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Contact Information
Provess Flexible Benefits
4050 Katella Avenue, Suite 213
Los Alamitos, CA 90720
Phone: (866) 639-5289
E-Fax: (866) 264-4093
E-mail: admin@provess.com
Palm Springs and Midwest Locations...
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SHORT-TERM DISABILITY COVERAGE ACCIDENT/ILLNESS (*California Rates/Benefits)
Enrollment in this plan will place coverage on you when you miss work due to accidents or illness.
Choose from five plans depending on your income level. (Other States will vary)
|
PLAN 1 |
PLAN 1 ½ |
PLAN 2 |
PLAN 2.5 |
PLAN 3 |
If you earn at
least |
$1,000
per month |
$1,500
per month |
$2,000
per month |
$2,500
per month |
$3,000
per month |
Monthly Benefit |
$600 |
$900 |
$1,200 |
$1,500 |
$1,800 |
Individual
Monthly Cost |
$29.26 |
$42.85 |
$56.43 |
$70.02 |
$83.59 |
Family
Monthly Cost |
$45.06 |
$66.54 |
$88.03 |
$109.52 |
$130.99 |
The above disability benefits are paid for up to 6 months after missing work for 3 days for accidents and 7 days for illness. Pregnancy is also covered after policy is in force for 10 full months.
The following benefits are automatically included in your plan at no additional cost and no time off from work is required:
Breaks, Fractures |
PLAN 1 |
PLAN 1 ½ |
PLAN 2 |
PLAN 2.5 |
PLAN 3 |
Up to $2,000 |
Up to $3,000 |
Up to $4,000 |
Up to $5,000 |
Up to $6,000 |
Hospital Confinement |
PLAN 1 |
PLAN 1 ½ |
PLAN 2 |
PLAN 2.5 |
PLAN 3 |
$100/day for
90 days |
$150/day for
90 days |
$200/day for
90 days |
$250/day for
90 days |
$300
/day for
90 days |
Ambulance |
PLAN 1 |
PLAN 1 ½ |
PLAN 2 |
PLAN 2.5 |
PLAN 3 |
$100 |
$150 |
$200 |
$250 |
$300 |
Medical Expenses, X-Rays, Emergency Services |
PLAN 1 |
PLAN 1 ½ |
PLAN 2 |
PLAN 2.5 |
PLAN 3 |
$250 |
$375 |
$500 |
$625 |
$750 |
Accidental Death |
PLAN 1 |
PLAN 1 ½ |
PLAN 2 |
PLAN 2.5 |
PLAN 3 |
$20,000 |
$30,000 |
$40,000 |
$50,000 |
$60,000 |
To apply for the coverage click here to download the application (Please note that you must have Adobe Acrobat Reader installed to view and/or print this form)
Download Acrobat player FREE! |
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Flexible Benefits
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January 2010