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Plan Description

 

KEY BENEFITS

  • Helps pay expenses not covered by medical insurance

  • Covers over 20 serious illnesses, plus 21 childhood illnesses (7 serious illnesses in New York)

  • Pays lump sum directly to you, not medical providers


What Is Critical Illness Insurance?

Critical Illness insurance helps cover out-of-pocket expenses associated with a serious illness. You may have medical insurance. But that doesn't mean you're covered for all of the expenses resulting from a serious illness that you probably haven't budgeted for  things like co-pays, deductibles, loss of income, child care and travel expenses. Group Critical Illness insurance helps fill the gap caused by these out-of-pocket costs, creating a financial safety net for you and your family.

How Does Critical Illness Insurance Work?

Critical Illness insurance provides an extra layer of protection that can make a big difference in your ability to pay out-of-pocket expenses associated with a serious illness. It pays a lump-sum benefit directly to you upon diagnosis of a covered illness, regardless of your treatment costs or what’s covered by your medical insurance.

BENEFIT EXAMPLES

Help Ensure Your Financial Plans Stay Healthy Even When You're Not

Critical Illness insurance is an affordable way to make up the difference between what your health insurance covers and what you'd owe out of pocket if you or a family member were diagnosed with a covered serious illness.

Back surgery

Cancer
Shayna beat cancer, but there were many costs she didn't expect. Beyond her medical plan’s coinsurance for chemotherapy treatments and copays for doctor appointments, she purchased hair prosthetics, had to pay for travel to specialists, and underwent alternative treatments that she felt helped her. What's more, her husband missed work to help care for her. Fortunately, she had Critical Illness insurance coverage, which helped provide an essential buffer for her family's finances while she was being treated.

Shayna used her insurance benefit to help pay for:

  • Medical insurance deductible
  • Out-of-pocket expenses for six months
  • Alternative treatments and diets not covered by her medical plan
  • Transportation to medical appointments and treatments
  • Lodging near treatment facility
  • Husband's lost wages

*Example is for illustrative purposes. Eligibility for benefits and amounts shown in this example may vary from any policy your employer may offer and may vary based upon your individual circumstances, policy definitions, waiting periods, exclusions and limitations.

Pregnancy

Heart Attack
Meghan's husband suffered a heart attack that not only required hospitalization, but made it impossible for him to work for months. Fortunately, Meghan signed up for Critical Illness insurance for her spouse. The benefits not only helped her pay for their medical insurance deductible, copays and other out-of-pocket expenses, but they also helped provide a much-needed buffer for their regular monthly expenses while he recovered. They even used a portion of the benefit for specialists who helped her husband improve his health and manage his stress.

Meghan used the benefit to help pay for:

  • Medical insurance deductible
  • Prescription copays and coinsurance
  • Sessions with wellness specialist
  • Lost wages

*Example is for illustrative purposes. Eligibility for benefits and amounts shown in this example may vary from any policy your employer may offer and may vary based upon your individual circumstances, policy definitions, waiting periods, exclusions and limitations.

Asthma

Congenital Illness
The birth of Mateo’s new baby took a surprising turn when he found that their baby had a developmental defect called spina bifida. While not life threatening, this condition meant his son required specialist visits, surgeries and assistive devices to promote his development. Fortunately, Mateo's Critical Illness coverage paid a benefit equal to 25 percent of the coverage amount he chose for himself. This benefit helped his family cover much of the unexpected costs of taking special care of his son.

Mateo used the benefit to help pay for:

  • Medical insurance deductible
  • Specialist copays (six visits)
  • Coinsurance for two surgeries
  • Assistive devices

*Example is for illustrative purposes. Eligibility for benefits and amounts shown in this example may vary from any policy your employer may offer and may vary based upon your individual circumstances, policy definitions, waiting periods, exclusions and limitations.

Hospital

Advanced Alzheimer's Disease
When Steven's spouse was in the early stages of Alzheimer’s disease, she could still function independently despite a few memory lapses. But recently, her condition has progressed to an advanced stage, and caring for her condition was becoming very expensive. There were constant copays because of ongoing doctors’ visits and medication, and expensive therapies not covered by medical insurance. Eventually, he needed to hire in-home help. Fortunately, Steven's Critical Illness benefit helped cover those expenses as their lives adjusted to meet her needs.

Steven used his benefit to help pay for:

  • Doctor visit copays
  • Prescription copays
  • Safety-related home modifications
  • In-home caregiver (20 hours per week)

*Example is for illustrative purposes. Eligibility for benefits and amounts shown in this example may vary from any policy your employer may offer and may vary based upon your individual circumstances, policy definitions, waiting periods, exclusions and limitations.

 

BENEFITS

Plan Availability All States
Enrollment Deadline 18th of month Prior to Effective date
Eligibility

Must meet the following criteria to be eligible for coverage:

1. full-time employment, working 20 or more hours per week,

2. 30 days of continuous employment with the employer,

3. actively at work on the effective date of coverage, and

4. Must be between 18 and 69 years of age (Primary and Spouse) for Guaranteed Issue. Dependent Children (unmarried) ages 0-25.

