Critical Illness

Critical Illness  

Overview

Heart attack, stroke, and cancer are examples of common critical illnesses that often lead to unexpected medical bills. If you are being treated for such a critical illness, shouldn't your primary focus be on getting well --not worrying about how to pay for your care?


Critical Illness Insurance, underwritten by Transamerica Life Insurance Company, can help you by paying a lump sum benefit to help cover your out-of-pocket medical costs, including deductibles, copays, and cost-shares or pay daily living expenses such as grocery bills, mortgage payments, transportation costs, etc.
 

  • You can choose among a lump sum cash benefit of $10,000 or $20,000.
  • Your benefit is paid directly to you in addition to your medical insurance.
  • You pay an affordable employee group rate. Your premium is conveniently deducted from your paycheck.
  • You’re guaranteed acceptance provided you enroll during the Enrollment Period.          
  • Portable—you can keep your insurance if you leave your employer with the portability option.
     

 

Thanks to your employer’s group rates, you could pay less for this insurance than you would for individual insurance you’d find on your own.
 

 

Employee

Tobacco

Non-Tobacco

Age

$10,000

$20,000

$10,000

$20,000

18-29

$16.70

$27.40

$11.50

$17.00

30-39

$18.80

$31.60

$12.70

$19.40

40-49

$32.70

$59.40

$19.30

$32.60

50-59

$61.00

$116.00

$31.20

$56.40

60-64

$111.50

$217.00

$60.40

$114.80

65+

$123.10

$240.20

$70.40

$134.80

1 Parent Family

   

18-29

$18.40

$29.30

$13.20

$18.90

30-39

$20.50

$33.50

$14.40

$21.30

40-49

$34.40

$61.30

$21.00

$34.50

50-59

$62.70

$117.90

$32.90

$58.30

60-64

$113.20

$218.90

$62.10

$116.70

65+

$124.80

$242.10

$72.10

$136.70

2 Parent Family

       

18-29

$24.90

$38.30

$18.40

$25.30

30-39

$27.20

$42.90

$20.90

$30.30

40-49

$49.90

$88.30

$30.90

$50.30

50-59

$93.00

$174.50

$47.20

$82.90

60-64

$168.00

$324.50

$90.90

$170.30

65+

$184.70

$357.90

$99.60

$187.70

 

Enroll Online

Add Critical Illness Insurance coverage to help offset costs that may not be covered under your employer's existing medical plan. You can enroll during Annual Enrollment or as a New Hire.

How It Works

Contact Us

 Address
Mercer Voluntary Benefits
12421 Meredith Drive
Urbandale, IA 50398
 Phone
1-800-626-9011
 Hours
 M-F 8a-5p CT
 Email
employerbenefitsinquiries.service@mercer.com
EBD BJIRWEB 0618

FAQs

Answers about the policy, including eligibility, options, enrollment, customer service and more.
  • Who is the provider?

    Transamerica Life Insurance Company

    This is a brief summary of CriticalAssistance AdvanceSM, Critical Illness Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa. Policy form series CPCI0400 and CCCI0400. Forms and form numbers may vary. This insurance may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details.

  • How can this help me?

    Gives you the comfort to recover in confidence while helping with the financial strain a serious illness can cause.

    Critical Illness Insurance pays you a lump sum benefit you can use for whatever you wish. So you can ease your worries and concentrate on getting back on your feet. Use your lump-cash payment for whatever helps the most: deductibles, ongoing household bills, in-home caregivers, mortgage or rent, family visit, anything you need.

     

  • Who can enroll?

    You, your eligible spouse and eligible children qualify for this insurance.

  • When can I enroll?

    As a new hire, you can enroll during your new hire enrollment period. Outside of your new hire enrollment period, enrollment is limited to the company’s annual enrollment period.

  • How much will this insurance cost me?

    Thanks to your employer’s group rates, you could pay less for this insurance than you would for individual insurance you’d find on your own.

     

    Your rate is determined when you first enroll and is based on your age at the effective date and your tobacco status. After that, premiums will not change due to changes in your age or health, or if you file an individual claim.

  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your policy without interruption with the portability option. Although payroll deduction will no longer be available if you retire or leave your company, you may opt for other payments options. 

  • What serious illnesses and diseases will be covered?

    Once you’re enrolled in this insurance, benefits will be paid if you have a heart attack, stroke, major organ transplant, end stage renal failure or are diagnosed with heart or coronary artery disease, or many more conditions.
  • Will my insurance end once I collect benefits for a critical illness?

    If the total benefit paid in a category is less than 100% of the Elected Benefit, the insurance company will pay upon the diagnosis of a different type of critical illness within the same category.
  • Will my rates increase as I get older or if I file a claim?

    Your rates will not increase due to age, health or individual claims.

Limitations and Exclusions
We do not pay benefits for losses caused by, or as a result of, the following:

  • Conditions other than those due to a covered Critical Illness.
  • The insured person participating or attempting to participate in an illegal activity.
  • The insured person intentionally causing self-inflicted injury.
  • The insured person committing or attempting to commit suicide, whether sane or insane. The insured person's involvement in any period of armed conflict.
  • Surgeries performed outside the United States or its Territories.

 

Under no condition will we pay any benefits for losses or medical expenses incurred prior to the effective date.
We may reduce or deny a claim or void insurance for loss incurred by an insured person during the first 2 years from the effective date of such insurance for any misstatements in the application which would have materially affected our acceptance of the risk.

