Critical Illness Insurance

Critical illness insurance provides a lump sum payment to help provide you and your family financial support in a difficult time.

Please note that Jacobs Technology Employees are not eligible for Critical Illness Insurance

Critical Illness Insurance

Lump sum payment to use as you see fit for yourself and your family

Emotionally managing illnesses like cancer, a heart attack or a stroke is hard enough. Financially managing the costs on top of this is often overwhelming. Critical illness insurance provides a lump sum payment to ensure you and your family have financial support in a difficult time. So, you’ll be able to spend less time worrying about money and more time focusing on healing.

  • You’ll receive a lump sum payment to use as you see fit
  • Use it for prescriptions, deductibles, co-payments, experiential/non-traditional treatments and even non-medical expenses like everyday bills
  • Pays out in addition to what your medical insurance covers
  • Payments may be paid directly to you, not to the doctors, to the hospitals or to the healthcare providers
Outlines of coverage

How it Works.

As a MetLife certificate holder, if you or a Covered Family Member experiences one of the Covered Conditions within any category and meet the group policy and certificate requirements, you will receive a lump-sum benefit payment to use as you see fit. You have a choice of a $15,000 or $30,000 Initial Benefit Amount.

As an employee, the maximum amount that you can receive through your Critical Illness Insurance plan is called the Total Benefit and is 3 times the amount of your Initial Benefit. This means that you can receive Initial and Recurrence Benefit payments until your Total Benefit Amount is reached $45,000 or $90,000, maximum of 300%.

Please refer to the table below for the percentage benefit amount for each Covered Condition.

Covered Conditions

Initial Benefit

Recurrence Benefit

Full Benefit Cancer5

100% of Initial Benefit

50% of Initial Benefit

Partial Benefit Cancer5

25% of Initial Benefit

12.5% of Initial Benefit

Heart Attack

100% of Initial Benefit

50% of Initial Benefit

Stroke6

100% of Initial Benefit

50% of Initial Benefit

Coronary Artery Bypass Graft

100% of Initial Benefit

50% of Initial Benefit

Kidney Failure

100% of Initial Benefit

Not applicable

Alzheimer’s Disease7

100% of Initial Benefit

Not applicable

Major Organ Transplant Benefit

100% of Initial Benefit

Not applicable

22 Listed Conditions

25% of Initial Benefit

Not applicable

The payment amount depends on the illness you experience.

Example of Initial & Recurrence Benefit Payments

The example below illustrates an employee who elected an Initial Benefit of $15,000 and has a Total Benefit of 3 times the Initial Benefit Amount or $45,000.

Illness – Covered Condition Payment Total Benefit Remaining
Heart Attack – first diagnosis Initial Benefit payment of $15,000 or 100% $30,000
Heart Attack – second diagnosis, two years later Recurrence Benefit payment of $7,500 or 100% $22,500
Kidney Failure – first diagnosis, three years later Initial Benefit payment of $15,000 or 100% $7,500

 

This example is for illustrative purposes only. The MetLife Critical Illness Insurance Policy and Certificate are the governing documents with respect to all matters of insurance, including coverage for specific illnesses. The specific facts of each claim must be evaluated in conjunction with the provisions of the applicable Policy and Certificate to determine coverage in each individual case.

In most states there is a preexisting condition limitation. If advice, treatment or care was sought, recommended, prescribed or received during the three months prior to the effective date of coverage, we will not pay benefits if the covered condition occurs during the first six months of coverage. The preexisting condition limitation does not apply to heart attack or stroke.

Take advantage of employee rates when applying for coverage through your employer. 

Attained Age

Employee Rates

Spouse Rates

Dependent Child(ren)

<25

$0.11

$0.12

$0.07

25–29

$0.13

$0.15

—

30–34

$0.22

$0.24

—

35–39

$0.40

$0.45

—

40–44

$0.72

$0.86

—

45–49

$1.28

$1.38

—

50–54

$2.14

$2.21

—

55–59

$3.43

$3.17

—

60–64

$5.33

$4.50

—

65–69

$8.23

$6.52

—

70-74

$11.79

$9.43

—
75-79 $16.23 $13.67 —
80-84 $19.98 $17.49 —
85+ $21.27 $18.95 —

*Multiply the per $1,000 rates shown above by the benefit amount divided by $1,000 (e.g., 15 for $15,000 of coverage) and round to two decimals to calculate rates for the quoted benefit amounts. Note that the per $1,000 rates are only applicable to the benefit amounts shown in this C&B. 

