IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 Offered by:...

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IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 icut General Life Insurance Company, Life Insurance Company of North America, or Cigna Life Insurance

Transcript of IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 Offered by:...

Page 1: IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 Offered by: Connecticut General Life Insurance Company, Life Insurance.

IT’S YOUR CHOICEFinancial protection benefits

Kellogg Community College

864857

Offered by: Connecticut General Life Insurance Company, Life Insurance Company of North America, or Cigna Life Insurance Company of New York

Page 2: IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 Offered by: Connecticut General Life Insurance Company, Life Insurance.

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You are one of a kind.

That’s why we offer coverage tools resources that will work for you as an individual

®

to help you feel more secure

And we want to help you live that way.

Page 3: IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 Offered by: Connecticut General Life Insurance Company, Life Insurance.

These benefits are all about you

and giving you what you need to feel more financially secure.

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helping you to protect your income and savings

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WHY CONSIDER FINANCIAL PROTECTION BENEFITS?

Economical group rates

You’ll probably pay less as an employee than you would as an individual for the same coverage.

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• Disability benefitsShort Term

• Accidental injury insurance

• Critical illness insurance

• And more

Convenientpayrolldeductions

No separate bills to pay or checks to write

Choice

You select the coverage that suits your needs.

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disability benefits

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WHAT IF YOU CAN’T WORK?

Just over 1 in 4of today’s 20 year-olds will become disabled before they retire3

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Disability benefits are paid if you are out of work due to a covered disability.

Your ability to earn a living is a valuable asset

The average long term disability claim lasts more than 30 months.1

Is your household income sufficient to pay for living and other expenses in the event you are disabled?

About 90% of disabilities are caused by illnesses rather than accidents2

1 Gen Re, U.S. Individual DI Risk Management Survey 2011, based on claims closed in 2010 2 Council for Disability Awareness, Long-Term Disability Claims Review, 20123 U.S. Social Security Administration, Fact Sheet, February 7, 2013

DISABILITYBENEFITS

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SHORT TERM DISABILITY

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All plans have exclusions and limitations. Please review your Benefit Summary for more information about what is and is not covered under your plan.

14 days until coverage starts

Benefits start after any sick leave has been used, or 14 days of continuous disability, whichever is longer

11 weeks of coverage

If you continue to be disabled, benefits are subject to a maximum of 11 weeks

No need to answer medical questions if you enroll during this initial open enrollment period.

DISABILITYBENEFITS

Receive 60% of your salary when you’re out of work because of a covered disability

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ACCIDENTS HAPPEN

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ACCIDENT INSURANCE

Accidents are the

5th leading cause of death1

Accidents are

the #1 causeof death for people under 411

1 in 3 children who play a team sport is injured seriously enough to miss practice or games.3

In 2009, 1 in 8 Americans sought medical treatment for accidents1

$1,265 average cost of an emergency room visit2

ER

Lives are lost and lives are changed. And if unprotected and unprepared, the financial impact of an accident can be felt by everyone involved.

1 – U.S. Department of Health & Human Services , National Vital Statistics Reports, Vol. 61, No. 6, October 10, 20122 – PlosOne, “How much will I get charged for this?,” February 20133 – Mickalide AD, Hansen LM. Coaching Our Kids to Fewer Injuries: A Report on Youth Sports Safety. Washington, DC: Safe Kids Worldwide, April 2012.More

Page 10: IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 Offered by: Connecticut General Life Insurance Company, Life Insurance.

ACCIDENTAL INJURY

Pays a lump sum cash benefit directly to you, or your designee, that can help pay for any out-of-pocket expenses related to covered accidents.

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* To receive benefits, the event must meet the terms and definitions of the policy. Waiting periods may apply. Subject to all other plan exclusions and limitations. See slides 30 and 31 for more information.

Examples of covered injuries may include:*

• Broken bones

• Burns

• Torn ligaments

• Concussion

• Eye injuries

• Ruptured discs

• Cuts requiring stitches

Covered events may include:

• Initial treatment

• Emergency room visit

• Hospitalization– Admission (per occurrence)– Confinement (per day)

• Follow-up care

ACCIDENT INSURANCE

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ADDITIONAL FEATURES

• Enhanced Accident – Increases the value of a standard plan by expanding the list of coverage

• Wellness – Provides annual benefit of $50 for broad range of preventive services including (but not limited to) office visits, immunizations and health screenings. 30 day waiting period.

11Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

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• Slips on wet floor• Injures knee and wristmeet Sue

PLAN EXAMPLE

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Sample expenses NOT covered by majormedical insurance plan

Urgent care copay $ 100.00

Deductible 1,000.00

Surgery copay 750.00

10 physical therapy visits copay 150.00

OUT-OF-POCKET COSTS 2,000.00

Benefits paid by accidental injury plan

Emergency room visit $ 100.00

Dislocated knee 500.00

Fractured wrist 400.00

Follow-up appointment 50.00

10 physical therapy visits 250.00

BENEFITS PAID 1,300.00

This is an example used for illustrative purposes only and assumes injuries were the direct result of a covered accident.

ACCIDENT INSURANCE

Sue pays $12.81* monthly for employee only Accidental Injury coverage.

*Refer to benefit summary for complete exclusions, limitations and premiums

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critical illness

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LIFE CHANGING HEALTH EVENT

• [More than 13.5 million American have high-deductible health plans 1]

• [Maximum out-of-pocket expenses for a high-deductible health plan can reach up to $6,050 a year ($12,100 for families).1]

• [Each year, nearly 1 million Americans have a heart attack and 1.6 million are expected to be diagnosed with cancer. 2, 3]

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1 – America's Health Insurance Plans (AHIP), 2012 HSA census.2 – Heart Disease Foundation. Heart Disease: Scope and Impact., May 3, 2012.3 – Cancer Facts and Figures 2012, American Cancer Society

CRITICALILLNESS

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HOW IT HELPS

Helps you pay for additional out-of-pocket expenses from a life changing health event, such as:• Travel, room and board for medical treatment• Child care• Treatment options not covered by traditional insurance

Use the money to pay for everyday household bills that may pile up due to loss wages

Uncoordinated benefit – Lump sum payment directly to you

It provides financial relief so you can focus on getting better

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1. See slide 32 for full definitions of each covered condition.2. If the covered person receives 25% of the benefit, the remaining 75% will be available for a first diagnosis of another covered condition.

All plans have exclusions and limitations. Please review your Benefit Summary for more information about what is and is not covered under your plan.

CRITICALILLNESS

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BENEFIT

Lump sum benefit is paid upon the diagnosis of a coveredcondition – $10,000

During your open enrollment period only, you can elect $10,000 of coverage without completing a medical questionnaire

30 day benefit waiting period from the coverage effective date

Covered conditions1:– Invasive Cancer– Heart Attack– Stroke– Renal (Kidney) Failure– Major Organ Transplant– ALS (Lou Gehrig’s Disease)– Blindness – Paralysis– Coronary Artery Disease (25%)2

– Carcinoma in Situ (25%)2

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1. See slide 32 for full definitions of each covered condition.2. If the covered person receives 25% of the benefit, the remaining 75% will be available for a first diagnosis of another covered condition.

All plans have exclusions and limitations. Please review your Benefit Summary for more information about what is and is not covered under your plan.

CRITICALILLNESS

Page 17: IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 Offered by: Connecticut General Life Insurance Company, Life Insurance.

• 40 years old• Diagnosis: Heart attack1meet Marco

PLAN EXAMPLE

Lump sum payment to Marco upon diagnosis to use as he sees fit

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Sample expenses NOT covered by traditional medical insurance plan

Emergency care copay $ 100.00

Deductible 1,000.00

Coinsurance 2,000.00

Specialist visit copay 240.00

Lost wages 2,000.00

OUT-OF-POCKET COSTS $5,340.00

Critical Illness Plan

COVERAGE PAID $10,000.00

This is an example used for illustrative purposes only.

1. Heart Attack is defined under the policy as a clinical event which has at least 2 of the following: a) chest pain, b) EKG changes, c) biochemical markers of heart tissue death, that results in permanent functional loss of heart contraction

CRITICALILLNESS

Marco pays $5.33* biweekly for Critical Illness coverage for himself and his spouse

*Refer to benefit summary for complete exclusions, limitations and premiums.

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ADDITIONAL FEATURES

• Additional benefit – Coverage for a different covered condition (with a 6 month separation and maximum 1 time additional payment)

• Recurrence benefit – Coverage for an additional diagnosis– 12-month separation period – No lifetime maximum

• Health Screening Benefit – Benefit of $50 per covered person, per calendar year, for a health screening or diagnostic test.– Eligible tests include (but are not limited to)

mammography, chest X-ray, blood tests– 30 day waiting period

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CRITICALILLNESS

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MORE FOR YOUAvailable with your plan*

• Healthy Rewards® – Discounts of up to 60% on health and wellness products and services such as weight management, nutrition, fitness, smoking cessation and more

• Identity Theft – Access to personal case managers who give step-by-step assistance and guidance if your identity is stolen

• Will Preparation & Funeral Planning Services – Online forms and tools to build state-specific customized wills, powers of attorney, other legal documents, as well as assistance in funeral planning.

