCAN ME10
MyHealth & Wellness Association Discount HighlightsMyHealth & Wellness Associaon Membership is oponal in Texas and Michigan. These benets are applicable to your MWA Membership and are not provided under Your Fixed Indemnity Plan insured by SGIC. MWA and SGIC are separate organizaons. You are purchasing both a membership in MWA and the SGIC Fixed Indemnity Plan. The discounts highlighted on this page are summarized. Please reference your specic MyHealth & Wellness Associaon Membership fullllment package for complete details.Teledoc | Virtual Care DiscountAetna | Dental Care DiscountCoast to Coast | Vision Care DiscountPoint Health | Patient Billing Advocacy DiscountTeladoc™ offers you the convenience of 24/7 access to U.S. board‑certified physicians either a phone call or a click away. Physicians can discuss symptoms, recommend treatment options, diagnose many common non-emergency conditions and prescribe medication when medically appropriate. It’s health access at the palm of your hand. 24/7 access to US licensed doctors by phone or video Our doctors diagnose, treat, and prescribe medication Quality care, wherever you areHealthcare NavigatorWhen you have time to make an informed decision about where to receive medical care, our navigation service makes sure that you pick the best option for your budget and preferences.Bill NegotiatorHave a huge ER bill? Or maybe you were stuck with an out-of-network bill that’s more than you can afford. No matter the situation, our Karis Patient Advocates can step in to help you negotiate your bill and guide you out of a tough situation.This vision program offers members 10% to 60% off eyeglasses, contact lenses and other retail eyewear items as well as 10% to 30% off eye examinations and 40% to 50% off the national average on LASIK. Over 20,000 eye care professionals nationwide – including many local opticians participate in this Benefit. Some Major Participating Eye Care Professionals Include: JCPenney, LensCrafters, Pearle Vision, Target Optical, Visionworks just to name a few.Members can save 15% to 50%* per visit, in most instances, on services at any of the many available dental practice locations nationwide. Dental services include: cleanings, X‑rays, fillings, root canals and crowns. Members can also save on specialty care such as orthodontics and periodontics where available. 11
Your Networks & First Health is a brand name of First Health Group Corp. First Health Network access is not available in New Mexico for certain fully insured limited benet plans due to state regulaons. 6,000 Hospitals 1,046,000 Professional Providers 137,000 Ancillary Facilities Approximately 98% of Hospital & 95% of Physicians are Retained Each YearSCAN MESee Your Available Providers With Our Provider LocatorPlease visit www.sgicdualnetwork.com to verify your provider is in the network prior to receiving service.Purchasing an All American Fixed Indemnity Insurance Plan by SGIC means you have Your choice of doctors and hospitals. However, because SGIC wants you to have control over how far your benefits go, they've included the First Health Network with access to participating providers in the MultiPlan Network. With use of a network, you may be able to receive discounts that wouldn't have otherwise been provided which means your benefit payment may cover more of your bill or even put money back in your pocket.First Health NetworkLimited Benefit PlanComplementary Competitive Health Inc.12
Complementary Competitive Health Inc.All American MedPlans Optional RidersEach of the following rider options are available at enrollment as additional benefits to enhance Your Fixed Indemnity Insurance coverage. Medical Relief Rider Maternity & Childbirth Rider Emergency Room Coverage RiderBuild the Coverage You Need – How You Need ItSelect Optional Riders to Fit Your Specific Needs *MyHealth & Wellness Associaon Membership is oponal in Texas and Michigan. OPTIONAL Medical Bill Relief RiderOPTIONAL Emergency Room Coverage Rider OPTIONALMaternity & Childbirth RiderAllAmerican MedPlans INCLUDEDReviveRxINCLUDEDWaiver Of Premium INCLUDED 2 Rate LockGuaranteeINCLUDEDMyHealth & Wellness*INCLUDEDDualNetworkAccess13
Medical Relief Optional RiderProtect Your Finances With MedBillBe ready for the unexpected. Life is full of surprises, and while SGIC hopes You never face a sudden accident or illness, it’s essential to be prepared. The Medical Bill Relief Rider is designed to provide You and Your family with peace of mind when unforeseen medical expenses arise.This rider ensures that when a Covered Person faces significant medical bills from a single Covered Illness or Injury, they’re not alone. Once Your out-of-pocket expenses meet or exceed the Medical Bill Minimum Amount defined on Your Rider, The Medical Bill Relief Indemnity Benefit will step in by paying out the lump sum benefit selected.1 MedBill Benets Opon 1 Opon 2 Opon 3Medical Bill Minimum Amount $50,000 $75,000 $100,000Benet Payout 1 per Year $25,000 $37,500 $50,000*The Medical Bill Benet does not extend, change, or increase any individual Benet Amount or the duraon of coverage. This benet is payable only once per term and is subject to a waing period.Covered Accident or Illness Bill As long as they relate to a single covered accident or illness, this rider will help You out.Financial Support When You Need It Most When Your out-of-pocket costs hit the Medical Bill Minimum Amount, The Indemnity Benefit activates to provide a lump sum payment.Peace of Mind Focus on recovery, knowing that You have a safety net in place to protect Your finances.1 The Medical Bill Minimum Amount is calculated aer network discounts.14
