ALPA COMPASS ACCIDENT AND CRITICAL ILLNESS INSURANCE Frequently Asked Questions (FAQs)

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1 1. What is Compass Critical Illness insurance and who can be covered? 1a. What Critical Illnesses are covered? 1b. Is health screening required or is there a waiting period? 1c. Is there a pre-existing condition exclusion? 1d. Are there any exclusions or limitations? 1e. What happens if I am diagnosed with a different illness? What is the Restoration of Benefits Rider? 1f. What happens if I am diagnosed with the same illness? What is the Recurrence Rider? 1g. What is the Wellness Benefit Rider? 2. What is Compass Accident Insurance and who can be covered? 2a. What types of accidents are covered? 2b. What are the benefit amounts? 2c. Is health screening required or is there a waiting period? 2d. What is the Wellness Benefit Rider? 3. Who is eligible to enroll in Compass Critical Illness or Compass Accident insurance? 4. Can I enroll or re-enroll at any time during the policy year? 5. Can my dependent(s) enroll without me? 6. When would member coverage terminate? 7. What happens to spouse and dependent coverage upon termination of a member s coverage? 8. How does coverage apply to Members on Military Leave? 9. What happens if my ALPA membership classification changes from an eligible to an ineligible membership class? 10. How do I enroll during the October 1-December 31, 2017 Open Enrollment period? 11. When will my coverage be effective? 12. How do I enroll outside of the October 1- Dec. 31, 2017 Open Enrollment period, if I have a qualifying life event? 13. Who is the insurance company this coverage is through? Page 1

2 1. What is Compass Critical Illness insurance and who can be covered? Compass Critical Illness Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. Critical illness insurance pays a lump sum benefit amount upon the diagnosis of a covered disease or illness. You choose the level of the Maximum Critical Illness Benefit. Members can choose from a Maximum Critical Illness Benefit amount of $5,000 to $30,000 in $5,000 increments. If you are covered, you can cover your spouse for $5,000, $10,000, or $15,000. Your unmarried children through age 26 are eligible for coverage amounts of $1,000, $2,500, $5,000, or $10,000. You can use this money for any purpose you like, for example: to help pay for expenses not covered by your medical plan, lost wages, child care, travel, home health care costs, or any of your regular household expenses. Benefits reduce 50% for the member and spouse, if applicable, on the policy anniversary following the insured s 70 th birthday. Premiums do not reduce as a result of this benefit change. Member and spouse premium rate is determined based on their own age as of their effective date. After that, premiums will change based on their own age as each enter a new age bracket (25-29, 30-34, etc.) or potentially during the renewal process. 1a. What Critical Illnesses are covered? Covered Critical Illnesses and Conditions, and their benefit percentage of the Maximum Critical Illness Benefit are: Base Critical Illness Module: Heart Attack (100%), Stroke (100%), End Stage Renal (Kidney) Failure (100%), Coronary Artery Bypass (25%), Coma (100%), Major Organ Failure (100%), Permanent Paralysis (100%) Module A: Deafness (100%), Blindness (100%), Benign Brain Tumor (100%), Occupational HIV (100%) Module B: Multiple Sclerosis (100%), Amyotrophic Lateral Sclerosis (ALS) (100%), Parkinson s Disease (100%), Alzheimer s Disease (100%), Infectious Disease (100%) Cancer Module: Cancer (100%), Carcinoma In Situ (25%) and Skin Cancer (10%). Childhood Illness: Cerebral Palsy, Congenital Birth Defects, Cystic Fibrosis and Down Syndrome One payment for the elected coverage amount is payable under each of the modules listed above. (Example: A diagnosis of Heart Attack and Parkinson s disease are both payable under the policy). An insured can collect 100% of the benefit for a covered condition under each module (Base Critical Illness Module, Module A, Module B, & Cancer Module). In addition, an insured can also be diagnosed with one of the illnesses covered at 25% and/or 10% and receive the partial benefit. The partial benefits covered at 25% and/or 10% do not reduce the benefit payable for the other covered conditions. 1b. Is health screening required or is there a waiting period? No. There is no health screening required. There are no health questions. And there is not a waiting period. 1c. Is there a pre-existing condition exclusion? No. There are no pre-existing condition limitations. 1d. Are there any exclusions or limitations? Refer to the brochures, certificate of coverage and any riders for complete provisions, limitations and exclusions. Page 2