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MORE FOR YOU

*These programs and services are NOT insurance. Some Cigna Healthy Rewards discount programs are not available in all states, may be discontinued at any time, and you must pay the entire discounted charge. Cigna’s Identity Theft services are provided under a contract with Europ Assistance USA. Full terms, conditions and exclusions are contained in Cigna’s Identity Theft program service agreement. Will Preparation services are independently administered by ARAG®. Cigna does not provide legal services and makes no representations or warranties as to the quality of the information on the ARAG website or the services of ARAG. Phone and face-to-face counseling sessions must be used within one year of the date the claim is approved. Counseling, legal or financial assistance programs are not available under policies insured by Cigna Life Insurance Company of New York.

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ENROLLMENTNext steps

Enroll online at www.benefitsinsight.com

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MORE FOR YOU

Please read the summary of benefits, exclusions and limitations for a complete description of the insurance plan along with the premiums.

Come speak with us to learn more today

Page 22: IT’S YOUR CHOICE Financial protection benefits Kellogg Community College 864857 Offered by: Connecticut General Life Insurance Company, Life Insurance.

The information in this presentation summarizes the highlights of your plan. For a complete list of both covered and not covered services, including benefits required by your state, see your employer’s group insurance policy, summary plan description or group service agreement – the official plan documents. If there are any differences between the information in this presentation and the plan documents, the information in the plan documents takes precedence.

Group Universal Life (GUL) insurance plans are offered by Connecticut General Life Insurance Company. Term Life, Accidental Death and Dismemberment, Accidental Injury, Critical Illness and Disability plans are insured or administered by Life Insurance Company of North America, except in New York, where coverage is provided by Cigna Life Insurance Company of New York. “Cigna,” the “Tree of Life” logo, “GO YOU,” “Healthy Rewards” and “Cignassurance” are registered service marks, and “Life Assistance” is a service mark, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company, Life Insurance Company of North America, and Cigna Life Insurance Company of New York. All models are used for illustrative purposes only.

864857 07/13 © 2013 Cigna. Some content provided under license.

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ACCIDENTAL INJURY SAMPLE INJURY DEFINITIONS

• Fracture BenefitsBone broken, within {90} days of accident, as diagnosed by physician and corrected by open (Surgical) or closed (Non-Surgical) reduction. If more than one fracture, we pay one benefit, whichever is greater.

• Small Burns – 2nd or 3rd degree burn covering 20% or less body surface and within {90} days of accident. If 3rd degree burn benefit is payable, 2nd degree burn benefit for same accident and burned area is not payable. Payable 1 time per accident. Not payable for burns caused from sunburn or if Large Burns benefit is payable.

• Large Burns - 2nd or 3rd degree burn covering more than {20}% of body surface and within {90} days of accident. If 3rd degree burn benefit is payable, 2nd degree burn benefit for same accident and burned area is not payable. Payable 1 time per accident. Not payable for burns caused from sunburn.

• Tendon, Ligament, Rotator Cuff, or Knee Surgery – Repair - torn, ruptured, or severed and performed by a physician within {90}days of accident. Payable {1} time per accident. Not payable if exploratory surgery is performed with no repair.

• Tendon, Ligament, Rotator Cuff, or Knee Surgery – Exploratory – performed by a physician within {90}days of accident. Payable 1 time per accident.

• Concussion - diagnosed within 90 days of accident. Payable 1 time per accident.• Eye Injury Surgery - performed by a physician within {90}of accident. Payable 1 time per accident.• Eye Injury - Removal of Foreign Object - performed by a physician within {90} days of accident. Payable 1 time

per accident. Not payable if Eye Injury Surgery benefit is paid.• Ruptured Disc Surgery – Repair - performed by a physician within {90} days of accident. Payable 1 time per

accident.• Small Lacerations – one or more lacerations, less than or equal to{6} inches long and requires 2 or more sutures

and within {90} days of accident. Multiple lacerations pay maximum {2} times. Payable 1 time per accident. • Large Lacerations - one or more lacerations, more than {6} inches long and requires {2} or more sutures and

within {90} days of accident. Multiple lacerations pay maximum {2}times.

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ACCIDENTAL INJURY SAMPLE COVERED CONDITION DEFINITIONS

• Physician Office Visit – provided by a licensed health care provider within [90] days of accident. Does not include: routine health exams or immunizations for age 60 and older; mental or nervous disorder visits; visits by surgeon while confined to hospital. Payable [1] X per accident. Not payable with Emergency Treatment benefit.