Emergency Room Coverage Optional RiderBoost Your Emergency Room CoverageEnhanced protection for unexpected emergencies. Accidents and unexpected illnesses can happen at any time, and when they do, the costs can add up quickly. With the Emergency Room Indemnity Benefit Amount Increase rider, You can elevate Your Emergency Room Indemnity Benefit Amount to better manage these unexpected expenses.Prepare for the unexpected. Enhance Your emergency room coverage today and gain the peace of mind that comes with knowing You're better prepared for life’s surprises.How It WorksEmergency Room Benets *Red White BlueBenet Opons Days per Year$500 2 $400 2 $300 1* The increase applies to any covered emergency room visits within the coverage term; no addional days are added. All other terms and condions of Your Cercate of Insurance remain unchanged. Changes to the Increase Amount may only be made before the Rider Eecve Date or upon renewal.When You attach this rider to Your Certificate of Insurance, the Emergency Room Indemnity Benefit Amount defined in Your plan is automatically doubled. The benefit amount on the rider is added to the Emergency Room Indemnity Benefit amount in Your base plan for each Covered Person, providing You with extra financial protection when You need it most.15
Maternity & Childbirth Optional RiderMaternity & Childbirth Benets Opon 1 Opon 2 Opon 3Maternity Well-Care Days per Year $75 10 $50 7 $25 5 Childbirth 1 per Year $5,000 $3,000 $1,500 Well Newborn Care Days per Year $75 10 $50 7 $25 5 Maternity Well-CarePregnancy is a beautiful journey, and with the Maternity Well-Care Indemnity Benefit, ensure that Your regular prenatal visits are covered*. This benefit is paid on a daily basis for each visit related to the development of Your pregnancy. Focus on Your health and Your baby’s growth, knowing that Your Well-being is the priority.Childbirth IndemnityWhen it’s time to Welcome Your little one into the world, the Childbirth Indemnity Benefit will help cover the hospital bill. This benefit supports You during Your hospital stay for childbirth* as SGIC believes that the moment You meet Your child should be filled with joy, not financial stress.Well Newborn CareYour baby’s first days are precious, and so is their health. The Well Newborn Care Benefit provides coverage for routine treatments and examinations Your newborn needs in the first 30 days. This benefit ensures that Your baby receives the best start in life with the care they deserve.*Benets are subject to a 10 month waing period during Your inial coverage term. All benets are subject to the benet amounts and the number of days payable selected and on the rider schedule of benets. Benets are paid on a daily basis, regardless of the number of tests completed, checks done, or oces visited completed within a single day.16
Fixed Indemnity Plan SpecificsPlan SpecificsPre-Existing ConditionsOne of the biggest differences between Our Plans and those available from the ACA Exchange is a Pre-Existing Condition Limitation. If You haven’t been diagnosed or treated for a medical condition in the past 12 months, or experienced symptoms that should have led You to get care but did not, this rule will not impact you.Waiting Period1The Fixed Indemnity Insurance Plan has waiting periods which include: Next day coverage for injuries 5 day waiting period for sickness 30 day waiting period for cancer 90 days for preventative carePlan BenetsThis plan only provides the benefits listed on the schedule of benefits. Benefits are only payable a set number of “days” per coverage term and are only payable up to the benefit amount listed on the schedule, subject to the deductible where indicated.Pre-Authorization2Pre-Authorization is required for all inpatient hospitalizations and outpatient surgeries. Call (888) 312‑7442 to get Your services pre-authorized. Pre-Authorization does not guarantee coverage.1. Addional waing periods may apply on riders. Always review Your insurance plan documents for a full descripon of benets.2. Subject to state rules and regulaons.17
