The following policy/certificate benefits are as approved in most states. Benefits and provisions may vary by state. For complete details of coverage, please contact Assurity or review the policy/certificate.
Group Critical Illness Policy (Forms G H1715/G H1715C)
Group Critical Illness provides a lump sum benefit for each insured person upon diagnosis of certain specified illnesses, conditions and procedures. The amount payable is the percentage for each specific critical illness specified in the chart found in the Benefits section multiplied by the selected benefit amount.
Eligible Persons: Employee (primary insured person), spouse, insured children and dependent grandchildren
Insured child(ren) means the primary insured person’s or their spouse’s natural children, stepchildren, foster children, adopted children or children placed as foster children or for adoption, who are younger than age 26. Dependent grandchild(ren) means the primary insured person’s grandchild under 26 years of age, who is legally dependent on the primary insured person.
Issue Ages: Employee and spouse 18+, children from birth through 25 years; age last birthday as of issue date
Renewability: The group master policy is cancelable with 61 days’ notice; certificates under a master policy are annually renewable for life provided the master policy has not been cancelled and the certificate has not been terminated in accordance with any contract provision. The renewability of coverage under a certificate of an active master policy applies to only those insured persons listed on the certificate for whom coverage has not already terminated for any contractual or other reason and who continue to meet the definition of eligible persons insured. See Portability for continuation of coverage after termination of employment with the master policyholder.
Underwriting Classes: Unisex; Non-Tobacco and Tobacco (Unismoke rates are available upon request to your Regional Sales Team, if necessary for an enrollment platform)
Covered Critical Illnesses: Based on plan selected – Tier 1, Tier 1 without Cancer, Tier 2, Tier 2 without Cancer and Prime – as described in the Benefits section.
Benefit Amount: As follows in increments of $5,000:
Guaranteed Issue
•Employee – up to $30,000
•Spouse – automatically 50% of employee benefit amount
•Insured Children and Dependent Grandchildren – automatically 25% of employee benefit amount
Simplified Issue
•Employee – $5,000 through $50,000; up to $100,000 with authorization and additional underwriting
•Spouse – 50% or 100% of employee benefit amount, as applied for at enrollment
•Insured Children and Dependent Grandchildren – 25% of employee benefit amount, as applied for at enrollment
Benefits will be reduced by 50% at age 70 for the Prime plan, as described in the Benefits section.
Waiting Period: 30 days as follows per conditions –
•Loss of Independent Living (ADL) benefit - no coverage if the insured person initially incurred or received a diagnosis of the permanent inability to perform two or more activities of daily living before the end of the waiting period.
•Invasive Cancer, Non-Invasive Cancer and Skin Cancer benefits – no benefits payable if the insured received diagnosis or sought medical consultation, advice or treatment leading to diagnosis during the waiting period.
Elimination Period: 180 days for Loss of Independent Living (ADL) benefit only; the period insured person must be unable to perform ADLs to receive benefit (period must begin after the waiting period)
Rate Structure: Premiums are level and unisex; based on tobacco use (according to employee use only), age band (according to employee age only; 18-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70+), coverage (employee, employee and spouse, employee and children, family) and benefit amount. Children coverage is provided at no additional cost.
Attained age (5-year step) and unismoke rates are available upon request to your Regional Sales Team, if necessary for an enrollment platform.
Policy Fee: None
Portability: Coverage may continue for all insured persons when employment ends with the policyholder or the employer’s policy terminates. A written request and first premium payment for the portable coverage must be received by Assurity within 90 days of the certificate termination date.
Return of Premium for a Non-CI Death (not available with the Prime plan, as described in the Benefits section): If the primary insured person (employee) dies from a cause other than a specified critical illness, 100 percent of premiums paid for coverage under the certificate and any riders will be returned, net of benefits paid under the certificate and any riders. This includes any rider attached, including the Health Screening Rider.
Additional Diagnosis Benefit: Once benefits have been paid for a critical illness, benefits will be paid for each different critical illness when –
•the date of diagnosis for the new critical illness is separated from the prior, different critical illness by at least 30 consecutive days;
•the new critical illness is not caused or contributed to by a critical illness for which benefits have already been paid; and
•the date of diagnosis of the new critical illness occurs while the coverage under the policy is in force.
If an additional diagnosis is for a diagnosis of cancer, the insured person must also be:
•symptom and treatment-free from cancer for at least 12 months before the subsequent date of diagnosis; and
•in complete remission prior to the date of subsequent diagnosis as evidenced by the absence of all clinical, radiological, biological and biochemical proof of the presence of cancer.
Reoccurrence Diagnosis Benefit: Once benefit have been paid for a critical illness, benefits are payable for that same critical illness up to one time per insured person per lifetime when –
•the insured person was symptom and treatment-free for a period of at least 12 consecutive months between a date of diagnosis and a subsequent date of diagnosis of the same critical illness;
•the critical illness is not caused or contributed to by a critical illness for which benefits have been paid; and
•the subsequent date of diagnosis of the same critical illness occurs while the coverage under the policy is in force.
If a subsequent diagnosis is for a diagnosis of cancer, the insured person must also be:
•symptom and treatment-free from cancer for at least 12 months before the subsequent date of diagnosis; and
•in complete remission prior to the date of subsequent diagnosis as evidenced by the absence of all clinical, radiological, biological, and biochemical proof of the presence of cancer.
Waiver of Premium: Renewal premiums will be waived on the first premium due date after the insured person has been totally disabled for 90 days due to a critical illness for which benefits have been paid. Any premium paid during this period which became due after your total disability started will be refunded.