FAQs

Who is eligible to enroll? Collapsed Expanded

Regular active full-time and modified full-time employees who are actively at work along with their spouse/domestic partner and dependent children can enroll for MetLife Critical Illness Insurance coverage.3

 

I have a good medical plan at work. Why do I need critical illness insurance? Collapsed Expanded

Even quality medical and disability income plans don’t always cover all of your expenses.

For example, your medical coverage may have deductibles and copays and may not cover out-of-network treatments. And if you’re out on disability, only a portion of your income may be covered. With the average family spending thousands of dollars during a time of critical illness and recovery,9 most people will need the means to cover extra medical and daily living expenses.  Such costs can include deductibles or items like groceries, housing expenses, car payments, and more. 

Can I enroll for this coverage without having to take a medical exam? Collapsed Expanded

Yes. Provided you are actively at work, your enrollment is guaranteed.5

How do I pay for coverage? Collapsed Expanded

Coverage is paid through convenient payroll deduction.

 

What happens if my employment status changes? Can I take my coverage with me? Collapsed Expanded

Yes. This coverage is "portable," meaning you can take it with you wherever you go. 

Who do I call for assistance? Collapsed Expanded

Contact a MetLife Customer Service Representative at 1 800- GET-MET8 (1-800-438-6388), Monday through Friday from 8:00 a.m. to 8:00 p.m., EST or 7 a.m. to 7 p.m. Central. Individuals with a TTY may call 1-800-855-2880.

 

How do I access my Certificate of insurance terms and coverage details? Collapsed Expanded

 Access your certificate online. Go to www.metlife.com/mybenefits, enter your company name and ‘click submit.’ On the Home Page, click on ‘Register Now’ and perform the one-time registration process, if you don’t already have an account.

How do I file a claim? Collapsed Expanded

Online claim submission is hassle-free and simple! Log on to www.metlife.com/mybenefits and enter Jacobs Engineering in the Company Name field. Click the ‘Next’ button. You will then see the ‘Welcome to MyBenefits’ page where you can register as a MyBenefits user or if you have already registered, enter your name and password. Select “File a Claim Online” from the 'I want to' dropdown, or call 1-866-626-3705. Answer some questions about the claim and attach/provide completed physician statement.

What happens after my claim submission? Collapsed Expanded

A Claims Acknowledgement Letter is mailed to you, so you know we are working to review and process your claim. A MetLife claims specialist will review your information, call you to collect any missing information and notify you in writing of a claim decision. You may also visit MyBenefits frequently to check claim status, letters and benefit payments.

 

What happens if I have a recurrence? Collapsed Expanded

Your plan pays a Recurrence Benefit for the following covered conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer and Partial Benefit Cancer. A Recurrence Benefit is only available if an Initial Benefit has been paid for the Covered Condition. There is a Benefit Suspension Period between Recurrences.8

What are the 22 Listed Conditions? Collapsed Expanded

MetLife Critical Illness Insurance will pay 25% of the Initial Benefit Amount for each of the 22 Listed Conditions until the Total Benefit Amount is reached. A Covered Person may only receive one payment for each Listed Condition in his/her lifetime. The Listed Conditions are Addison’s disease (adrenal hypofunction); amyotrophic lateral sclerosis (Lou Gehrig’s disease); cerebrospinal meningitis (bacterial); cerebral palsy; cystic fibrosis; diphtheria; encephalitis; Huntington’s disease (Huntington’s chorea); Legionnaire’s disease; malaria; multiple sclerosis (definitive diagnosis); muscular dystrophy; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE); systemic sclerosis (scleroderma); tetanus; and tuberculosis.

1 Coverage for Domestic Partners, civil union partners and reciprocal beneficiaries varies by state. Please contact MetLife for more information.

2 Dependent Child coverage varies by state. Please contact MetLife for more information.

3 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. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.

4 We will not pay a Recurrence Benefit for a Covered Condition that Recurs during a Benefit Suspension Period. We will not pay a Recurrence Benefit for either a Full Benefit Cancer or a Partial Benefit Cancer unless the Covered Person has not had symptoms of or been treated for the Full Benefit Cancer or Partial Benefit Cancer for which we paid an Initial Benefit during the Benefit Suspension Period.

5 Please review the Disclosure Statement or 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 Cancers.

6 In certain states, the covered condition is Severe Stroke.

7 Please review the Outline of Coverage for specific information about Alzheimer’s disease.

10 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.

Metropolitan Life Insurance Company | 200 Park Avenue | New York, NY 10166

L0318503289[exp0419][All States]

NW 3.5 AA OHIV

METLIFE’S 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 is a preexisting condition exclusion. There is a Benefit Suspension Period between Recurrences. Attained Age rates are based on 5-year age bands and 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 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 or GPNP10-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.