HOSPITAL INDEMNITY The Guardian Hospital Indemnity Plan is designed to provide you and eligible family members , with cash benefits when you ' re hospitalized due to a covered illness or injury . When first eligible , there are no physical exams or blood tests required , and coverage is 100 % portable . Benefits are paid directly to you ! Description of Benefits Hospital | ICU Admission $ 1 , 000 | $ 2 , 000 Hospital | ICU Confinement $ 100 | $ 200 Per Day Hospital Short Stay ( 1 Day Per Year ) $ 200 Newborn Nursery Care ( 1 Day Per Year ) $ 100 Newborn Increased Admission | Confinement 25 % Increase to Child Benefit Child Organized Sports 25 % Increase to Child Benefit Annual Health Screening Benefit for $ 50 / Year * Employee , Covered Spouse & Child ( ren ) * Must Complete Annual Wellness Screenings or Procedures Plan Pays Employee Only $ 11 . 55 Employee + Spouse $ 29 . 35 Employee + Child ( ren ) $ 21 . 04 Employee + Family $ 38 . 84 Monthly Premium * Wellness Benefit includes coverage for screenings & procedures such as , mammography , colonoscopy , pap smear , PSA , chest x - ray , and many more . The benefit is payable once per calendar year for the covered employee spouse , and child ( ren ). Employee Only Annual Premium = $ 138 . 60 Annual Wellness Benefit = $ 50 . 00 * Net Annual Cost = $ 88 . 60 Employee + Spouse Annual Premium = $ 352 . 20 Annual Wellness Benefit = $ 100 . 00 * Net Annual Cost = $ 252 . 20 Employee + Child ( ren ) Annual Premium = $ 252 . 48 Annual Wellness Benefit = $ 100 . 00 * Net Annual Cost = $ 152 . 48 Employee + Family Annual Premium = $ 466 . 08 Annual Wellness Benefit = $ 150 . 00 * Net Annual Cost = $ 316 . 08 * Wellness Benefit Annual Net Cost - Shows the Employee + Child ( ren ) and Family with only one child . The benefit is paid to each covered participant after the annual heath screening has been completed . Annual Net Cost