Voluntary Critical Illness Insurance

It is important to plan ahead when considering your health care needs. Even though you may have health care coverage, your out-of-pocket expenses could reach into the thousands of dollars, after health insurance pays for your covered services.

Voluntary Critical Illness Insurance (VCII) can help protect your finances from the expense of a serious health problem, such as a stroke, heart attack or cancer.

This plan pays a lump sum benefit directly to you – not to a doctor or health care provider – at the first diagnosis of a covered condition. Family coverage is available, including specific childhood conditions, such as cystic fibrosis and Down syndrome.

You can use this coverage more than once. If you receive a full benefit payout for a covered illness, your coverage can be continued for the remaining covered conditions. The diagnosis of a new covered illness must occur at least 90 days after the most recent diagnosis. Each condition is payable once per lifetime. You can choose the amount of that protection when you enroll. In order to enroll for VCII, you must have comprehensive health coverage, either through the Company or another source. You can click here to view a video regarding Unum's critical illness plan.

VCII is available in benefit amounts of $5,000, $10,000 and $15,000. If you enroll for coverage, you can also enroll your spouse/domestic partner ages 17 to 64 for a benefit amount of $5,000. Unmarried dependent children are automatically covered at 25% of the amount you choose for yourself ($1,250, $2,500 or $3,750).

If you enroll for coverage during your initial enrollment period, coverage will be effective on the first day of the month following 30 days of employment.

If you do not enroll for coverage during your initial enrollment period, you may enroll for coverage during the next Annual Enrollment period. This plan does not permit mid-year enrollments or changes.

Your Cost

Your cost for VCII coverage depends on your age at the time of enrollment, your tobacco use, the amount of coverage you choose, and on whether you enroll your spouse/domestic partner (and his or her age at the time of enrollment). Once you enroll, your cost will not change on account of your age.

You pay the entire cost of VCII. Refer to the section titled Employee Contributions for the applicable cost.

VCII Benefits

VCII provides lump-sum payments of $5,000, $10,000, or $15,000 when you are diagnosed with any of these medical conditions: benign brain tumor, blindness, cancer, end-stage kidney failure, heart attack, major organ failure or stroke. You will also receive payments if you suffer an injury that results in a coma or permanent paralysis. Benefits are paid at 25% of your coverage amount for carcinoma in situ and coronary artery bypass surgery.

In addition to the diagnoses previously mentioned, children are also covered for cerebral palsy, cleft lip/palate, cystic fibrosis, Down syndrome or spina bifida.

If you suffer more than one covered illness, you can receive a full benefit payout for each as long as the other diagnosis is medically unrelated and separated by 90 days or more. Use this claim form to submit a VCII claim to UNUM.

VCII Wellness Benefits

VCII includes a Wellness Benefit to encourage you to visit your doctor for important diagnostic and preventive tests. The plan pays $75 (limit one payment per year per insured person) in addition to payments made by any other insurance, when you receive any of these health screening tests:

Use this claim form to submit your Wellness Benefit claim to UNUM.

VCII Benefit Limitations and Exclusions

You should be aware of certain limitations and restrictions to the VCII plan, including:

Voluntary Critical Illness Insurance is a limited benefit policy underwritten and administered by Unum. Pioneer Medical Group is not the plan sponsor or the plan fiduciary. As a result, this program is not covered by the Employee Retirement Income Security Act of 1974, as amended (ERISA). All administration of this program is performed by Unum.