2019 Critical Illness Insurance
The Critical Illness plan with Aflac provides a lump-sum payment following the diagnosis of one or more of the covered conditions. This lump-sum payment may be used on anything you need - medical or non-medical expenses. This allows you to focus on recovery and not on economic issues.
Coverage Amounts Available
Critical Illness benefit amounts are available in increments of $5,000: Employee benefit options are $5,000 to $50,000 and Spouse benefit options are $5,000 to $25,000, not to exceed one half of the employee’s amount.
Guaranteed Issue and Evidence of Insurability
First Occurrence Benefit
After the waiting period, a lump sum benefit is payable upon initial diagnosis of a covered critical illness.
Additional Occurrence Benefit
If an insured collects full benefits for a critical illness under the plan and later is diagnosed with one of the remaining covered critical illnesses, then Aflac will pay the full benefit amount for each additional illness. Occurrences must be separated by at least 6 months (for cancer at least 6 months treatment free) and not caused by or contributed to by a critical illness for which benefits have been paid.
If you collect full benefits for a covered critical illness and are later diagnosed with the same condition, Aflac will pay the full benefit again. The two dates of diagnosis must be separated by at least 12 months or 12 months treatment free for cancer. Cancer that has spread (metastasized), even though there is a new tumor, will not be considered an additional occurrence unless you have been treatment free for 12 months.
50% Child Coverage at no Additional Cost
Each dependent child is covered at 50 percent of the primary insured amount at no additional charge.
$75 Health Screening Benefit
An insured (employee/spouse) may receive $75 for any one covered health screening test per calendar year. Aflac will pay this benefit regardless of the results of the test. Payment of this benefit will not reduce the amount payable for the diagnosis of a critical illness. This benefit is only payable for health screening tests performed as the result of preventive care, including tests and diagnostic procedures ordered in connection with routine examinations. The Mohawk Health Assessment program biometrics test is a fasting blood glucose test and is one of the eligible tests for the $75 reimbursement.See Covered Health Screening Tests and Claim Form below:
Covered Health Screening Tests
Critical Illness Rates*
Please note, all (employee and spouse) critical illness rates are based on the age and the tobacco use status of the employee. Critical Illness policies enrolled with Aflac February 2013 and later are subject to 10 year age bands - see Aflac Rates below.
*All Critical Illness policies are administered by Aflac. If you had a policy with Unum in 2013, Aflac took over that policy. You may have also enrolled in additional coverage through Aflac. The advantage to retaining the policy previously held with Unum, is that the rates will not increase as you age. The rates are locked in for the life of the policy, and are not reflected in the rates contained above. If you have any questions regarding your Critical Illness coverage, please contact the Benefits Service Center at 866.481.4922.
For questions, contact Aflac or the BSC
Benefits Service Center | 1-866-481-4922
Aflac | 1-800-433-3036
Group products are underwritten by Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers. CAIC is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands.
The Aflac coverage described here is subject to plan limitations, exclusions, definitions, and provisions. For detailed information, please see the plan brochures, as this material is intended to provide general summaries of the coverage. These overviews are subject to the terms, conditions, and limitations of the plans.
Notice to Consumer: The coverages provided by Continental American Insurance Company (CAIC) represent supplemental benefits only. They do not constitute comprehensive health insurance coverage and do not satisfy the requirement of minimum essential coverage under the Affordable Care Act. CAIC coverage is not intended to replace or be issued in lieu of major medical coverage. It is designed to supplement a major medical program.