Critical Illness – Explore Your Benefits Flyer 2024
There are more than just medical bills to pay after a heart attack, stroke, or other unexpected covered medical condition. Critical Illness Insurance provides a benefit payment that can help.
Critical Illness Insurance Explore Your Benefits & Costs Group Name: UnityPoint Health Group Number: 688941 There are more than just medical bills to pay after a heart attack, stroke, or other unexpected covered medical condition. Critical Illness Insurance provides a benefit payment that can help. This document includes expanded cost and benefit information for Critical Illness Insurance. As you explore, keep in mind: Benefit payments go directly to Coverage is always Employees get an annual you. Use them however you’d guaranteed issue. Wellness Benefit of $50 for like! completing an eligible health screening test. Critical Illness Insurance doesn’t replace your medical coverage; instead, it complements it. The benefit payments don’t go out to pay for medical bills or treatments you may need, instead they come in— directly to you—to be used however you’d like. Choose this supplemental health insurance product for added protection if one of the following covered conditions comes your way. Critical Illness Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. ReliaStar Life Insurance Company a member of the Voya® family of companies
How much coverage is available? You have the option to enroll in coverage in the amount(s) below. Coverage Amount For you Choice of $10,000, $20,000 or $30,000 Your spouse $10,000 – Not to exceed 100% of employee benefit Your children* $5,000 – Not to exceed 50 % of employee benefit *Child(ren) up to age 26. What’s covered by Critical Illness Insurance? Critical Illness Insurance provides benefits for the covered conditions and diagnoses shown below. The most common conditions we pay claims for include: Heart attack* Major organ Stroke transplant** Coronary artery bypass Cancer Sample benefit amounts If one of these events happens on or after your coverage effective date, and your claim is approved, benefits are payable at 100% of the Critical Illness benefit amount shown above unless otherwise stated. Use your benefit payment however you’d like: Covered Condition % of Benefit Heart attack* 100% Cancer 100% Stroke 100% Coronary artery bypass 25% * A sudden cardiac arrest is not in itself considered a heart attack. **Listed in the certificate of coverage as “major organ transplant,” which means the irreversible failure of your heart, lung, pancreas, entire kidney or liver, or any combination thereof, determined by a physician specialized in care of the involved organ. This is only a small preview of the benefits available to you. See the full Schedule of Benefits toward the end of this document.
How much does Critical Illness Insurance cost? The table below shows how much you’ll pay for Critical Illness Insurance. Rates are dependent on your age and amount of coverage selected. Employee Coverage Spouse Coverage* Bi-Weekly Rates (26 pay periods) Bi-Weekly Rates (26 pay periods) Includes Wellness Benefit Rider Includes Wellness Benefit Rider Age $10,000 $20,000 $30,000 Age $10,000 Under $2.22 $4.43 $6.65 Under 30 $2.68 30 30-39 $3.18 30-39 $2.77 $5.54 $8.31 40-49 $5.22 $10.43 $15.65 40-49 $6.00 50-59 $10.15 $20.31 $30.46 50-59 $12.55 60-64 $14.68 $29.35 $44.03 60-64 $19.15 65-69 $18.88 $37.75 $56.63 65-69 $21.92 70+ $25.48 $50.95 $76.43 70+ $33.05 Children Coverage Bi-Weekly Rates (26 pay periods) Includes Wellness Benefit Rider Coverage Amount Rate $5,000 $1.41 *Spouse rate dependent on spouse age. Children birth to age 26; no limit to the number of children per family. Schedule of Benefits The table below outlines a more detailed list of what’s covered. Please note that the covered condition/diagnosis must happen on or after your coverage effective date. Benefits are payable at 100% of the Critical Illness benefit amount unless otherwise stated. For a list of standard exclusions and limitations, please refer to the exclusions section later in this document. For a complete description of your benefits, along with applicable provisions, conditions on benefit determination, exclusions and limitations, see your certificate of insurance and any riders. Covered Condition % of Benefit Heart attack* 100% Cancer 100% Stroke 100% Sudden cardiac arrest 25%
