Protective BENEFITgroup

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Protective BENEFITgroup Critical Illness
Critical Illness Insurance for your employees
benefit.
PLC.1335.04.04
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What is Critical Illness?

• A critical illness is a health related condition
  where the patient has a good chance of surviving.
  Some of the most common critical illnesses
  include
• Heart Attack
• Cancer
• Stroke
• Kidney Failure

Major Organ Transplant Paralysis Loss of
Limbs
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Why Critical Illness Coverage is Important.

• In the past, many critical illnesses were
  terminal. The good news is that with advances in
  medical technology, more patients are finding
  successful treatment and living for years to
  come.
• The bad news is that many of these people also
  face the difficulty of surviving financially.

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Financial Commitments Continue Even During
Illness

• A critical illness can have a significant impact
  on your employees lifestyle and that of their
  familys. If an employee is diagnosed with a
  critical illness, they could be faced with
• Loss of income even with disability
  insurance, income replacement usually covers
  only a portion of current income and waiting
  periods may apply.
• Medical expenses including deductibles,
  co-payments, prescription medications, private
  nursing care, or durable medical equipment may
  not be covered by group health insurance.

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Financial Commitments Continue Even During
Illness

• Alterations to their home such as for
  wheelchair accessibility.
• Outstanding and mounting personal living
  expenses such as mortgage and car payments,
  credit card debt, utilities, childcare, and
  food.
• Depletion of savings, stock funds or retirement
  plans to pay uncovered expenses.

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Financial Commitments add Stress and Inhibit the
Recovery Process

• Physical recovery is painful enough. When
  emotional and financial stress are added, the
  task may become extremely difficult.
• Relief from the financial strains posed by a
  critical illness can be provided through a plan
  with living benefits benefits that provide the
  cash to help pay the bills. As a result, the
  employee can focus on getting better, not on how
  to get out of debt.

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Protective BENEFITgroup Critical Illness

• Protective BENEFITgroup Critical Illness is a
  health insurance supplement that provides a
  Living Benefit through critical illness coverage.
  
• It pays a lump-sum benefit upon the first
  diagnosis by a physician that the insured has a
  covered critical illness.

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Covered Conditions

• Invasive Cancer
• Heart Attack
• Stroke
• Kidney Failure
• 100 of the benefit amount can be paid upon first
  diagnosis for any one of these covered illnesses.
  Once the benefit has been paid, coverage
  terminates.

Major Organ Transplant Paralysis Loss of
Limbs
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Did You Know

• According to the U.S. Department of Housing and
  Urban Development, 50 of home foreclosures
  are the result of the homeowner suffering a
  critical illness.1
• Research shows 33 of all families deplete all
  or most of their
• savings because of a serious illness.1
• In 1996, 1.5 million people in the U.S. filed
  for personal
• bankruptcy and the reason most commonly given
  was illness.1
• 1 LIMRAs Marketfacts Spring 2002 Critical
  Illness Insurance A Lump-Sum Review

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Did You Know

• 61.8 million Americans are living with one or
  more forms of
• cardiovascular disease, which includes heart
  disease, according to
• current estimates. Of the 1.5 million Americans
  who suffer a heart
• attack each year, 70 survive at least three
  years.2
• 8.9 million Americans with a history of cancer
  were alive in 1997.
• Five years after diagnosis, there is a 60
  survival rate for all
• cancers combined.3
• 4.5 million stroke survivors are alive today.
  The death rate from
• stroke declined 15.1 percent from 1988 to 1999.4
• 2 Heart Facts 2002 All Americans American Heart
  Association 55-0556 2/02
• 3 Cancer Facts Figures 2002, American Cancer
  Society, 02-250M-No. 5008.02
• 4 Stroke Statistics American Heart Association
  id 4725

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Benefit Group Coverage Options

• Base Critical Illness The employer pays some or
  all of the premium for all covered employees.
• Voluntary Group Critical Illness The employee
  pays 100 of premium.
• Base/Buy-up Group Critical Illness The employer
  pays 100 of premium for the base plan and the
  employee has the option to purchase additional
  coverage.

