PROTECTION solutions What can living with a critical illness mean to you? FOR SALE mortgage doctor prescriptions Daily out-of-pocket expenses for fighting the disease while still paying your bills! Benefit coverage for Peninsula Regional Medical Center On average, every 40 seconds, someone in the United States has a stroke. 1 1 Heart Disease and Stroke Statistics 2012 Update, American Heart Association. CILP1 CRITICAL ILLNESS INSURANCE the right coverage your future great choice ABJ24061X Page 1 of 6
your coverage your choice! With advancements in medical technology and research, diseases that were once life threatening have now become controllable through advanced treatment. However, treatments that help you survive the disease can mean bigger bills to pay and more out-of-pocket expenses. Allstate Benefits (AB) Critical Illness coverage can provide a lump-sum benefit to help you cover those out-of-pocket expenses with each diagnosis, allowing you to concentrate on getting well. i meeting your needs AB Critical Illness coverage helps offer financial peace of mind, should a covered critical illness be diagnosed. Offering from $5,000 $50,000 in basicbenefit coverage Spouse and child(ren) receive the same basic-benefit option as you Benefits are payable for critical illness, wellness, and do not reduce at attained age Benefits paid at time of diagnosis, not treatment, and are paid directly to you unless you choose to sign them over to someone else Premiums are affordable Coverage options include: individual, single parent family, or family coverage The policy is guaranteed renewable for life, subject to change in premiums by class Section 125 qualified, so you can pay your premiums with pre-tax dollars. There could be tax consequences, please consult with your tax advisor AB Critical Illness coverage can help secure your financial future. your benefit coverage The amount payable for each critical illness is the percentage next to that critical illness multiplied by the basic-benefit amount. Benefits are payable only once for each initial occurrence of a critical illness for each covered person. AB will continue to pay benefits until the maximum total percentage of 100% of the basic-benefit amount is reached for each covered person, for each benefit category. CATEGORY 1 BENEFITS Heart Attack (100%) - Pays when you are diagnosed with a heart attack. Stroke (100%) - Pays when you are diagnosed with a stroke. Heart Transplant (100%) - Pays when you require a heart transplant. Bypass Surgery (25%) - Pays when you have bypass surgery. Angioplasty, Atherectomy, Stent Placement (25%) - Pays when you require Angioplasty, Atherectomy, or Stent Placement, based on Angiographic evidence and at the recommendation of a licensed cardiologist. CATEGORY 2 BENEFITS Major Organ Transplant (100%) - Pays when you require a major organ transplant of a lung, liver, pancreas, or kidney. Heart transplant is not included in this benefit. End Stage Renal Failure (100%) - Pays when you are diagnosed with end stage renal failure affecting both kidneys, due to whatever cause or causes, with your undergoing peritoneal dialysis or hemodialysis or resulting in a renal transplant. Paralysis** (50% 2 limbs; 100% 4 limbs) - Pays when you suffer a paralysis which results in a complete and permanent loss of two or four limbs. **Not covered if a result of a stroke. Multiple Sclerosis (25%) - Pays when you are diagnosed with Multiple Sclerosis by a consultant neurologist. Alzheimer s Disease (25%) - Pays when you are diagnosed by a psychiatrist or neurologist with Alzheimer s (must be unable to perform 2 or more of these activities - bathing, dressing, toileting, eating, taking medication). Page 2 of 6 ABJ24061X
Stroke is the leading cause of serious, long-term disability in the United States. 2 2 Heart Disease and Stroke Statistics 2012 Update, American Heart Association. ADDITIONAL RIDER BENEFITS Wellness Benefit Rider (WBR5) - Pays annual benefit when you receive one of the following tests: Biopsy for skin cancer Blood test for triglycerides Bone Marrow Testing CA15-3 (cancer antigen 15-3 - blood test for breast cancer) CA125 (cancer antigen 125 blood test for ovarian cancer) CEA (carcinoembryonic antigen blood test for colon cancer) Chest X-ray Colonoscopy Doppler screening for carotids Doppler screening for peripheral vascular disease Echocardiogram EKG (Electrocardiogram) Flexible sigmoidoscopy Hemocult stool analysis HPV (Human Papillomavirus) Vaccination Lipid panel (total cholesterol count) Mammography, including Breast Ultrasound Pap Smear, including ThinPrep Pap Test PSA (prostate specific antigen blood test for prostate cancer) Serum Protein Electrophoresis (test for myeloma) Stress test on bike or treadmill Thermography Ultrasound screening of the abdominal aorta for abdominal aortic aneurysms There is no limit to the number of years a covered person can receive cancer screening tests. This benefit is paid regardless of the result of the test(s). Critical Illness Cancer Rider 3 (100%) - Pays when you are diagnosed for the first time ever with cancer. We do not pay a benefit under the rider for any disease other than cancer as defined in the rider. how benefits are paid Benefits vary based on the benefit amount and the rider chosen under the plan. EXAMPLE A Below is an example of the amount payable under a $20,000 basic Critical Illness benefit amount. The insured purchased a $20,000 individual critical illness policy. The coverage under the policy included Critical Illness benefits from Categories 1 and 2, plus the Critical Illness Cancer Rider. If you have: an Angioplasty procedure at 25% = $5,000 then a Stent Placement at 25% = $0 (due to Angioplasty benefit being paid) then a Stroke at 75% = $15,000 ($5,000 already paid under Category 1) then Dianosed with cancer (first time) at 100% = $20,000 Total Category 1 and Critical Illness Cancer Rider paid = $40,000 The insured is still eligible for up to $20,000 under the Category 2 benefits, plus $50 under the Wellness Benefit Rider. After 100% of the basic-benefit amount of the policy has been paid within a category (Category 1 or Category 2), AB does not pay any more benefits for any illness associated with that category for that covered person. 3 If you currently have cancer coverage with AB you are not eligible for this rider. ABJ24061X Page 3 of 6