• Diagnostic Exam – covers x-rays or laboratory studies prescribed by a physician within [90] days of accident. Does not include CT or CAT Scans, MRI, PET, SPECT or other similar tests. Payable for [1] diagnostic exam per covered accident and payable up to [1] time per [month].

• Emergency Care Treatment – in a trauma center or special area of hospital equipped and staffed for emergency care on outpatient basis (not include a clinic or doctor's office) and within [30] days of accident. Payable [1] time per accident, up to [1] time per month.

• Hospitalization BenefitsHospital meets all of the following: Licensed as hospital pursuant to law; Provides medical care and treatment; under supervision of medical doctor staff; 24-hour nursing services by or under supervision of Registered Nurse (R.N.); Major surgical facilities available on premises or prearranged basis; Charges for services (includes VA hospitals without service charges). Does not include clinic, facility, or unit of hospital for: Rehabilitation, convalescent, custodial, educational or nursing care; Aged, drug addicts or alcoholics.Hospital Admission– Benefit Waiting Period {0} days– Within {90 days} of accident; inpatient hospital stay required; first admission for accident.– Payable on day {0}for 1 accident, up to {1} admission per {month}. Not payable for treatment only given in emergency room; outpatient; or re-

admission from same accident.

Hospital Stay– Benefit Waiting Period {1} day– Maximum Benefit Period {365} days– Stay must begin within {90 days} of accident and admitted for at least {23 hours} and/or on an inpatient basis. Payable on day {0}for up to {1} time per

{month}. If payable under Hospital Stay and Initial Intensive Care Unit benefits, only {1} benefit is payable for same accident, whichever is greater. Re-hospitalization within {90 days} for same accident is one stay. Re-hospitalization after {90 days} for same accident is as different stay.

Intensive Care Unit Stay– Benefit Waiting Period {1} day– Maximum Benefit Period up to {365} days– Stay must begin within {90 days} of accident and admitted for at least {23 hours} and/or on an inpatient basis in a special area of hospital for treatment

of patients in acute, critical condition; furnished with emergency life-saving equipment and supplies; staffed 24 hours a day by ICU nurses; can monitor patient's vital signs around-the-clock. Not a recovery room or area used for post-operative or post-anesthesia care. Not payable for hospital readmission for same accident.

– Payable on day {1}for up to {1} time per {month}. If benefit is payable under Hospital Stay and Initial Intensive Care Unit benefits, only 1 benefit paid for same accident, whichever is greater. If readmitted within {90 days} for same accident, it counts as one stay. If released for at least {90 days} and returns for same accident, it counts as different stay.

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CRITICAL ILLNESS CONDITION DEFINITIONS

• Invasive Cancer - uncontrolled/abnormal growth or spread of invasive malignant cells (not including skin cancers, unless metastatic disease develops)

• Heart Attack - a clinical event which has at least 2 of the following 3: a) chest pain, b) EKG changes, c) biochemical markers of heart tissue death, that results in permanent functional loss of heart contraction

• Stroke - cerebrovascular event (e.g. cerebral hemorrhage) confirmed by neuroimaging with neurological deficits lasting 30 days or more (not including TIAs, brain injury from trauma/hypoxia/anoxia or hypotension, or disease/disorders of the eyes or ears)

• Renal (Kidney) Failure - chronic irreversible kidney failure requiring hemodialysis or peritoneal dialysis• Major Organ Transplant - surgical transplant of human-donor organ (liver, lung, pancreas, kidney or heart only)

upon first hospitalized day for surgery (1 benefit payable for multi-organ transplants) • Paralysis - complete and permanent loss of use of 2 or more limbs 100%• Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) - motor neuron disease resulting in muscular weakness

and atrophy • Blindness - irreversible reduction of sight (both eyes) with 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 • Occupational Human Immunodeficiency Virus (Occupational HIV) - HIV infection from accidental exposure to

HIV-contaminated body fluids during normal course of work in your occupation. Incident Report and confirmatory anti-body test by state certified lab (with negative result) required within 5 days of exposure. Follow-up confirmatory test (with positive result) required within 90-180 days post-exposure. (Not including infection from IV drug use, sexual transmission or non-accidental contraction)

• Coronary Artery Disease (Surgery) - heart disease/angina requiring Coronary Artery Bypass Surgery, as indicated by angiographic test results. (Not including angioplasty, stent implants or related procedures)

• Carcinoma in Situ - non-invasive malignant tumor (Not including skin cancers – basal or squamous cell carcinoma or melanoma/melanoma in situ)