Distributed by: Operating subsidiaries of Cigna Corporation. Insurance benefits are underwritten by Cigna Health and Life Insurance Company. Employee-Paid CRITICAL ILLNESS INSURANCE SUMMARY OF BENEFITS Prepared for: Mid-America Apartments, L.P. Critical Illness insurance provides a cash benefit when a Covered Person is diagnosed with a covered critical illness or event after coverage is in effect. See State Variations (marked by *) below. Who Can Elect Coverage: Eligibility for You, Your Spouse and Your Children will be considered by Your employer. You: All active, full-time Employees of the Employer who are regularly working in the United States a minimum of 20 hours per week and regularly residing in the United States and who are United States citizens or permanent resident aliens and their Spouse and Dependent Children who are United States citizens or permanent resident aliens and who are residing in the United States. You will be eligible for coverage on the first of month coinciding with or next following 90 days from date of hire or Active Service. Your Spouse:* Up to age 100, as long as you apply for and are approved for coverage yourself. Your Child(ren): Birth to age 26; 26+ if disabled, as long as you apply for and are approved for coverage yourself. Available Coverage: The benefit amounts shown will be paid regardless of the actual expenses incurred. The benefit descriptions are a summary only. There are terms, conditions, state variations, exclusions and limitations applicable to these benefits. Please read all of the information in this Summary and your Certificate of Insurance for more information. All Covered Critical Illness Conditions must be due to disease or sickness. For the Recurrence benefit to be available, the Covered Person must be treatment free and a Physician has determined that there is no evidence of active disease. Benefit Amount Guaranteed Issue Amount Employee $10,000, $20,000 Up to $20,000 Spouse 50% of employee amount Up to $10,000 Children 50% of employee amount, including Childhood Conditions. All guaranteed issue See “Guaranteed Issue” section below for more information. Covered Conditions Benefit Amount Cancer Conditions Skin Cancer* $250 1x per lifetime
Recurrence % of Initial Benefit Amount
Covered Conditions Invasive Cancer Carcinoma in Situ Vascular Conditions Heart Attack
Initial Benefit Amount %
100% 25% 100% 100% 25%
100% 25% 100% 100% 25%
Stroke
Coronary Artery Disease
Recurrence % of Initial Benefit Amount
Covered Conditions Nervous System Conditions Advanced Stage Alzheimer's Disease Amyotrophic Lateral Sclerosis (ALS)
Initial Benefit Amount %
25% 25% 25% 25%
Not Available Not Available Not Available Not Available Not Available Not Available Not Available Not Available
Parkinson's Disease Multiple Sclerosis Childhood Conditions* Cerebral Palsy Cystic Fibrosis Muscular Dystrophy Other Specified Conditions Benign Brain Tumor Poliomyelitis
100% 100% 100% 100% 100% 100% 25% 100% 100% 100%
100%
Blindness
Not Available
Coma
25% 100% 100%
End-Stage Renal (Kidney) Disease
Major Organ Failure
Paralysis 100% For Childhood Conditions please refer to the beginning of the Available Coverage section above for details on how much coverage is available for covered children. Wellness Treatment, Health Screening Test and Preventive Care Benefit* Benefit Amount
The benefit amount shown will be paid regardless of the actual expenses incurred and is paid on a per day basis. Also includes COVID-19 Immunization. Virtual Care accepted.
$50 1 per year
Benefits
Benefit for a diagnosis made after the effective date of coverage for each Covered Condition shown above. The amount payable per Covered Condition is the Initial Benefit Amount multiplied by the applicable percentage shown. Each Covered Condition will be payable one time per Covered Person. Benefit for the diagnosis of a subsequent and same Covered Condition for which an Initial Critical Illness Benefit has been paid.
Initial Critical Illness Benefit
Recurrence Benefit Skin Cancer Benefit
Pays benefit stated above.
Additional Benefits Hospital Indemnity - Pandemic Infectious Disease Admission Only Benefit* Pays when a Covered Person is confined to a hospital due to any Pandemic Infectious Disease (PID) hospitalization, including COVID-19.
Hospital PID Admission: $3000 per admission (Limited to 1 days, 1 benefit every 12 months)
Portability Feature: You can continue 100% of coverage for all Covered Persons at the time Your coverage ends. You must be covered under the policy and be under the age of 100 in order to continue your coverage. Rates may change and all coverage ends at age 100. Applies to United States Citizens and Permanent Resident Aliens residing in the United States.