Major organ transplant (includes Major Organ Failure & End Stage Renal (Kidney) Failure)** 100% Coronary artery bypass 25% Carcinoma in situ 25% Type 1 Diabetes 100% Transient ischemic attacks (TIA) 10% Ruptured or dissecting aneurysm 10% Abdominal aortic aneurysm 10% Thoracic aortic aneurysm 10% Open heart surgery for valve replacement or repair 25% Severe burns 100% Transcatheter heart valve replacement or repair 10% Coronary angioplasty 10% Pacemaker Placement 10% Implantable/internal cardioverter defibrillator (ICD) placement 25% Benign brain tumor 100% Skin cancer 10% Bone marrow transplant 25% Stem cell transplant 25% Permanent paralysis 100% Loss of sight 100% Loss of hearing 100% Loss of speech 100% Coma 100% Multiple sclerosis 100% Amyotrophic lateral sclerosis (ALS) 100% Parkinson’s disease 100% Advanced dementia, including Alzheimer’s disease 100% Huntington’s disease 100% Muscular dystrophy 100% Infectious disease (hospitalization requirement)*** 25% Addison’s disease 10% Myasthenia gravis 50% Systemic lupus erythematosus (SLE) 50% Systemic sclerosis (scleroderma) 10% Occupational HIV 100%
Occupational Hepatitis B or C 100% * A sudden cardiac arrest is not in itself considered a heart attack. ** Major organ transplant means the irreversible failure of your heart, lung, pancreas, entire kidney or liver, or any combination thereof, determined by a physician specialized in care of the involved organ. *** Diagnosis of a severe infectious disease by a Doctor, including COVID-19, when a diagnosis occurs on or after the group’s coverage effective date; AND Confinement to a Hospital for 5 or more consecutive days, or in a transitional facility for 5 or more consecutive days. Benefits for insured children In addition to the covered conditions mentioned above, coverage for your insured children includes: Covered Condition % of Benefit Cerebral palsy 100% Congenital birth defects 100% Cystic fibrosis 100% Down syndrome 100% Gaucher disease, type II or III 100% Infantile Tay-Sachs 100% Niemann-Pick disease 100% Pompe disease 100% Sickle cell anemia 100% Type 1 diabetes 100% Type IV glycogen storage disease 100% Zellweger syndrome 100% Multiple benefit payments You can receive a lump–sum benefit payment (up to 100% of the benefit amount associated with that condition) for each covered condition. The number of times a benefit is payable for each covered condition is unlimited. Additional details are provided in the certificate of coverage.
What else is included? The Critical Illness Insurance available through your employer includes the following additional benefits: Wellness Benefit Receive $50 to The Wellness Benefit provides an annual benefit if you complete a covered use however health screening test whether or not there is any out-of-pocket cost to you. you’d like Employees receive an annual benefit of $50. Spouses receive an annual benefit of $50. Children receive 100% of your benefit amount per child. Infectious Condition Additional Benefit Rider If you are diagnosed with COVID-19**, this pays a benefit amount of $100. If you are hospitalized for COVID-19 and there is a room & board charge for that hospitalization, this pays a benefit amount of $1,000. Confinement is Receive a specifically defined in the certificate and also includes assignment to an benefit for an observation unit in a Hospital for at least 20 consecutive hours. (This benefit is infectious separate from Infectious Disease and does not require a hospital confinement condition of 5 or more consecutive days) A benefit is payable up to a maximum of 1 times per Covered Person per Policy calendar year. Coverage benefits for infectious conditions, such as COVID-19, have NOT been filed or approved in Washington. **COVID-19 diagnosis must be confirmed by a medical professional.