Limitations & ExclusionsKnowing exactly what Your Fixed Indemnity Insurance plan does and does not cover is important. To give You the best possible experience, We oer this summary of what is not covered. Please see Your plan documents for a complete list of exclusions, benet amount limitaons, and frequency limitaons on benets.• Pre-exisng condions.*• Sicknesses that begin, by occurrence of symptoms and/or receipt of treatment during the waing period, which is 5 days following the eecve date.• Outpaent Prescripon Drugs, Dental, and Vision services.• Elecve Surgery that is not Medically Necessary.• Pregnancy and related services; except for Complicaons of Pregnancy.• Treatment, services and supplies received outside of the United States or its possessions, except as specically covered.• Roune foot care.• Treatment of acne or varicose veins, allergy tesng and allergy injecons, speech therapy, and diagnosis or treatment of a sleeping disorder.• Diabetes, diabec equipment, supplies and self-management training.**• Genec tesng.• Treatment, services, and supplies provided by a Family Member; and Programs, Treatment or procedures for tobacco use cessaon• Hearing exams, hearing aids or ng of hearing aids.• Treatment for cataracts.• Weight loss, non-smoking, exercise or similar programs.• Illness or injury that is self-inicted, caused while under the inuence or while engaged in a felony, in a hazardous occupaon or acvity, in military service, or while parcipang in interscholasc or intercollegiate sports.• Surgery during the rst 6 months aer the Eecve Date of Coverage for a Covered Person for a total or partial hysterectomy, unless it is Medically Necessary due to a diagnosis of carcinoma (subject to all other coverage provisions, including but not limited to the preexisting condition exclusion); tonsillectomy, adenoidectomy, repair of deviated nasal septum or any type of surgery involving the sinus, myringotomy, tympanotomy, herniorrhaphy, or cholecystectomy.* Pre-Exisng Condion – means the existence of signs, symptoms, diagnosis, care, Treatment and/or receipt of medical advice regarding a medical condion in the 12-month period preceding the Coverage Eecve Date. Pre-exisng Condions are covered under this Cercate beginning aer 12 months of being sign, symptoms and Treatment free.**State benets and exclusions may vary.18
FAQsWhat is an In-Network Provider?An In-Network Provider is a Physician, Hospital or other healthcare Provider that is currently aliated with the network oered by SGIC to its Policyholders.How can I locate my In-Network Provider?1. Call member services at (888) 312-74422. Go to www.sgicdualnetwork.comWhy should I go to an In-Network Provider?In-Network Providers will provide discounts that are not available with Out-of-Network Providers, this means that there may be more out of pocket costs for You by going to Out-of-Network Providers.Are my Fixed Indemnity benets eective right away?Waing periods apply as follows*: Next day from enrollment for injuries 5 day waiting period from enrollment for sickness. 30 day waiting period for cancer 90 days for preventative care.* Some benets may not be covered in Your plan and are subject to preexisng condion exclusions. Rider benets may be subject to addional waing periods.Is my policy ACA compliant?This coverage is not required to comply with certain federal market requirements, principally those contained in the Affordable Care Act (ACA). Review Your Certificate carefully to be sure You are aware of and understand any exclusions and limitaons regarding coverage of pre-exisng condions or health benets (such as hospitalizaon, emergency services, maternity care, prevenve, care, prescripon drugs, and mental health and substance use disorder services). Your coverage also has lifeme and/or annual limits on health benets. If this coverage expires or You lose eligibility for this coverage, You might have to wait unl an open enrollment period to get other health insurance coverage.What is Pre-Authorization?Most healthcare plans require a form of pre-authorizaon, which is a process that protects You by verifying Your procedure is medically necessary. For this vericaon please call us at (888) 312-7442, as seen on Your ID card. These services include all Inpaent Hospitalizaons and procedures done at an Outpaent Surgical Facility but please see Your cercate for full details. You can reach us at (888) 312-7442, as seen on Your ID card as Well.What is Coverage Period Maximum?The total maximum benet amount payable by Your insurance plan during any single coverage period.How does my deductible apply?The deducble is the dollar amount that You and/or any other Covered Person is responsible for paying of any idened covered treatments listed in Your schedule of benets before the indemnity benets become payable. All plans are subject to a family deducble, the maximum total deducble amount that will be applied in any one policy term. The family deducble is 3x the deducble selected, which means any plan with more than 3 people will only need to meet a maximum of 3x the deducble during that coverage term.19
All American Plans built by an American Insurance Company.Support@SGICinsurance.com1-888-312-7442SGICinsurance.comFIC2024NA, State variaons may apply. © 2025, SGIC. All rights reserved.SCAN MEFor agent use only. Not for public distribution.