Covered illnesses include cancer (internal or invasive), heart attack, stroke, major organ transplant, renal failure (requiring dialysis), carcinoma in situ (limited benefit) and coronary artery bypass surgery (limited benefit). The plan also pays in the event of an additional occurrence and/or recurrence (refer to certificate for details).
Coverages available are as follows: $5,000 to $50,000 for yourself and $5,000 to $25,000 for your spouse. The spouse amount may not exceed 50% of the employee amount, subject to the minimum face amount of $5,000. Children up to age 26 are covered at 50% of the primary insured amount at no additional charge.
Critical Illness Summary of Benefits
Employees (benefits reduce by 50% at age 70)
Spouses (benefits reduce by 50% at age 70)
$2,500 increments (with a $5,000 minimum)
Child(ren) (up to age 26)
50% of the primary insured’s coverage (no additional charge)
Waiting Period and First Diagnosis Clause
The plan contains a 30-day waiting period. This means that no benefits are payable for any insured who has been diagnosed before their coverage has been in force 30 days from the effective date. (In order for coverage to apply, the date of diagnosis of a covered illness must occur after the waiting period and while this certificate is in force.)
Cancer means a malignant tumor characterized by the uncontrolled growth and spread of malignant cells and the invasion of distant tissue. Cancer includes Leukemia. Excluded are Cancers that are non-invasive such as:
1. Pre-malignant tumors or polyps;
2. Carcinoma in Situ;
3. Any skin Cancers except melanomas;
4. Basal cell carcinoma and squamous cell carcinoma of the skin; and 5. Melanoma that is diagnosed as Clark's Level I or II or Breslow less than .77mm.
Cancer is also defined as disease which meets the diagnosis criteria of malignancy established by The American Board of Pathology after a study of the histocytologic architecture or pattern of the suspect tumor, tissue or specimen.
Health Screening Benefit
The plan includes a $50 Health Screening Benefit. You can receive a maximum of $50 for any one covered screening test per year. This benefit is paid to you regardless of the results of the test. Covered health screenings include but are not limited to: stress tests, colonoscopies, mammograms, pap smears, PSAs (for prostate cancer), fasting blood glucose tests, chest x-rays, and more. Simply submit your claim form along with proof of your screening to receive your screening benefit.
Critical Illness Monthly Payroll Deductions
Documents & Additional Information
For additional information about the critical illness plan, please contact the Benefits Service Center at 1-855-481-1489 or AFLAC at 1-800-433-3036 | www.aflacgroup.com.