Critical Illness

Critical Illness  

Overview

Every 40 seconds, someone in the U.S. has a heart attack or stroke or is diagnosed with cancer or other serious disease.* If it happens to you, shouldn’t your primary focus be on getting well, and not worrying about how to pay for your treatment and care?
Critical Illness Insurance can help you by paying a lump sum cash 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.


  • Pays a lump sum cash benefit of $15,000.
  • Your benefit is paid directly to you, and is in addition to your medical insurance.
  • You pay an affordable employee discounted group rate. Monthly group rates are based on the employee's attained age and the coverage tier selected. Your premium is conveniently deducted from your paycheck.
  • Provided by an insurance carrier you can trust: MetLife.
  • You’re guaranteed acceptance provided you enroll during the Enrollment Period and are actively at work.**      
  • Portable—you can keep your coverage if you leave your employer.***

 

*http://www.criticalillnessinsuranceinfo.org/learning-center/critical-illness-coverage-facts.php
**Coverage is guaranteed provided (1) the employee is actively at work and (2) any dependents to be covered are not under medical restriction as described in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas. For CA sitused cases, coverage is guaranteed provided (1) the employee is performing all of the usual and customary duties of your job at the employer's place of business or at an alternate place approved by your employer (2) dependents are not subject to medical restrictions as set forth on the enrollment form and in the Certificate.
***Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.

 

Enrollment

Your next opportunity to enroll in this coverage is during Open Enrollment in Fall 2022. Please call Mercer Customer Service with questions: 1‑855‑781‑5198.

Contact Us

 Phone:
X-XXX-XXX-XXXX
 Hours
 M-F 8a-5p CST
 Email
employerbenefitsinquiries.service@mercer.com

How It Works

FAQs

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

    With over 150 years of experience, MetLife is a recognized leader in protection planning and retirement & savings solutions.
  • How can this help me?

    MetLife Critical Illness Insurance can help give you the comfort to recover in confidence while helping to avoid the financial strain a serious illness can cause.

    MetLife Critical Illness insurance provides a lump-sum payment if you or a covered family member have a verified diagnosis of covered medical condition and meet the policy and certificate requirements.
  • Who can enroll?

    You, your spouse and eligible children qualify for this coverage.7 You and your eligible family members just need to enroll during your employer's enrollment period and be actively at work for your coverage to be effective.
  • 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 annual enrollment period.
  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your coverage without interruption, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available, you can opt for other payment methods such as direct bank account deduction, or home billing.

    Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier.5
  • What serious illness and diseases am I covered for?

    Critical illness insurance helps you manage expenses — so you can focus on getting well.

    As long as you or your loved one meets the policy and certificate requirements, Critical Illness Insurance provides a lump-sum payment for covered conditions such as heart attack8, cancer9 or stroke10.

 

For complete plan details, talk with your company’s benefits administrator or review your plan summary.

 

1Medical Bankruptcy and the Economy, Updated April 30, 2021. www.thebalance.com/medical-bankruptcy-statistics-4154729. Accessed January 2022.
2(48% of those who have medical bills, 12% of adults). Kaiser Family Foundation Data Note: Americans' Challenges with Health Care Costs, December 21, 2021. https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/ Accessed January 2022.
3Bankrate, How much should you have in savings at each age? May 7, 2021. Accessed January 2022. https://www.bankrate.com/retirement/how-much-do-you-need-in-savings-retirement-emergency-fund/
4Coverage is guaranteed provided: (1) the employee is actively at work and (2) any dependents to be covered are not under medical restriction as described in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas. For CA-sitused cases, coverage is guaranteed provided” (1) the employee is performing all of the usual and customary duties of your job at the employer's place of business or at an alternate place approved by your employer; and (2) dependents are not subject to medical restrictions as set forth on the enrollment form and in the Certificate.
5Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
7Eligible Family Members mean all persons eligible for coverage as defined in the Certificate. Dependent Child coverage varies by state. Please contact MetLife for more information.
8The Heart Attack Covered Condition pays a benefit for the occurrence of a myocardial infarction, subject to the terms of the certificate. A myocardial infarction does not include sudden cardiac arrest.
9[For 3.5 Policy: Please review the Outline of Coverage/Disclosure Document for specific information about cancer benefits. Not all types of cancer are covered. Some cancers are covered at less than the Initial Benefit Amount. For NH sitused cases and NH residents, there is an Initial Benefit of $100 for All Other Cancer.][For CI 19 Policy: Please review the certificate for specific information about cancer benefits. In most states, not all types of cancer are covered.]
10In certain states, the Covered Condition is Severe Stroke.


[For 3.5 policy -- METLIFE CRITICAL ILLNESS INSURANCE (CII) IS A LIMITED BENEFIT GROUP INSURANCE POLICY. Like most group accident and health insurance policies, MetLife’s CII policies contain certain exclusions, limitations and terms for keeping them in force. Product features and availability may vary by state. The plan may include a pre-existing condition exclusion. After a covered condition occurs, there is a benefit suspension period during which benefits will not be paid for a recurrence, except in the case of individuals covered under a New York certificate. Attained Age rates are based on 5-year age bands and will increase when a Covered Person reaches a new age band. A more detailed description of the benefits, limitations, and exclusions applicable can be found in the applicable Disclosure Statement or Outline of Coverage/Disclosure Document available at time of enrollment. For complete details of coverage and availability, please refer to the group policy form GPNP07-CI, GPNP09-CI, GPNP10-CI, GPNP14-CI or contact MetLife for more information. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York.

MetLife's Critical Illness Insurance is not intended to be a substitute for Medical Coverage providing benefits for medical treatment, including hospital, surgical and medical expenses. MetLife's Critical Illness Insurance does not provide reimbursement for such expenses.]

[For CI 19 policy -- METLIFE CRITICAL ILLNESS INSURANCE (CII) IS A LIMITED BENEFIT GROUP INSURANCE POLICY. Like most group accident and health insurance policies, MetLife's CII policies contain certain exclusions, limitations and terms for keeping them in force. Product features and availability vary by state. There may be a preexisting condition exclusion. There may be a Benefit Reduction Due to Age provision. There may be a Benefit Suspension Period between recurrences of the same Covered Condition or occurrences of different Covered Conditions. Attained Age rates will increase when a Covered Person reaches a new age band. Rates are subject to change. A more detailed description of the benefits, limitations, and exclusions applicable to MetLife’s CII product can be found in the applicable Disclosure Statement or Outline of Coverage/Disclosure Document available at time of enrollment. For complete details of coverage and availability, please refer to the group policy form GPNP07-CI, GPNP09-CI, GPNP10-CI, GPNP14- CI, GPNP19-CI or contact MetLife for more information. Please contact MetLife for more information. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York.

MetLife's Critical Illness Insurance is not intended to be a substitute for Medical Coverage providing benefits for medical treatment, including hospital, surgical and medical expenses. MetLife's Critical Illness Insurance does not provide reimbursement for such expenses.

L0122019037[exp0323][All States][DC,GU,MP,PR,VI]

Voluntary Critical Illness Plan Summary

Mercer's Role & Compensation

Details of Mercer disclosure of the compensation.