Employee’s Bi-Weekly Cost of Coverage: Benefit Amount: $10,000 Age Employee
Employee + Spouse
Employee + Children
Employee + Family
<25
$1.06 $1.20 $1.62 $2.22 $2.88 $4.08 $6.01 $8.62
$1.73 $1.95 $2.59 $3.60 $4.66 $6.66 $9.60 $13.50 $17.25 $21.08 $29.33 $39.82 $49.62 $68.03 $68.03 $68.03 $3.45 $3.90 $5.19 $7.20 $9.31 $13.31 $19.19 $27.00 $34.50 $42.16 $58.65 $79.64 $99.24 $136.05 $136.05 $136.05
$2.01 $2.16 $2.58 $3.17 $3.83 $5.03 $6.96 $9.57
$2.67 $2.90 $3.54 $4.55 $5.61 $7.61 $10.55 $14.45 $18.20 $22.02 $30.27 $40.77 $50.57 $68.98 $68.98 $68.98 $5.34 $5.80 $7.08 $9.09 $11.22 $15.21 $21.09 $28.90 $36.41 $44.05 $60.54 $81.54 $101.14 $137.95 $137.95 $137.95
25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 94
$11.12 $13.49 $18.87 $26.71 $34.38 $43.05 $43.05 $43.05 $2.11 $2.41 $3.25 $4.44 $5.76 $8.16 $12.03 $17.24 $22.25 $26.98 $37.74 $53.42 $68.76 $86.10 $86.10 $86.10
$12.07 $14.44 $19.81 $27.66 $35.33 $44.00 $44.00 $44.00 $4.02 $4.31 $5.15 $6.34 $7.66 $10.06 $13.92 $19.14 $24.15 $28.88 $39.63 $55.32 $70.66 $88.01 $88.01 $88.01
95+
Benefit Amount: $20,000 Age Employee
Employee + Spouse
Employee + Children
Employee + Family
<25
25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 94
95+
Costs are subject to change. Actual per pay period premiums may differ slightly due to rounding. The policy's rate structure is based on attained age, which means the premium can increase due to the increase in your age.
Important Policy Provisions and Definitions: Covered Person: An eligible person who is enrolled for coverage under the Policy. Covered Loss: A loss that is specified in the Policy in the Schedule of Benefits section and suffered by the Covered Person within the applicable time period described in the Policy. When your coverage begins: Coverage begins on the later of the program’s effective date, the date you become eligible, the first of the month following the date your completed enrollment form is received, or if evidence of insurability is required, the first of the month after we have approved you (or your dependent) for coverage in writing, unless otherwise agreed upon by Cigna. Your coverage will not begin unless you are actively at work on the effective date. Coverage for all other Covered Persons will not begin on the effective date if the covered person is confined to a hospital, facility or at home, disabled or receiving disability benefits or unable to perform activities of daily living. When your coverage ends: Coverage ends on the earliest of the date you and your dependents are no longer eligible, the date the group policy is no longer in force, or the date for the last period for which required premiums are paid. For your dependent, coverage also ends when your coverage ends, when their premiums are not paid or when they are no longer eligible. (Under certain circumstances, your coverage may be continued. Be sure to read the provisions in your Certificate about when coverage may continue.) 30 Day Right To Examine Certificate: If a Covered Person is not satisfied with the Certificate of Insurance for any reason, it may be returned to us within 30 days after receipt. We will return any premium that has been paid and the Certificate will be void as if it had never been issued. Benefit Reductions, Common Exclusions and Limitations: Exclusions: In addition to any benefit-specific exclusions, benefits will not be paid for any Covered Loss that is caused directly or indirectly, in whole or in part by any of the following:• intentionally self-inflicted injury, suicide or any attempt
Benefit Reductions, Common Exclusions and Limitations: thereat while sane or insane; • commission or attempt to commit a felony or an assault; • declared or undeclared war or act of war; • a Covered Loss that results from active duty service in the military, naval or air force of any country or international organization (upon our receipt of proof of service, we will refund any premium paid for this time; Reserve or National Guard active duty training is not excluded unless it extends beyond 31 days); • voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; • operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant (‘’Under the influence of alcohol’’, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Loss occurred)• a diagnosis not in accordance with generally accepted medical principles prevailing in the United States at the time of the diagnosis. Specific Definitions, Benefit Exclusions and Limitations: The date of diagnosis must occur while coverage is in force and the condition definition must be satisfied. Only one Initial Benefit will be paid for each Covered Condition per person. Skin Cancer, basal cell/squamous cell carcinoma or certain forms of melanoma. Invasive Cancer, uncontrolled/abnormal growth or spread of invasive malignant cells. Excludes pre-malignant conditions or conditions with malignant potential. Carcinoma in