3 1e. What happens if I am diagnosed with a different illness? What is the Restoration of Benefits Rider? The Restoration of Benefits Rider provides an additional benefit for a different covered condition after 12 consecutive months without another covered critical illness and an insured is also free of the critical illness for which the Maximum Critical Illness benefit was paid. (Example: A diagnosis of a Heart Attack and End State Renal Failure separated by 12 months may be payable under the Restoration Benefit). 1f. What happens if I am diagnosed with the same illness? What is the Recurrence Rider? The Reccurence Rider provides a second Maximum Critical Illness Benefit for the same condition after 12 consecutive months without another covered critical illness and the insured is also free of the critical illness for which the Maximum Critical Illness benefit was paid. The Recurrence Rider is not applicable to the Cancer Module. 1g. What is the Wellness Benefit Rider? If a covered insured has a health screening test, a wellness benefit is payable ($100 for member, $100 for spouse, and $50 for each child up to $200 per family for children). Health screening tests include, but are not limited to: - Blood test for triglycerides - Pap smear - Flexible sigmoidoscopy - CEA (blood test for colon cancer) - Bone marrow testing - Serum cholesterol test for HDL & LDL levels - Hemoccult stool analysis - Serum Protein Electrophoresis (myeloma) - Breast ultrasound - Chest x-ray - Mammography - Colonoscopy - CA 15-3 (breast cancer) - Stress test on bicycle or treadmill - Fasting blood glucose test - Thermography - PSA (prostate cancer) - Electrocardiogram (EKG) Example: If a pilot has an electrocardiogram (EKG) completed during their annual or biannual FAA flight physical (or any of the above health screening tests), a wellness benefit would be payable. NOTE: If you are insured under both the Compass Critical Illness and Compass Accident then you are eligible to receive a wellness benefit for both coverages. A claim is required to be submitted for each product. 2. What is Compass Accident Insurance and who can be covered? Compass Accident Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. Accident insurance pays you a specified amount for specific injuries and events resulting from a covered accident. You can use this money in any way you like, for example: Expenses not covered by your medical plan (Co-Pays & Deductibles) Lost Wages Child Care Travel Costs Home Health Care Costs Any of your regular household expenses If you are covered, you can also cover your spouse and/or your unmarried children to age 26. 2a. What types of accidents are covered? There are so many! Some common injuries are burns, eye injuries, torn knee cartilage, lacerations, concussion, dislocations, and fractures. Please refer to the Accident brochure for a complete listing and the certificate of coverage for complete conditions on benefit eligibility, exclusions and limitations. Page 3