Here are some things you should consider:
Although improved medical treatment and survival rates are a good thing, that's only half the story.
Even if you have primary health insurance, there are many expenses that may not be covered.
Can I afford my deductible and coinsurance payments? Does my current insurance cover fees for specialists and experimental treatment?
Can I afford an unpaid leave of absence from work? How would I pay my mortgage, rent or car payment if I could not work for a period of time?
What's so great about Critical Illness Insurance?
Pays in addition to any other insurance you may have
 
Pays a cash lump sum upon diagnosis of a critical illness
 
Benefits can be used to pay:
Coinsurance and deductibles from other insurance plans, Necessities like mortgage, rent, car payments, Specialist fees and experimental treatment, Day-to-day living expenses like additional childcare, Special equipment OR Home modifications necessary for recovery, Treatment-related travel expenses like parking, food, gas, hotel stays and pet boardin and the list foes on.
Benefits
Category 1 Category 2 Category 3
- Invasive Cancer (100%) - Heart Attack (100%) - Coma (100%)
- Invasive Cancer -diagnosis prior to 90 days
of in force coverage (10%)*
- Heart Transplant (100%) - End-Stage Renal Failure (100%)
- Cancer In Situ (25%) - Stroke (100%) - Major Organ Transplant, other than heart (100%)

- Cancer In Situ -diagnosis prior to 90 days
of in force coverage (2.5%)*

- Angioplasty (25%)
- Paralysis (100%)
  - Aortic Surgery (25%)  
  - Coronary Artery Bypass Surgery (25%)  
  - Heart Valve Replacement/Repair Surgery (25%)  
 
*No additional benefits will be paid if diagnosis or treatment in first 90 days (30 days for Employer Group).
WHAT MAKES US UNIQUE

1. Multiple Benefit Feature:
A maximum of 100% of the benefit applied for is paid in each category (other than Category 1 in the first 90 days) for a total of up to three (3) times the policy benefit amount as long as the illnesses are diagnosed at least 180 days apart.8 If you become ill and the first benefit paid under a category does not equal 100% of the benefit amount you selected, you are then eligible for subsequent benefit payments for covered illnesses in the same category until you reach 100% of your selected benefit amount.

2. Recurrence Benefit:
If you become ill and are paid full benefits for a Category 2 or 3 Critical Illness, you can receive an additional 25% payment of the benefit amount you selected if you have a recurrence. This is available for up to 2 recurrences as long as you have not exceeded your maximum benefit amount and the occurrences are more than 18 months apart.

3. Additional Benefit:
If you are paid benefits for the first occurrence of a specified covered Critical Illness more than 90 days after your policy is issued, we will pay an additional cash lump sum, equal to 6 months of premium, to help cover premium payments or other expenses.

4. Optional Mortgage Protection
If you are totally disabled for more than 30 days, for each 30-day period you continue to be totally disabled, we will pay the monthly Mortgage Protection Benefit up to the maximum rider benefit you selected.

   
1 Heart Disease and Stroke Statistics, 2010 Update At-A-Glance, American Heart Association
2 Clinical Research Study. Harvard U. 16 Mar. 2011. hp.org/new_bankruptcy_study/Bankruptcy-2009.pdf
3 American Cancer Society, Cancer Facts and Figures 2010
4 The Merck Manuals Online Medical Library, Acute Kidney Failure, 16 Feb. 2011, www.merckmanuals.com
5 Essential Benefits, Why do I need critical illness insurance? 2 Feb. 2011, www.essentialbenefits.ca
6 FAQs.org, Health, Organ Transplantation 16 Feb. 2011, www.faqs.org/health/topics
7 Bloomberg Businessweek Study Links Medical Costs and Personal Bankruptcy.
4 Jun. 2009. Web. 3 Mar. 2011, www.businessweek.com
8 Benefits will not be paid for critical illnesses in more than a single category during any 180 day period.

THIS POLICY PROVIDES LIMITED BENEFITS. Policy Form Series SLA-CI11/SLA-CI11-GEP and Mortgage Protection Benefit Rider SLA-CIMP11/SLA-CIMPGE is not available in all states and benefits may vary. The policy has specific terms and conditions relating to coverage, including limitations and exclusions. For costs and complete details of the coverage, please call or write the company or your insurance professional.
   
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About Standard Life and Accident Insurance Company

Standard Life and Accident Insurance Company (Standard Life) was founded to provide clients with realistic life and health products that solve their needs for financial security.

Since its inception, more than 70 years ago, the Company's ethic has never changed. "People's needs change from day to day. The shrinking value of the dollar makes insurance protection more important to the individual...We must develop think-ahead programs today which will provide benefits in keeping with the economic changes of tomorrow. While we've grown so fast, it has not been at the expense of the human factor, so vital to this business. Efficiency is emphasized. However, we try never to lose sight of the personal aspects of our relations with policyowners and business clients, as well as our own agents and employees." Leonard H. Savage, President 1948-1973, Standard Life and Accident Insurance Company.

Standard Life and Accident Insurance Company (“Standard Life”) has been evaluated and assigned the following ratings by nationally recognized, independent rating agencies. The ratings are current as of November 2018.

A.M. Best1: A
Standard & Poor's2: A-

Ratings reflect current independent opinions of the financial capacity of an insurance organization to meet the obligations of its insurance policies and contracts in accordance with their terms. They are based on comprehensive quantitative and qualitative evaluations of the company and its management strategy. The rating agencies do not provide ratings as a recommendation to purchase insurance or annuities. The ratings are not a warranty of an insurer’s current or future ability to meet its contractual obligations.

Ratings may be changed, suspended, or withdrawn at any time.

1A.M. Best’s active company rating scale is: A++ (Superior), A+ (Superior), A (Excellent), A- (Excellent), B++ (Good), B+ (Good), B (Fair), B- (Fair), C++ (Marginal), C+ (Marginal), C (Weak), C- (Weak) and D (Poor).

2Ratings from ‘AA’ to ‘CCC’ may be modified by the addition of a plus (+) or minus (-) sign to show relative standing within the major rating categories. For a list of Standard & Poor's active company rating scale visit www.standardandpoors.com.






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