Open Enrollment 2017What's New - Critical Illness

Stay Tuned! Open Enrollment 2018 Info Coming Soon.

  1. Critical Illness Overview
  2. Plan Design Table
  3. Rates & Structure Table
  4. Important Note

Critical Illness Supplemental Insurance

The State of Alaska is pleased to offer you an opportunity to enroll in the new Critical Illness Supplemental Insurance plan that can pay a lump sum upon certain diagnoses. Diagnoses include cancer, heart attack, major organ transplant, kidney failure, Alzheimer’s disease, and other illnesses.

MetLife Critical Illness Insurance can complement existing medical coverage and help fill financial gaps caused by out-of-pocket expenses such as mortgage payments, college tuition, hiring household help, or treatment not covered by your medical plan.

Critical Illness Insurance provides several features that could be valuable to you, including:

  • Portability which gives you the ability to keep your existing coverage if your employment status changes;
  • No coordination with other insurance benefits;
  • A lump-sum benefit that you can use as you feel necessary.
  • Benefits are paid regardless of what is covered by medical insurance.

You can elect one of 2 levels of coverage, $15,000 or $30,000.

2018 Critical Illness Plan Design
Benefit for Covered Conditions Initial Benefit Recurrence Benefit
Alzheimer’s Disease 100% of Benefit Amount NONE
Coronary Artery Bypass Graft 100% of Benefit Amount 50% of Benefit Amount
Full Benefit Cancer 100% of Benefit Amount 50% of Benefit Amount
Partial Benefit Cancer 25% of Benefit Amount 12.5% of Benefit Amount
Heart Attack 100% of Benefit Amount 50% of Benefit Amount
Kidney Failure 100% of Benefit Amount NONE
Major Organ Transplant 100% of Benefit Amount NONE
Stroke 100% of Benefit Amount 50% of Benefit Amount
Listed Conditions

Receive 25% of the initial benefit amount for 22 conditions: Addison's disease (adrenal hypofunction); amyotrophic lateral sclerosis (Lou Gehrig’s disease); cerebrospinal meningitis (bacterial); cerebral palsy; cystic fibrosis; diphtheria; encephalitis; Huntington’s disease (Huntington’s chorea); Legionnaire’s disease; malaria; multiple sclerosis (definitive diagnosis); muscular dystrophy; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE); systemic sclerosis (scleroderma); tetanus; and tuberculosis.

Benefit Suspension Period

After a covered condition occurs there is a 365 days day Benefit Suspension Period during which most plans do not pay Recurrence benefits. The Benefit Suspension Period does not apply to first occurrences of distinct covered conditions.

Cancer Recurrence

We will not pay Recurrence benefits for Full Benefit Cancer or Partial Benefit Cancer benefits unless the insured has not been treated nor had symptoms for at least 180 days.

Other Benefits
Health Screening Benefit

If you take one of the screening/prevention measures listed below while such covered person is insured under the certificate MetLife will pay a health screening benefit upon submission of proof that such measure was taken. When MetLife receives such proof, MetLife will review it, and if MetLife approves the claim, MetLife will pay a health screening benefit of $50 or $100, depending on level of coverage.

The Covered Tests are: physical exam, biopsies for cancer, blood test to determine total cholesterol, blood test to determine triglycerides, bone marrow testing, breast MRI, breast ultrasound, breast sonogram, cancer antigen 15-3 blood test for breast cancer (CA 15-3), cancer antigen 125 blood test for ovarian cancer (CA 125), carcinoembryonic antigen blood test for colon cancer (CEA), carotid Doppler, chest x-rays, clinical testicular exam, colonoscopy, digital rectal exam (DRE), Doppler screening for cancer, Doppler screening for peripheral vascular disease, Echocardiogram, electrocardiogram (EKG), endoscopy, fasting blood glucose test, fasting plasma glucose test, flexible sigmoidoscopy, hemoccult stool specimen, hemoglobin A1C, human papillomavirus (HPV) vaccination, lipid panel, mammogram, oral cancer screening, pap smears or thin prep pap test, prostate-specific antigen (PSA) test, serum cholesterol test to determine LDL and HDL levels, serum protein electrophoresis, skin cancer biopsy, skin cancer screening, skin exam, stress test on bicycle or treadmill, successful completion of smoking cessation program, tests for sexually transmitted infections (STIs), thermography, two hour post-load plasma glucose test, ultrasounds for cancer detection, ultrasound screening of the abdominal aorta for abdominal aortic aneurysms, and virtual colonoscopy.

  • MetLife will only pay one health screening benefit per covered person per calendar year.
Effective: Jan. 1 - Dec. 31, 2018
2018 Critical Illness Rates & Structure
Age Tiers Rate Basis (multiple by $15,000 or $30,000)
Employee Only Employee + Spouse Employee + Children Employee + Spouse & Children
Under 25 $0.19 $0.33 $0.36 $0.50 Per $1,000/mth
25–29 $0.21 $0.35 $0.37 $0.52 Per $1,000/mth
30–34 $0.29 $0.48 $0.45 $0.64 Per $1,000/mth
35–39 $0.41 $0.67 $0.58 $0.84 Per $1,000/mth
40–44 $0.63 $1.00 $0.79 $1.17 Per $1,000/mth
45–49 $0.95 $1.50 $1.12 $1.66 Per $1,000/mth
50–54 $1.39 $2.17 $1.55 $2.33 Per $1,000/mth
55–59 $1.95 $3.05 $2.12 $3.21 Per $1,000/mth
60–64 $2.82 $4.40 $2.99 $4.57 Per $1,000/mth
65–69 $4.27 $6.65 $4.44 $6.81 Per $1,000/mth
70+ $6.49 $10.04 $6.66 $10.21 Per $1,000/mth
Effective: Jan. 1 - Dec. 31, 2018

Important Note

Your Critical Illness certificate provides limited benefits – read your certificate carefully. By enrolling for Critical l Illness Insurance, you declare that no person proposed for Critical Illness coverage is covered under any Title XIX program (Medicaid or any similarly named program); that all persons to be insured have medical coverage in force that provides benefits for medical treatment, including hospital, surgical and medical expenses; you acknowledge you have read Shopper’s Guide to Cancer Insurance; and you have received and read a copy of the Outline of Coverage or other disclosure document for the group Critical Illness plan. By enrolling in Critical Illness you agree you have read the enrollment documentation and declare that all information you have given is true and complete to the best of your knowledge and belief; and, you have read the applicable Fraud Warning(s) provided.