SUPPLEMENTAL BENEFITS
Group Cancer Insurance - Continued
Base Benefit
Low High
Outpatient Surgical , per day Calendar Yar Maximum
$250 $750
$750 $2,250
Ambulance, per trip, limit 2 trips per confinement
$100
$100
Attending Physician, per day, maximum 180-days per calendar year
$50
$50
Experimental Treatment , per treatment Lifetime Maximum
$300 $10,000
$300 $10,000
Hair External Breast, Voice Box Prosthesis , per calendar year
$200
$200
Prosthesis, Artificial Limb per device, limit 1 per site Lifetime Maximum
$2,000 $4,000
$2,000 $4,000
Skilled Nursing Care Facility , per day up to days confined
$300
$300
Hospice , per day, no lifetime limit
$300
$300
Home Health Care Services , per day, up to greater of 30-days per calendar year or 2 times a day confined Specified Disease – these benefits pay a lifetime maximum of $125,000 for a covered specified disease for any covered person
$300
$300
Hospital Confinement – per day, up to lifetime limit Ambulance – for each trip, up to lifetime maximum Attending Physician – per day up to lifetime limit, while confined to a hospital
$300 $100 $50
$300 $100 $50
Initial Diagnosis Benefit Amount – pays for the first diagnosis of internal (not skin) cancer
$1,000
$5,000
Group Cancer Insurance - Riders When you add this rider to your group cancer insurance coverage, you add valuable coverage related to the following specified diseases. Specified Diseases : adrenal hypofunction, botulism, bubonic plague, cerebral palsy, cholera, cystic fibrosis, diphtheria, encephalitis (including encephalitis contracted from West Nile Virus), Huntington’s Chorea, Legionnaires’ Disease, Lou Gehrig’s Disease (Amyotrophic Lateral Sclerosis), Lyme disease, malaria, bacterial meningitis, multiple sclerosis, muscular dystrophy, myasthenia gravis, Necrotizing fasciitis, osteomyelitis, poliomyelitis, rabies, Reye’s Syndrome, scleroderma, scarlet fever, sickle cell anemia, systemic lupus, tetanus, toxic epidermal necrolysis, toxic shock syndrome, tuberculosis (mycobacterial), tularemia, typhoid fever, variant Creutzfeldt-Jakob disease (Mad Cow Disease), yellow fever
Rider Benefits
Hospital Confinement
We will pay this benefit if you incur charges for and are confined to a hospital for treatment of one of the specified diseases listed above. We will pay this benefit if you incur charges for and use a professional ambulance to transport you, on the advice of a doctor, to or from a hospital where you are confined as an inpatient for the treatment of a specified disease listed above. Limit two one-way trips per confinement. We will pay this benefit if you incur charges for a use the services of an attending physician while confined to a hospital for the treatment of a specified disease listed above.
Ambulance
Attending Physician
Rider features covers the same family members as your cancer insurance coverage. It pays benefits regardless of any other insurance you have with other insurance companies. It also pays benefits directly to you, unless you specify otherwise. This rider has exclusions and limitations. For cost and complete details of the coverage, see your Colonial Life benefits counselor.
See page 30 for employee premiums
CONMB Employee Benefit Guide 2025
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