Increase Your Hospital Indemnity Insurance Plan Today.
This guaranteed issue1 coverage is available to you and your spouse/domestic partner. Use the cash benefit for anything you need: deductibles, home care, medicines, car payments or pet care — the choice is yours.
Enrollment Instructions
- Print the enrollment form
- Complete, sign and date the enrollment form
-
To return, please scan and email the completed form to
gsp.sarasota.upmarketing@ajg.com or mail to the address:
Union Plus Insurance Programs
8430 Enterprise Cir, Ste 200
Lakewood Ranch, FL 34202-9907
Low Coverage Plan Monthly Premium
Choose this benefit level for $500 in First Day Hospital coverage, $100 in Daily Hospital coverage, and $200 in Daily ICU coverage.
|
Union Member Age Band | Union Member |
Union Member + Spouse/Domestic Partner |
Union Member + Child(ren) | Family |
|---|---|---|---|---|
| 25-29 | $5.80 | $16.00 | $13.41 | $24.87 |
| 30-34 | $6.20 | $14.87 | $13.80 | $23.73 |
| 35-39 | $5.40 | $11.55 | $13.00 | $20.41 |
| 40-44 | $4.91 | $10.06 | $12.51 | $18.92 |
| 45-49 | $5.84 | $11.78 | $13.44 | $20.64 |
| 50-54 | $7.69 | $15.39 | $15.29 | $24.25 |
| 55-59 | $10.06 | $20.06 | $17.66 | $28.92 |
| 60-64 | $11.77 | $23.47 | $19.37 | $32.33 |
Medium Coverage Plan Monthly Premium
Choose this benefit level for $1,000 in First Day Hospital coverage, $150 in Daily Hospital coverage, and $300 in Daily ICU coverage.
|
Union Member Age Band | Union Member |
Union Member + Spouse/Domestic Partner |
Union Member + Child(ren) | Family |
|---|---|---|---|---|
| 25-29 | $10.48 | $29.12 | $23.86 | $44.71 |
| 30-34 | $11.20 | $26.95 | $24.57 | $42.54 |
| 35-39 | $9.72 | $20.83 | $23.10 | $36.43 |
| 40-44 | $8.81 | $18.05 | $22.18 | $33.65 |
| 45-49 | $10.42 | $21.02 | $23.80 | $36.62 |
| 50-54 | $13.64 | $27.31 | $27.02 | $42.90 |
| 55-59 | $17.72 | $35.35 | $31.10 | $50.94 |
| 60-64 | $20.54 | $40.96 | $33.92 | $56.55 |
High Coverage Plan Monthly Premium
Choose this benefit level for $1,500 in First Day Hospital coverage, $200 in Daily Hospital coverage, and $400 in Daily ICU coverage.
|
Union Member Age Band | Union Member |
Union Member + Spouse/Domestic Partner |
Union Member + Child(ren) | Family |
|---|---|---|---|---|
| 25-29 | $15.17 | $42.23 | $34.32 | $64.55 |
| 30-34 | $16.19 | $39.03 | $35.34 | $61.35 |
| 35-39 | $14.04 | $30.12 | $33.19 | $52.44 |
| 40-44 | $12.70 | $26.05 | $31.85 | $48.37 |
| 45-49 | $15.00 | $30.27 | $34.15 | $52.59 |
| 50-54 | $19.59 | $39.22 | $38.74 | $61.55 |
| 55-59 | $25.39 | $50.64 | $44.54 | $72.96 |
| 60-64 | $29.31 | $58.45 | $48.46 | $80.77 |
If you have any questions, please do not hesitate to call us at 800.393.0864, Monday-Friday, 8 a.m. to 8 p.m. ET. We are honored that you have chosen us to assist you in planning for the future of your family.