Situ, non-invasive malignant tumor. Excludes premalignant conditions or conditions with malignant potential, skin cancers, invasive cancer (basal/squamous cell carcinoma or melanoma/melanoma in situ). Heart Attack, includes the following that confirms permanent loss of heart muscle function: 1) EKG; 2) elevation of cardia enzyme. Must have an inpatient admission. Stroke, cerebrovascular event–for instance, cerebral hemorrhage–confirmed by neuroimaging studies and neurological deficits lasting 96 hours or more. Excludes transient ischemic attack (TIAs), brain injury related to trauma or infection, brain injury associated with hypoxia or anoxia, vascular disease affecting eye or optic nerve or ischemic disorders of the vestibular system. Must have an inpatient admission. Coronary Artery Disease, heart disease/angina resulting in a blockage that restricts blood flow to the heart. Advanced Stage Alzheimer’s Disease, progressive degenerative disorder that attacks the brain’s nerve cells resulting in cognitive deficits interfering with independence in completion of instrumental activities of daily living and may also require the inability to perform at least 2 physical activities of daily living. Amyotrophic Lateral Sclerosis (ALS aka Lou Gehrig’s Disease), motor neuron disease resulting in muscular weakness and atrophy. Parkinson’s Disease, progressive, degenerative neurologic disease with indicated signs of the disease. Multiple Sclerosis, disease involving damage to brain and spinal cord cells with signs of motor or sensory deficits confirmed by MRI. Includes Neuromyelitis Optica and Transverse Myelitits. Cerebral Palsy, brain injury or abnormality occurring within 24 hours of birth resulting in developmental brain disorder. Cystic Fibrosis, progressive disorder that affects exocrine glands. Muscular Dystrophy, progressive disorder that interferes with formation of healthy muscles. Poliomyelitis, acute, infectious disease caused by the poliovirus with indicated signs of the disease. Excludes non- paralytic polio or post-polio syndrome. Benign Brain Tumor, non-cancerous abnormal cells in the brain. Blindness, irreversible sight reduction in both eyes; Best corrected single eye visual acuity less than 20/200 (E-Chart) or 6/60 (Metric) or with visual field reduction (both eyes) to 20 degrees or less. May require loss be due to specific illness. Coma, unconscious state lasting at least 96 continuous hours. Excludes any state of unconsciousness intentionally or medically induced from unconsciousness intentionally which the Covered Person is able to be aroused. May require loss be due to specific illness. End-Stage Renal (Kidney) Disease, chronic, irreversible function of both kidneys. Requires hemo or peritoneal dialysis. Major Organ Failure, includes: liver, lung, pancreas, kidney, heart or bone marrow. Happens when transplant is prescribed or recommended and placed on UNOS registry. If the Covered Person has a combination transplant (i.e. heart and lung), a single benefit amount will be payable. Recurrence Benefit not payable for same organ for which a benefit was previously paid. Paralysis, complete, permanent loss of use of two or more limbs due to a disease. Excludes loss due to Stroke and Multiple Sclerosis. May require loss be due to specific illness. No Evidence of Disease, for cancer means recommended treatment has been completed and a physician through a round of bloodwork or special imaging studies confirms there is no evidence of active primary malignant disease. For Heart Attack and Stroke means person discharged from the hospital. ***Benefits-Specific Conditions, Exclusions and Limitations (Additional Benefits): Hospital Indemnity: The Common Exclusions apply to this Additional Benefit. In addition, the following applies: Hospital Pandemic Infectious Disease Admission: Must be admitted inpatient due to a Pandemic Infectious Disease. Excludes: treatment in an emergency room, provided on an outpatient basis. Hospital Admission: Must be admitted inpatient due to injury or sickness. Excludes: treatment in an emergency room, provided on an outpatient basis, or for re-admission for the same injury or sickness. Hospital Chronic Condition Admission: Must be admitted inpatient due to a chronic condition. Excludes: treatment in an emergency room, provided on an