Specified Conditions Rider ** Specified Conditions Diagnosis Benefit We will pay you a Specified Condition Diagnosis benefit if you are diagnosed with Autism Spectrum Disorder Level 3 on or after the coverage effective date. If your spouse and/or child(ren) are covered for Critical Illness, they are eligible for this benefit, also. This pays a benefit amount as shown below: CI Benefit Amount CI Benefit Amount Specified Condition $10,000 $20,000 EE SP CH EE SP CH Autism Spectrum Disorder Level 3 $5,000 $5,000 $5,000 $5,000 $5,000 $5,000 CI Benefit Amount $30,000 EE SP CH $5,000 $5,000 $5,000 Specified Condition Facility Confinement Benefit If you are diagnosed with Bipolar disorder or Depressive disorder that results in a Confinement to a Hospital*, Rehabilitation Facility or Transitional Care Facility, we will pay you a Specified Condition Facility Confinement benefit. This benefit is payable if the Confinement occurs on or after the coverage effective date regardless of when the Specified Condition is Diagnosed. If your Receive a spouse and/or child(ren) are covered for Critical Illness they are eligible for this benefit for a benefit. Specified Condition Confined or Confinement means that on the advice of a Health Care Provider, your assignment to a bed as a resident inpatient in a Hospital, Rehabilitation Facility or Transitional Care Facility. Being admitted to an Observation Unit for 20 hours or more also meets the definition of Confined or Confinement. There must be a charge for room and board for the Confinement, other than in any government, military or veterans’ facility or Observation Unit. A Specified Condition Facility Confinement benefit is payable up to a total maximum of one time per a Covered Person’s lifetime. This pays a benefit amount shown below: Benefit Amount Benefit Amount Specified Condition $10,000 $20,000 EE SP CH EE SP CH Bipolar disorder $2,500 $2,500 $1,250 $5,000 $2,500 $1,250 Depressive disorder $2,500 $2,500 $1,250 $5,000 $2,500 $1,250 Benefit Amount $30,000 EE SP CH $7,500 $2,500 $1,250 $7,500 $2,500 $1,250 **This rider is subject to approval by the Iowa Department of Insurance and Financial Services – Insurance Division and may change. Any claims that are filed prior to state approval may be delayed.
* Hospital means an institution that is run for the care and treatment of sick or injured persons as in-patients and which, on its premises or in facilities available to the Hospital on a pre-arranged basis, fully meets each of the following requirements: • It is operated in accordance with the laws pertaining to hospitals in the jurisdiction in which it is located; • It is under the supervision of a medical staff and has one or more Doctors available at all times; • It provides 24 hours a day service by registered graduate nurses (RNs); and • It is not an institution or any part of an institution used as: a hospice unit, including any bed designated as a hospice or a swing bed; a convalescent home; a rest or nursing facility; a free-standing surgical center; an extended-care facility; a skilled nursing facility; or a facility primarily affording custodial, educational care or care for the aged. Exclusions and limitations There are no exclusions and limitations. Ready to Enroll? Enrollment instructions will be provided by your employer. If you have additional questions before you enroll, please call: Voya Employee Benefits Customer Service at (877) 236-7564 or go to https://presents.voya.com/EBRC/UnityPointHealth This is a summary of benefits only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern. To keep coverage in force, premiums are payable up to the date of coverage termination. Critical Illness Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a ® member of the Voya family of companies. Policy form #RL-CI4-POL-16; Certificate form #RL-CI4-CERT2-20; Spouse Rider form #RL-CI4- SPR2-20; Children's Rider form #RL-CI4-CHR2-20; Wellness Benefit Rider form #RL-CI4-WELL2-20; Infectious Condition Additional Benefit rider form # RL-CI4-ICBR-22; and (pending state approval) Specified Condition Benefit Rider form #RL-C14-SCR-23. Form numbers, provisions and availability may vary by state and employer’s plan. CN3082180_0825 CI 2.1 Only Date Revised: 08/28/2023 213465-03152021