4 2b. What are the benefit amounts? Benefit amounts vary based on the type of injury, such as burns, fractures, dislocations, etc. 2c. Is health screening required or is there a waiting period? No. There is no health screening required. There are no health questions. And there is not a waiting period. 2d. What is the Wellness Benefit Rider? If a covered insured has a health screening test, a wellness benefit is payable each year ($100 for member, $100 for spouse, and $50 for each child up to $200 per family for children). Health screening tests include, but are not limited to: - Blood test for triglycerides - Pap smear - Flexible sigmoidoscopy - CEA (blood test for colon cancer) - Bone marrow testing - Serum cholesterol test for HDL & LDL levels - Hemoccult stool analysis - Serum Protein Electrophoresis (myeloma) - Breast ultrasound - Chest x-ray - Mammography - Colonoscopy - CA 15-3 (breast cancer) - Stress test on bicycle or treadmill - Fasting blood glucose test - Thermography - PSA (prostate cancer) - Electrocardiogram (EKG) Example: If a pilot has an electrocardiogram (EKG) completed during their annual or biannual FAA flight physical (or any of the above health screening tests), a wellness benefit would be payable. NOTE: If you are insured under both the Compass Critical Illness and Compass Accident then you are eligible to receive a wellness benefit for both coverages. A claim is required to be submitted for each product. 3. Who is eligible to enroll in Compass Critical Illness or Compass Accident insurance? If you are an active member in an eligible class (as determined by ALPA) who is a citizen or legal resident of the United States, you qualify for this insurance. There are no medical questions you need to answer or medical tests you need to take to get coverage. Eligible classes are considered Active (AC), Apprentice (AP), Reactivated Member (AR), Executive Active (EA), Executive Inactive (EI), and Inactive Participant (IP). A member that enrolls in ALPA s Compass Accident or Critical Illness plans may also enroll his/her spouse, domestic or civil union partner and any of the member s spouse s or partner s children who will be under the age of 26 on the January 1 of the plan year of enrollment. For purposes of this FAQ, spouse means a person of the same or opposite sex who is legally married to an active member under the laws of the state or jurisdiction in which the marriage took place. 4. Can I enroll or re-enroll at any time during the policy year? Newly hired pilots are automatically enrolled in the Compass Accident plan and also in the Compass Critical Illness plan at a $10,000 benefit level, and the premiums are paid by the VEBA Trust. Newly hired pilots may elect up to an additional $20,000 of the Compass Critical Illness plan and dependent coverage on a premium paying basis within 31 days of hire. Pilot groups new to ALPA may enroll within 31 days. After the inaugural Open Enrollment or initial eligibility, enrollment is only permitted during an annual openenrollment period. Coverage cannot be elected or changed until the next open-enrollment period unless you experience one of the following life events: Marriage, establishment or dissolution of civil union or domestic partnership, or divorce Birth or adoption of a child Death of a spouse or child Changes to your coverage must be completed within 31 days of the qualifying life event. Page 4

5 5. Can my dependent(s) enroll without me? No. Members must enroll in order to purchase coverage for dependents. 6. When would member coverage terminate? Coverage terminates on the earliest of the following dates: The date the Policy terminates. The date you are no longer in an eligible class. The date your eligible class is no longer covered. The date you voluntarily cancel your coverage. The end of the period for which you paid premiums, if you stop making a required premium contribution, subject to the grace period. The end of ALPA's 75 day grace period, if the ALPA does not remit premium to the insurance carrier by the end of such period. The date your membership terminates with the Association. 7. What happens to spouse and dependent coverage upon termination of a member s coverage? If a member s coverage terminates, spouse and dependent coverage will also terminate on the termination date. 8. How does coverage apply to Members on Military Leave? Eligible members that enrolled in coverage are able to participate in the Accident and/or Critical Illness plans. No benefits will be paid for any period which results from your service in the armed forces, military reserves, or National Guard for any country or international authority, while at war, declared or undeclared, or any act or hazard of war, or in a civilian unit serving with such forces, unless you are on temporary assignment in a war area on Employer business. Loss sustained while on active duty as a member of the armed forces of any nation is excluded. Your premium can be refunded, upon written notice of such service, any premium which has been accepted for any period not covered as a result of this exclusion. 9. What happens if my ALPA membership classification changes from an eligible to an ineligible membership class? You have the option to continue your coverage after it would otherwise terminate, if certain conditions are met. To continue your coverage, you must apply for portability and pay the first premium within 60 days of the date Your coverage would otherwise terminate due to any of the following: You retire or terminate membership with the Association, if coverage remains in effect under the Policy for other Insured Persons. ALPA terminates coverage under the Policy for all Insured Persons, and does not replace it with a similar insurance plan. You are no longer eligible for coverage under the Policy. Premiums will be billed directly to you by the insurance company. Continue premium payment is required to keep coverage in force. Please refer to the Portability section of your Certificate(s). 10. How do I enroll during the October 1 - December 31, 2017 Open Enrollment period? During the October 1 - December 31, 2017 Open Enrollment period, you will receive an from ALPA with instructions. Or you may go to to for more information. Page 5

6 11. When will my coverage be effective? All new plans following the open enrollment period and subsequent annual open enrollment periods are effective st November 1. Coverage in effect following a life event (new hires, divorce, child birth, etc.) will be effective the first of the month following the date that ALPA is notified, provided that ALPA is notified within the applicable grace period. 12. How do I enroll outside of the Open Enrollment period, if I have a qualifying life event? Go to complete the application form and submit to ALPA. 13. Who is the insurance company this coverage is through? Insurance is issued by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya family of companies. Page 6