|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
|Major organ transplant|
Undergoing surgery as a recipient of a transplant of a heart, lung, liver, kidney or pancreas
Covering the permanent paralysis due to a covered accident and continuing for a period of 180 consecutive days
|End-stage renal (kidney) failure|
|Coronary artery bypass surgery|
Paid once per lifetime
|Employee Coverage||You may choose a face amount from $5,000 to $50,000 in $1,000 increments.|
|Spouse Coverage||You 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 Amounts||You may choose a face amount for your children from $2,500 or $5,000. You must elect employee coverage to elect child coverage.|
Coverage on a dependent child terminates on the earliest of the following:
- 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.
- 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.
- 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 Benefits||The 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.|
|Exclusions||Benefits 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.
|Terminations||The 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.