While a major medical plan may pay for a good portion of the costs associated with a critical illness, there are a lot of expenses that may not be covered. And, during recovery, having to worry about out-of-pocket expenses and other financial issues is the last thing anyone needs.
The Critical Illness plan provides you a lump sum cash benefit ($10,000 to $50,000) in the event of a critical illness. Some of the covered illnesses are cancer, heart attacks, strokes, end stage kidney failure, major organ transplant and some childhood onset conditions like Autism. This benefit is directly paid to you giving you the flexibility to reimburse yourself for unexpected out of pocket costs, to take time off work or to afford some additional help around the house. The benefits are yours to use however you see fit.
Here are some highlights:
- Guaranteed Issue – no denials as long as you are currently an active employee.
- No pre-existing condition exclusions. As long as the diagnosis is after the effective date, policyholders will be eligible for benefits.
- No age restrictions. There is no age limit for enrolling.
- Coverage never decreases nor is terminated due to claim history or age.
- Extra conditions automatically added:
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Recommendations:
First recommendation: Employees with Pre-existing conditions. The plans are GI and there are no restrictions on pre-existing conditions. So, if you have a medical condition that would make you more at risk, then definitely sign up for whatever you can get. The GI limits are $10,000 to start off, but each year you can increase it by another $10,000 until you max out at $30,000. All other employees can select up to $50,000 of coverage.
Second recommendation: Anyone who routinely, or should routinely, get a mammogram. The plan offers this $200 per calendar year benefit for doing one, and in most cases, this will pay for your entire plan.
3rd recommendation: Anyone with a decade changing birthday coming soon. The plans rates lock in at the time of enrollment. So, anyone who is 29, 39, 49 years of age etc, would get to lock in the younger premiums for the rest of their lives.
4th recommendation: If you and your spouse both work for the City or County, we would recommend that you both get this coverage separately. The price is exactly the same if you split it up, however, children under the age of 26 are covered for free, so if you split it up, the kids are double covered for free.
How to enroll:
Enrollment is easy. It can be done online, or over the phone and only takes 3-5 minutes.
Enroll online: www.sdpeba.org/enroll
Enroll by Phone: 888-315-8027 or click here to book a convenient time for you to talk to one of our specialists.
If you have any questions about Aflac or any SDPEBA benefits, please email [email protected].