GROUP CRITICAL ILLNESS CI
Covered Specific Critical Illnesses: CANCER (Internal/Invasive) ....................................................100% HEART ATTACK (Myocardial Infarction) ............................100% STROKE (Apoplexy or Cerebral Vascular Accident) ......100% MAJOR ORGAN TRANSPLANT ..............................................100% RENAL FAILURE (End Stage)....................................................100% CARCINOMA IN SITU ....................................................................25% CORONARY ARTERY BYPASS SURGERY ................................25% NOTE: If a benefit is paid for carcinoma in situ, the internal cancer benefit will be reduced by 25%. If a benefit is paid for coronary artery bypass surgery, the heart attack benefit will be re- duced by 25%. All covered conditions are subject to the definitions found in your certificate.
PLAN BENEFITS First Occurrence Benefit After the waiting period, a Lump Sum Benefit is payable upon initial diagnosis of a covered illness. Employee benefit amounts available from $5,000 to $50,000. Spouse coverage is also avail- able in benefit amounts up to $25,000. If you are deemed ineligible due to a previous medical condition you still retain the ability to purchase spouse coverage. Additional Occurrence Benefit If an insured collects full benefits for a criti- cal illness under the plan and later has one of the remaining covered ill- nesses, then we will pay the full benefit amount for each additional illness. Occurrences must be separated by at least 6 months.
Re-Occurrence Benefit If an insured collects full benefits for a covered condition and is later diagnosed with the same condition, we will pay the full benefit again.The two dates of diagnosis must be separated by at least 12 months or for Cancer, 12 months treatment free. Cancer that has spread (metastasized) even though there is a new tumor, will not be considered an additional oc- currence unless the Insured has gone treatment free for 12 months.
25% Child Coverage at no Additional Cost Each dependent child is covered at 25 percent of the primary insured amount at no additional charge.
$50 Health Screening Benefit (employee and spouse) After the Waiting Period, pays a maximum of $50 for any one covered health screening test per calendar year.We will pay this benefit regardless of the results of the test. Covered health screening tests include (but are not limited to): mammography, colonoscopy, pap smear, breast ultrasound, chest x-ray, PSA (blood test for prostate can- cer), stress test on a bicycle or treadmill, and bone marrow testing. FEATURES Guaranteed Issue $10,000 employee/$5,000 spouse based on 20% participation and 50 applications • $5,000 employee based on 10% participation and 25 applications.
Same Day Coverage Coverage will be effective the date the employee signs the application pending underwriting approval.
Portability Employees can keep coverage at same rates and benefits if they leave their job, with certain stipulations.
Cancer Option May be sold with or without cancer benefit.
Premium Options May be sold on tobacco/non-tobacco structure or uni-tobacco structure.
HEART RIDER
PARALYSIS ................................................................................................100% SEVERE BURNS ........................................................................................100% COMA ........................................................................................................100% LOSS OF SPEECH ....................................................................................100% LOSS OF SIGHT ........................................................................................100% LOSS OFHEARING ..................................................................................100% ADDITIONAL BENEFIT RIDER
SPECIFIED SURGERIES OF THE HEART ........................................100% CORONARY ARTERY BYPASS SURGERY, MITRAL VALVE REPLACE- MENT/REPAIR, AORTIC VALVE REPLACEMENT/REPAIR, SURGICAL TREATMENT OF ABDOMINAL, AORTIC ANEURYSM INVASIVE HEART PROCEDURES AND TECHNIQUES ....................10% ANGIO CLOST BUSTING, BALLOON ANGIOPLASTY, LASER ANGIO- PLASTY, ATHERECTOMY, STENT IMPLANTATION, CARDIAC CATHETERI- ZATION, AUTOMATIC IMPLANTABLE CARDIOVERTER DEFIBRILLATOR, PACEMAKERS
CAI2880
13 YATES LLC 2022 BENEFIT GUIDE
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