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Published byLucy Cox Modified over 9 years ago
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Specified Illness Continental American Insurance Company (CAIC)
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February 2010 2 APRIL 2010 What is Specified Illness? With the group specified illness plan, the goal is to help you and your family cope with and recover from the financial stress of surviving a critical illness or condition. Illness Covered % of Face Amount Heart Attack100 Stroke100 Major Organ Transplant100 Renal Failure (End Stage)100 Internal Cancer100 Coma100 Severe Burns100 Paralysis 100 Loss of Sight/Hearing/Speech100 Alzheimer’s 25 Carcinoma in situ 25 Coronary artery 25 Lump-sum benefits paid directly to the insured following the diagnosis of each covered specified illness after you are hospital confined for the specified illness and charged for room and board. Rates cannot be individually increased due to change in age, health or individual claim. There is no medical underwriting required for up to $30,000 in coverage, and simplified medical underwriting process with only a few health questions.
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February 2010 3 APRIL 2010 What is Specified Illness? Provides a partial benefit (25%) for Carcinoma in situ Coronary artery Payment of the partial benefit for carcinoma in situ will reduce the benefit for internal cancer Payment of the partial benefit for coronary artery will reduce the benefit for a heart attack
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February 2010 4 APRIL 2010 Who Can Participate? Employees ages 18 - 69 are eligible for coverage When a person reaches age 70, the benefits are continued at 50% of selected coverage Premiums remain the same as long as coverage is maintained 6 COVERAGE LEVELS AVAILABLE FOR EMPLOYEES Level 1 - $5,000 Level 2 - $10,000 Level 3 - $20,000 Level 4 - $30,000 Level 5 - $40,000 Level 6 - $50,000
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February 2010 5 APRIL 2010 Specified Illness Spouse and Child Coverage SPECIFIED ILLNESS SPOUSE COVERAGE $5,000 of coverage available for the spouse Premium will be based on the employee’s age Premiums remain the same as long as coverage is maintained SPECIFIED ILLNESS CHILD COVERAGE Coverage is automatically added to existing employee coverage equivalent to 10% of employee’s coverage No Medical Underwriting required No additional premium
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February 2010 6 APRIL 2010 Occurrence Benefits FIRST OCCURRENCE BENEFIT Lump Sum benefit is payable upon initial diagnosis of a covered illness or condition after you are hospital confined for the specific critical illness and charged for room and board. ADDITIONAL OCCURRENCE BENEFIT If an insured collects full benefits for a critical illness under the plan and later has one of the remaining covered illnesses, then we will pay the full benefit amount for any additional illness Occurrences must be separated by at least 6 months
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February 2010 7 APRIL 2010 Re-Occurrence Benefit If an insured receives full benefit for a covered condition and is later diagnosed with the same condition, we will pay the full benefit again Two dates of diagnosis must be separated by at least 12 months, or 12 months treatment free for Internal Cancer
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February 2010 8 APRIL 2010 Health Screening Benefit An insured may receive a maximum of $50 for any one covered screening test per calendar year Benefit will be paid regardless of results of the test Payment will not reduce the amount payable for diagnosis of a critical illness Health Screening Benefit List Stress test on a bicycle or treadmill Fasting blood glucose test, blood test for triglycerides or serum cholesterol test to determine level of HDL and LDL Bone marrow testing Breast ultrasound CA 15-3 (blood test for breast cancer) CA 125 (blood test for ovarian cancer) CEA (blood test for colon cancer) Chest X-Ray Colonoscopy Flexible sigmoidoscopy Hemocult stool analysis Mammography Pap smear PSA (blood test for prostate cancer) Serum protein electrophoresis (blood test for myeloma) Thermography
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