policy specifications PLEASE READ YOUR CERTIFICATE CAREFULLY. This section details the specifics of the policy and rider. Renewability/Termination - (a)the policy is guaranteed renewable for life, subject to change in premiums by class. A notice is mailed in advance of any change.(b) Family coverage may include you, your spouse and eligible children as defined in the policy. (c) Single Parent Family coverage includes you and eligible children as defined in the policy. (d) The policy terminates at the earliest of the end of the grace period for the payment of the premium for the policy; (e) the next renewal date after your request to terminate the policy; (f) or the date each covered person has received the maximum total percentage of the basic-benefit amount for each illness category. (g) Coverage for children ends when the child reaches age 26, unless he or she continues to meet the requirements of an eligible dependent. (h) Spouse coverage ends upon valid decree of divorce. Pre-existing Condition (for policy and riders) - (a) If a covered person has a pre-existing condition as defined, we do not pay benefits for such condition under the policy or any riders attached to the policy during the 12-month period beginning on the date that person became a covered person, unless the condition: was disclosed without material misrepresentation in answer to questions in the application; and is not excluded by name or specific description. (b) A pre-existing condition is a condition for which symptoms existed within the 12-month period before the effective date of coverage; or medical advice or treatment was recommended by or received from a medical doctor within the 12-month period before the effective date of coverage. (c) A pre-existing condition can exist even though a diagnosis has not yet been made. (d) A pre-existing condition does not include a condition admitted in the application which was not excluded by a signed waiver. Limitations and Exclusions - We do not pay benefits under the policy for an illness due to or resulting from: (a) any act of war, whether or not declared, your participation in an, insurrection or rebellion; (b) intentionally self-inflicted injuries; (c) injury incurred as a result of your committing or attempting to commit a felony; (d) attempted suicide, while sane or insane; or (e) participation in any form of aeronautics except as a fare-paying passenger in a licensed aircraft provided by a common carrier and operating between definitely established airports. Claims for benefits under the policy not satisfying all the criteria for diagnosis are subject to review by our medical director or his or her designee. The policy provides benefits only for the illnesses shown. The policy does not cover any other disease, sickness or incapacity. All covered conditions must be diagnosed by a medical doctor. Emergency situations that occur while the covered person is outside the United States will be reviewed and considered for approval by a United States medical doctor on foreign soil or when the covered person returns to the United States. Stroke - Transient ischemic attacks (TIAs) are excluded. Bypass Surgery Exclusion - The following procedures are not considered bypass surgery: balloon angioplasty, laser embolectomy, atherectomy, stent placement, or other nonsurgical procedures. ABJ24061X Page 4 of 6
Don t Wait for A Sign There are different signs that doctors look for when diagnosing critical illnesses. Being diagnosed with a critical illness can be one of the most frightening experiences anyone has to face, especially if you are unprepared. Don t wait for a sign to start thinking about the future or your finances. You can rely on our Critical Illness Insurance to help give you peace of mind, so you can cope with the challenges of treatment. Budget friendly Sometimes, undergoing expensive treatments for a critical illness is difficult if your money is tight. That s where we can help. Our supplemental benefit coverage pays in addition to your major medical insurance to help provide additional dollars that may be used to cover your out-of-pocket expenses. vs. According to the first National Critical Illness Risk Assessment Study published by the American Association for Critical Illness Insurance in 2010, 17 percent of non-smoking men and 36 percent of male smokers who reach the age of 55 without having a critical illness will be diagnosed with one prior to turning age 65. For women who reach age 55, some 12 percent of non-smokers and 23 percent of smokers will face a critical illness before reaching age 65. Page 5 of 6 ABJ24061X
This material is valid as long as information remains current, but in no event later than November 15, 2015. Wellness benefits provided by rider WBR3, or state variations thereof. Critical Illness benefits provided by policy form CILP1 or state variations thereof. Wellness benefits provided by rider WBR5 or state variations thereof. Critical Illness Cancer benefits provided by rider CICR1 or state variations thereof. The policy does not provide benefits for any other sickness or condition. The policy is not a Medicare Supplement Policy. If eligible for Medicare, review Medicare Supplement Buyer s Guide available from Allstate Benefits. This Is A Limited Benefit Policy With Riders. This is a brief overview of the coverage underwritten by American Heritage Life Insurance Company. For complete details, contact Allstate Benefits at 1-800-514-9525. Or, go to allstatebenefits.com. This brochure is for use in MD. Page 6 of 6 ABJ24061X Allstate Benefits is the marketing name used by American Heritage Life Insurance Company (Home Office, Jacksonville, FL), a subsidiary of The Allstate Corporation. 2012 Allstate Insurance Company. www.allstate.com or allstatebenefits.com.