Frequently Asked Questions

Take this opportunity to learn more about the benefits that are right for you and your family.

Annual Enrollment: October 11 - 22, 2021

Accident Disclosures

1 Coverage is guaranteed provided (1) the Team Member is actively at work and (2) dependents to be covered 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.

2 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.

Critical Illness Disclosures

3 Eligible Family Members means all persons eligible for coverage as defined in the Certificate.

4 Coverage is guaranteed provided (1) the Team Member 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. [For CA-sitused cases, Coverage is guaranteed provided (1) the Team Member 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.

5 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.

6 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.

Hospital Indemnity Disclosures

7 Coverage is guaranteed provided (1) the Team Member is actively at work and (2) dependents to be covered 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.

8 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.

9 You will be responsible to pay the difference, if any, between the Plan’s payment and the attorney’s charge for services. 

10 For more specific information, please refer to www.metlife.com/mybenefits.

11 Based on internal MetLife analysis. Negotiated Fees refers to the fees that in-network dentists have agreed to accept as payment in full for covered services, subject to any co-pays, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.

Auto & Home Disclosures

12 Use of credit/debit card is optional. The same insurance is available regardless of the method of payment. Payments may be made by cash, check or by credit/debit card. Reward points are not underwritten or funded by MetLife Auto & Home.

*Not all Pearle Vision locations participate in the MetLife Vision program. Please visit metlife.com to confirm participating locations by using our Find A Provider online directory.

Pet Disclosures

13 Independence American Insurance Company (“IAIC”) is the insurance carrier for this product. PetFirst Healthcare, LLC, a MetLife company, is the policy administrator authorized to offer and administer pet insurance policies. Independence American Insurance Company, a Delaware insurance company, is headquartered at 485 Madison Avenue, NY, NY 10022. For costs, complete details of coverage and exclusions, and a listing of approved states, please contact PetFirst Healthcare, LLC. Like most insurance policies, insurance policies issued by IAIC contain certain exclusions, exceptions, reductions, limitations, and terms for keeping them in force.

14 With deductible savings, your pet’s deductible automatically decreases by $25 each policy year that you don’t receive a claim reimbursement. May not be available in all states.

15 Accident coverage is midnight EST as of the day of enrollment compared to wait time of 2 to 15 days for many competitors. Illness coverage begins 14 days from the day of enrollment compared to 14 to 30 days for many competitors.

16 80% of claims are processed within 10 days or less.

17 Annual limit options range from $1,000 - $25,000 in $1,000 increments.

18 Deductible options range include: $0 - $750 in $50 increments and $1,000, $1,250, $1,500, $2,000 and $2,500.

19 Reimbursement options include: 65%, 70%, 80%, 90% and 100%.

20 This discount is not available in Tennessee. This discount is only available for individuals who access the policy through a group (10% for Groups > 1000 lives and 5% for Groups 50-999 lives).