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General guidelines for plan design

• Base Critical Illness Employer paid or shared
  with the Employee
• Participation
• 100 of eligible group when employer paid
• 75 of eligible group when both employer and
  employee paid
• Guaranteed Issue
• 5,000 - 25,000 depending upon census, group
  demographics and participation
  percentage
• Eligibility
• Eligible group determined by
• - Employer subject to meeting covered life
  minimums
• - Actively at work requirement 30 hours per
  week
• - An employer/employee relationship

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General guidelines for plan design

• Voluntary Group Critical Illness Employee paid
• Participation
• 20 of eligible group
• Guaranteed Issue
• 5,000 - 10,000 depending upon census and group
  demographics
• Eligibility
• Eligible group determined by
• - Employer subject to meeting covered life
  minimums
• - Actively at work requirement 30 hours per
  week
• - An employer/employee relationship

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General guidelines for plan design

• Base/Buy-up Group Critical Illness Employer
  paid base / Employee paid buy-up
• Participation
• 100 of eligible group covered for base plan
• 20 of eligible group must purchase the buy-up
  plan
• Guaranteed Issue
• 5,000 - 25,000 depending upon census, group
  demographics and participation percentage
• Eligibility
• Eligible group determined by
• - Employer subject to meeting covered life
  minimums
• - Actively at work requirement 30 hours per
  week
• - An employer/employee relationship

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General guidelines for plan design

• Plan Design Specifications
• Required minimum number of eligible
  participants
• Base Plan 10 lives or greater and 100
  participation
• Voluntary Plan 25 lives or greater and 20
  participation
• Base/Buy-up Plan 50 lives or greater and 100
  participation on the base plan with 20
  participation on the buy-up
• Class Structure
• Base Plan up to 3 classes
• Voluntary Plan 1 class
• Base/Buy-up Plan 1 or 2 classes
• Rate Structure Options
• Composite
• Age Banded

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General guidelines for plan design

• Waiting period for new hires
• 30 days recommended
• Benefit waiting period
• 30 days recommended (optional 0 and 60 days)
• Maximum benefit amount
• 1.2 or 3 times salary
• Flat amount (cannot exceed 100,000)
• Minimum benefit amount
• 50 if insured dies during 30 day waiting period
• Reduced benefit after age 65 is 75 after age 70
  is 50
• Evidence of insurability
• Simplified underwriting required for amounts in
  excess of the guaranteed issue levels. Full
  medical underwriting for late enrollments of
  employee and spouse.

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General guidelines for plan design

• Pre-Existing Conditions
• No benefit is payable for a critical illness
  which is diagnosed during the 24 months following
  the Insured's Effective Date of insurance if it
  is caused by or contributed to by a Pre-Existing
  condition.
• A Pre-Existing Condition means any condition
  which the Insured was diagnosed by or received
  treatment from a Physician within 12 months prior
  to the Insureds Effective Date of insurance or
  the Insured had symptoms for which an ordinarily
  prudent person would have consulted a healthcare
  provider in the 12 months prior to the Insured s
  Effective Date of insurance. Treatment means
  consultation, advice tests, attendance or
  observations, supplies or equipment, including
  the prescription or use of prescription drugs or
  medicines.
• Exclusions
• Intentionally self inflicted injury while sane or
  insane
• Misuse of alcohol or other controlled substances
  (other than as prescribed or directed by a
  physician)
• Committing or attempting to commit suicide
• Participating in a felony, riot or insurrection
• Involvement in war, or act of war, declared or
  not.

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Spouse Dependent Coverage Available

• Spouse and dependent coverage is an available
• benefit elected by the employer on Base Critical
  Illness only. (Not optional to the employee)
• Spouse benefits are 50 of the employees benefit
  amount.
• Dependent benefits are 25 of the employees
  benefit, but not to exceed 5,000. Coverage
  excludes kidney failure, heart attack, and
  stroke.

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Protective BENEFITgroup Critical Illness

• Help your employees focus on their recovery by
  offering a plan that helps lead to
• Better retention
• Increased job satisfaction
• More efficient employees They return to work
  after their recovery with less emotional and
  financial stress.
• The satisfaction that you are providing your
  employees with a Living Benefit that will help
  them when they need it most!

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Protective BENEFITgroup Critical Illness

• Policy GCI-01-P is a group critical illness
  coverage underwritten by Protective Life
  Insurance Company, Birmingham, AL. The policy has
  exclusions, limitations, reductions of benefit
  and terms under which the coverage may be
  continued in force. Consult the policy for
  complete details. Employer contributions may
  result in all or a portion of any benefits
  received being taxable as ordinary income.
  Consult your tax advisor regarding your
  individual situation.