Critical Illness Benefit Summary



Critical Illness Benefit Summary

Critical Illness Benefit Summary
Critical Illness insurance can supplement major medical coverage and group disability plans by helping employees pay the direct and indirect costs associated with a critical illness or event.

This plan will be discontinued 1-1-2009.

Plan Summary
A lump sum benefit is paid, based on a percentage of the face amount, upon diagnosis of one of the following critical illnesses or events.

Covered Critical Illness
Percentage of face amount paid
Heart attack
100%
Stroke
100%
Major organ transplant
Undergoing surgery as a recipient of a transplant of a heart, lung, liver, kidney or pancreas
100%
Permanent paralysis
Covering the permanent paralysis due to a covered accident and continuing for a period of 180 consecutive days
100%
End-stage renal (kidney) failure
100%
Coronary artery bypass surgery
Paid once per lifetime
25%
Employee CoverageYou may choose a face amount from $5,000 to $50,000 in $1,000 increments.
Spouse CoverageYou may choose a face amount for your spouse from $5,000 to $30,000 in $1,000 increments. You must elect employee coverage to elect spouse coverage. Covered conditions and payment percentages are the same as those for the employee.
Child AmountsYou may choose a face amount for your children from $2,500 or $5,000. You must elect employee coverage to elect child coverage.
    • Children newborn through 24 years
    • One rider covers all children.
    • Covered conditions and payment percentages are the same as those for the employee, except the coronary artery bypass surgery is paid at 100%.
    • There is no reduction of benefits for child coverage.
Coverage on a dependent child terminates on the earliest of the following:
    • When the child reaches age 25;
    • When the child becomes married;
    • When UnumProvident is notified there are no longer any children eligible for coverage;
    • When 100% of the available face amount for this rider is paid.
Optional Benefits
Additional Features
    • Coverage becomes effective upon enrollment.
    • Payable through payroll deductions.
    • No pre-existing limitation on basic coverage.
    • The lump sum benefit payment can be used however you choose.
    • You do not have to be terminally ill to receive benefits.
    • Helps offset costs not covered by medical insurance.
    • Policy is guaranteed renewable for life as long as premiums are paid and full benefits have not been paid.
    • Continuation of coverage - you can take your coverage with you if you change jobs or retire.
Reduction of BenefitsThe face amount for employees and spouses reduce by 50% on the first policy anniversary after the insured's 70th birthday, or five years after the policy date, whichever is later.Premiums will not be reduced.
ExclusionsBenefits will not be paid for a critical illness that occurs as a result of:
    • Transient ischemic attacks;
    • Balloon angioplasty, laser relief or other like procedures;
    • The insured participating or attempting to participate in illegal activity;
    • The insured committing or attempting to commit suicide or injuring him/herself intentionally, where he/she is sane or not;
    • The insured practicing for or participating in any semi-professional or professional competitive athletic contest for which any type of compensation or remuneration is received;
    • The insured's involvement in any period of armed conflict, even if it is not declared.
TerminationsThe policy will terminate on the earliest of the following:
    • Written request by the insured to terminate the policy;
    • Failure to pay the premiums for the policy, subject to the grace period allowed;
    • Payment of the available face amount as defined in the policy or in any other attached supplementary benefit;
    • Death of the insured.
Cancer and Carcinoma in Situ Rider
    • All insureds covered by a critical illness policy or critical illness rider may elect this additional coverage.
    • Upon diagnosis of cancer, as defined in the policy, the insured will be paid 100% of the face amount.
    • Upon diagnosis of carcinoma in situ, as defined in the policy, the insured will be paid 25% of the face amount (100% for children). Benefits for carcinoma in situ are payable only once per lifetime.
    • Benefits will be paid if the date of diagnosis occurs after the insured fulfills a 30-day waiting period.
    • The reduction of benefits follows the same basis as those for the critical illness base policy and/or critical illness rider.
    • There is an additional premium for this rider. The rider terminates when the base policy terminates or when 100% of the available face amount is paid out.