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Critical Illness

Critical Illness Insurance

55% of employees surveyed are concerned about having enough money to cover out-of-pocket medical costs that are NOT covered by health insurance (e.g. Premiums, deductibles, co-pays, travel).1

A serious illness can take a toll on an employee's health and financial well-being. Help employees keep their focus on recovery. MetLife's Critical Illness Insurance is a simple benefit solution that complements existing medical and disability benefits, providing employees with an option to add protection to lessen the burden of out-of-pocket expenses.

The Right Solutions

  • A lump sum payment directly to the covered employee to spend as they choose
  • Guaranteed coverage for employees, their spouses and dependents2
  • Benefits paid regardless of what is covered by medical insurance
  • Health Screening Benefits to encourage wellness3
  • Recurrence Benefits for additional protection4
  • Portability for continuation of coverage5
  • Industry leading 3/6 pre-existing condition limitation66
  • Choice of premium structure - Attained Age or Issue Age - that works best for your employees

Covered conditions:

  • Cancers (Full Benefit and Partial Benefit Cancer)7
  • Stroke8
  • Heart Attack
  • Kidney Failure
  • Major Organ Transplant9
  • Coronary Artery Bypass Graft10
  • Alzheimer's Disease11
  • PLUS 22 Listed Conditions12

An optional Occupational HIV benefit may also be added to the plan for certain health care and service industries.

You can trust our experienced professionals to collaborate with you, understand your needs, and recommend the right benefit solution for your workforce.

Please review the exclusions and limitations for the state of Arizona

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. In most plans, there is a pre-existing condition exclusion. In most states, after a covered condition occurs, there is a benefit suspension period during which most plans do not pay recurrence benefits. MetLife offers CII on both an Attained Age and an Issue Age basis. Attained Age rates are based on 5-year age bands and will increase when a Covered Person reaches a new age band. MetLife's Issue Age CII is guaranteed renewable, and may be subject to benefit reductions that begin at age 65. Premium rates for MetLife's Issue Age CII are based on age at the time of the initial coverage effective date and will not increase due to age; premium rates for increases in coverage, including the addition of dependents' coverage, if applicable, will be based on the covered person's age at the time of that increase's effective date. Rates are subject to change for MetLife's Issue Age CII on a class-wide basis. A more detailed description of the benefits, limitations, and exclusions applicable to both Attained Age and Issue Age CII 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 or GPNP14-CI, or contact MetLife for more information. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York. In New York, availability of MetLife's Issue Age CII product is pending regulatory approval.

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.

1 MetLife's 14th Annual Employee Benefit Trends Study, 2016.

2 Coverage is guaranteed provided (1) the employee is actively at work and (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.

3 The Health Screening Benefit is not available in certain states. In some states, there is a separate Mammogram Benefit. Please review your Disclosure Statement or Outline of Coverage/Disclosure Document for specific state variations and exclusions around this benefit.

4 There is a Benefit Suspension Period between Recurrences. 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. A Recurrence Benefit is available for the following conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer and Partial Benefit Cancer.

5 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.

6 Does not apply to Heart Attack and Stroke.

7 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 Cancer.

8 In certain states, the Covered Condition is Severe Stroke.

9 MetLife offers several different product variations. For certain products, the Major Organ Transplant Benefit is included within the Total Benefit Amount. With others, the benefit is payable in addition to the Total Benefit Amount. Please contact MetLife for additional information.

10 In NJ and NY sitused cases, the Covered Condition is Coronary Artery Disease.

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

12 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.

13 The Occupational HIV Benefit is available to qualified employers with a risk of exposure. Occupational HIV Benefit is not available in all states.

ADF# CI1247.16


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