 

Heart Attack - Diagnosis must be supported by 3 or more of the following indicators: typical chest pain suggestive of heart attack; new EKG changes indicative of myocardial infarction; diagnostic increase of specific cardiac markers typical for heart attack; or, confirmatory imaging studies.

 

Stroke - Diagnosis must be based on documented neurological deficits and confirmatory neuroimaging studies. Stroke does not include cerebral symptoms due to Transient Ischemic Attack (TIA), Reversible neurological deficit, migraine, cerebral injury resulting from trauma or hypoxia, or vascular disease affecting the eye, optic nerve or vestibular functions.

 

Heart Transplant Surgery - Being placed on the transplant list or undergoing surgery to receive a transplant of a human heart.

 

Coronary Bypass Surgery - Angiographic evidence to support the necessity for this surgery will be required. This benefit does not include balloon angioplasty, laser embolectomy, atherectomy, stent placement, or other non-surgical procedures.

 

Angioplasty/Stent - Coronary angioplasty must be performed by a physician who is also a board-certified cardiologist. This benefit is confined to the heart; therefore, angioplasty/stenting of renal arteries or other peripheral arteries are excluded from this benefit.

 

Major Organ Transplant - Being placed on the transplant list or undergoing surgery to receive a transplant of a human heart, lung, liver, kidney or pancreas.

 

End Stage Renal Failure - Chronic irreversible failure of both kidneys that requires treatment by renal dialysis or kidney transplant.

 

Paralysis - Quadriplegia, paraplegia, or hemiplegia that is expected to last for a continuous 12-month period or longer from the date of diagnosis to determine if paralysis is permanent. A benefit will not be paid for paralysis that results from a stroke or psychiatric related causes.

 

Burns - A full-thickness or third-degree burn covering at least 50% of the body surface.

 

Coma - Lasting for 30 consecutive days with no reaction to external stimuli, no reaction to internal needs and the use of life support systems. Diagnosis must indicate that permanent neurological deficit is present.

 

Loss of Sight, Speech, or Hearing - Total loss of sight in both eyes, total and permanent loss of speech, or total and irreversible loss of hearing in both ears that cannot be corrected by the use of a hearing aid or device.

 

Miscellaneous Diseases - Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease), Encephalitis/Meningitis, Rocky Mountain Spotted Fever, Typhoid Fever, Anthrax, Cholera, Primary Sclerosing Cholangitis (Walter Payton's Disease), or Tuberculosis.

 

Alzheimer's Disease - Requires the inability to independently perform 2 or more of the following activities: bathing, dressing, eating, toileting, transferring, or incontinence.

 

Cancer Benefit Rider
We will only pay for loss as a direct result of cancer or bone marrow transplant. We will not pay for any disease or incapacity that has been caused, complicated, worsened, or affected by, or as a result of cancer or its treatment.

 

Invasive Cancer - Evidenced by a malignant tumor and the invasion of tissue. Invasive cancer does not include pre-malignant conditions or conditions with malignant potential, prostatic cancers which are histologically described as TNM Classification T1 (including T1(a) or T1(b), or of other equivalent or lesser classification), and any malignancy associated with the diagnosis of HIV.

 

Carcinoma In Situ - Cancer that is in the normal place, confined to the site without having invaded neighboring tissue.

 

Prostate Cancer with TNM Classification of T1 - Microscopic tumors of the prostate that are neither palpable nor visible on transrectal ultrasonography.

 

Skin Cancer - Basal cell epithelioma or squamous cell carcinoma. Skin cancer does not include malignant melanoma or mycosis fungoides, which are not considered skin cancers.

 

Recurrent Critical Illness Benefit Rider
A recurrence of the same type of critical illness is not considered a Recurrent Critical Illness unless the diagnosis for the prior occurrence was at least 12 months from the most recent diagnosis and the person has been Treatment Free for at least 12 months. Treatment Free means the person is no longer receiving care from a physician, nor regular office visits, or being prescribed medication for a critical illness, other than routine checkups or maintenance medication for that critical illness.

 

Termination of Insurance
The date of the employee's death;
The date on which the employee ceases to be eligible for insurance; The last date for which premium payment has been made to us; The last date on which employment terminates;
The date the group master policy terminates; or
The date the employee sends us a written notice to cancel insurance.
Dependent insurance will terminate on the earliest of:
The date the employee's insurance terminates;
The last date for which premium payment has been made to us;
The date the dependent no longer meets the definition of dependent;
The date the group master policy is modified so as to exclude dependent insurance; or The date the employee sends us a written notice to cancel dependent insurance.
We will have the right to terminate the insurance of any insured person who submits a fraudulent claim under the policy.

 

Portability Option
If an employee loses eligibility for this insurance for any reason other than nonpayment of premiums, insurance can be continued by paying the premiums directly to us within 31 days after termination. We will bill the employee directly once we receive notification to continue insurance.

 

Termination of the Group Master Policy
The policyholder may end the policy on any premium due date by submitting a 60-day advance written notice. A group will not be continued if it drops below the minimum required participation. The group master policy will be terminated and insurance of all remaining insureds will end, subject to the Portability Option.

 

Other Insurance with Us
An individual can only have one critical illness policy or certificate with us. If a person already has critical illness insurance with us, such person is not eligible to apply for this insurance.

 

122480 06/19

Mercer's Role & Compensation

Details of Mercer disclosure of the compensation.