Philadelphia American Life Insurance Company Hospital Income Plan is a pre-tax hospital supplemental insurance plan for employees of the State of Florida.

This is an ideal supplement plan for State of Florida Employees who choose an HMO as their primary plan and also for employees using both preferred and non-preferred providers to help offset the out-of-pocket expenses when confined to a hospital. With this plan, benefits are paid directly to the Employee, never the HMO or hospital unless the employee chooses otherwise.

For a modest premium, you receive $100.00 or $200.00 for each night of room and board charges made by the hospital. Additionally, if you enroll in the $100.00 per day benefit with the Expanded Coverage Rider (ECR), you will receive an additional $200.00 per night of room and board charges for the 4th through the 10th night of your inpatient hospital stay (maximum $1,400.00 benefit per illness or injury unless 90 days separate hospital stays for same or related cause).

The following forms (PDF format) pertain to Hospital Income Insurance:

Informative brochure

Instructions for processing a claim:

1. Fill out the Statement of Employee form (if your spouse is the patient they will need to sign this form too).
2. Obtain a UB04 from the hospital

There has been a change in procedure to help our clients process their claims.  Philadelphia American has decided that if the UB04 can be obtained then an Attending Physician’s Statement is not needed in MOST cases.  The UB04 will give the claims examiner the information they are required to have to process the claim in MOST cases. If you are unable to obtain the UB04 from the hospital or outpatient facility, then you will need to fill out an Attending Physicians Statement and acquire an itemized bill from the hospital or outpatient facility. The Attending Physicians Statement may be filled out by the actual attending physician or by your primary care physician. We hope that this change will accommodate you more effectively.  Should you need the claim forms or have any questions or concerns please contact our office and we will be glad to help you with your claim.

Please contact us to convert policy if you are retiring or leaving state employment.