***Benefits-Specific Conditions, Exclusions and Limitations (Additional Benefits): outpatient basis, or for re-admission for the same injury or sickness. Hospital Stay: Must be admitted inpatient and confined to the Hospital, due to injury or sickness, at the direction and under the care of a physician. If also eligible for the ICU Stay Benefit, only 1 benefit will be paid for the same injury or sickness, whichever is greater. Hospital stays within 90 days for the same or a related injury or sicknesses considered one Hospital Stay. Intensive Care Unit (ICU) Stay: Must be admitted as an inpatient and confined in an ICU of a Hospital, due to injury or sickness, at the direction and under the care of a physician. If also eligible for the Hospital Stay Benefit, only 1 benefit will be paid for the same injury or sickness, whichever is greater. ICU stays within 90 days for the same or a related covered injury or covered illness is considered one ICU stay. Hospital Observation Stay: Must be receiving treatment for injury or sickness in a Hospital, including an observation room, or ambulatory surgical center, for more than 24 hours on a non-inpatient basis and a charge must be incurred. This benefit is not payable if a benefit is payable under the Hospital Stay Benefit or Hospital Intensive Care Unit Stay Benefit. Not available to residents of ID, OR and NH. Guaranteed Issue: If you are a new hire you are not required to provide proof of good health if you enroll during your employer's eligibility waiting period and you choose an amount of coverage up to and including the Guaranteed Issue Amount. If you apply for an amount of coverage greater than the Guaranteed Issue Amount, coverage in excess of the Guaranteed Issue Amount will not be issued until the insurance company approves acceptable proof of good health. Guaranteed Issue coverage may be available at other specified periods of time. Your employer will notify you when these periods of time are available. Your Spouse must be age 18 or older to apply if evidence of insurability is required. *State Variations For purposes of this brochure, wherever the term Spouse appears, it shall also include Domestic Partner registered under any state which legally recognizes Domestic Partnerships or Civil Unions.Spouse definition includes civil union partners in New Hampshire and Vermont, but excludes civil union partners for Idaho residents. Heart Attack benefits available for residents of AK. Not all shown covered conditions may be available and the Specific Definitions, Benefit Exclusions and Limitations for some of the conditions may vary for residents of ID, MD, NH, OR, WA. Portability in TX and VT is referred to as Continuation due to loss of eligibility. Portability conditions may differ for residents of UT, TX and VT. Exclusions may vary for residents of ID, LA, MN, NC, NH, SC, SD, VT, TX and WA. Wellness Treatment and Preventive Care Benefit is referred to as Health Screening Test or Preventive Care Benefit in WA and not available to residents of OR. Healthy Living Preventive Care Benefits may not be available to NC residents. Wellness Treatment, Health Screening Test or Preventive Care Benefit dental and ophthalmological exam benefits are not available to residents of NH and WA. Hospital Chronic Admission Only benefits are not available to residents of ID. Covid- 19 Test and Screening benefits are not available to residents of NH. The coverage effective date will not be deferred for residents of TX if receiving chemotherapy or radiation treatment and deferring due to disability or ADLS only applies to the Spouse. For residents of ID, NH, WA the effective date won’t be deferred due to ability to perform ADLs. Series 1.0 Terms and conditions of coverage for Critical Illness insurance are set forth in Group Policy No. CI111620. This is not intended as a complete description of the insurance coverage offered. This is not a contract. Please see your Plan Sponsor to obtain a copy of the Group Policy. If there are any differences between this summary and the Group Policy, the information in the Group Policy takes precedence. Product availability, benefits, riders, covered conditions, policy provisions and/or features may vary by state. Please keep this material as a reference. THIS POLICY PAYS LIMITED BENEFITS ONLY. IT IS NOT COMPREHENSIVE HEALTH INSURANCE COVERAGE AND DOES NOT COVER ALL MEDICAL EXPENSES. THIS COVERAGE DOES NOT SATISFY THE “MINIMUM ESSENTIAL COVERAGE” OR INDIVIDUAL MANDATE REQUIREMENTS OF THE AFFORDABLE CARE ACT (ACA). THIS COVERAGE IS NOT MEDICAID OR MEDICARE SUPPLEMENT INSURANCE. Product availability may vary by location and plan type and is subject to change. All group insurance policies may contain exclusions, limitations, reduction in benefits, and terms under which the policy may be continued in force or discontinued. An appeal of an adverse benefit determination before Cigna shall be a condition precedent to any legal or equitable action seeking the enforcement of rights under the Policy or plan, or any other remedies relating directly or indirectly to the claim under the Policy or plan. For costs and details of coverage, review your plan documents. Policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation and are administered and insured by Cigna Health and Life Insurance Company (Bloomfield, CT). The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.
958324 © 2024 Cigna. Some content provided under license.
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