Critical Illness Insurance

Critical Illness Insurance  

Overview

Every 40 seconds, someone in the U.S. has a heart attack or stroke or is diagnosed with cancer or other serious disease.* If it happens to you, shouldn’t your primary focus be on getting well—not worrying about how to pay for your treatment and care?

 

Critical Illness** Insurance can help you by paying a lump sum benefit if you are diagnosed with a covered illness or condition, on or after your coverage effective date. Features of this insurance include:

  • You can choose among a lump sum benefit of $10,000 or $20,000. You can also choose from benefit amounts of $5,000 and $10,000 for your spouse under age 70 and children under age 26 if family coverage is provided or elected. Age requirements may vary.
  • The benefit is paid directly to you and you can use the benefit payment for any purpose you like.
  • Rates are typically lower when you purchase group insurance coverage through your employer. Your premium is conveniently deducted from your paycheck.
  • Provided by an insurance carrier you can trust, ReliaStar Life Insurance Company, a member of the Voya® family of companies.
  • There are no medical questions or tests required for coverage if you enroll during the Enrollment Period.
  • Portable—you can keep your coverage if you leave your employer.
  • This is designed to complement your comprehensive medical plan insurance. It is not a replacement for medical insurance.
  • 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. 

 

The cost of Critical Illness Insurance varies based on your age and the amount of coverage. It is very likely that your monthly premiums will be less than your monthly lunch budget.

 

Employee Coverage
Bi-Weekly Rates (26 pay periods)
Includes Wellness Benefit Rider

Non-Tobacco

Issue Age

$10,000

$20,000

Under 25 $1.85 $2.49
25-29 $1.89 $2.58
30-34 $2.12 $3.05
35-39 $2.72 $4.25
40-44 $3.60 $6.00
45-49 $4.94 $8.68
50-54 $6.78 $12.37
55-59 $9.32 $17.45
60-64 $13.48 $25.75
65-69 $19.38 $37.57
70+ $24.65 $48.09

Tobacco

Issue Age

$10,000

$20,000

Under 25 $2.17 $3.14
25-29 $2.26 $3.32
30-34 $2.63 $4.06
35-39 $3.74 $6.28
40-44 $5.08 $8.95
45-49 $7.52 $13.85
50-54 $10.80 $20.40
55-59 $15.32 $29.45
60-64 $22.80 $44.40
65-69 $29.63 $58.06
70+ $37.57 $73.94

 

Spouse Coverage
Bi-Weekly Rates (26 pay periods)
Includes Wellness Benefit Rider

Non-Tobacco

Issue Age

$5,000

$10,000

Under 25 $1.62 $2.03
25-29 $1.66 $2.12
30-34 $1.73 $2.26
35-39 $2.10 $3.00
40-44 $2.63 $4.06
45-49 $3.48 $5.77
50-54 $4.87 $8.54
55-59 $6.67 $12.14
60-64 $9.37 $17.54
65-69 $13.50 $25.80
70+ $16.82 $32.45

Tobacco

Issue Age

$5,000

$10,000

Under 25 $1.82 $2.45
25-29 $1.87 $2.54
30-34 $2.05 $2.91
35-39 $2.65 $4.11
40-44 $3.42 $5.63
45-49 $4.92 $8.63
50-54 $7.22 $13.25
55-59 $10.29 $19.38
60-64 $15.35 $29.49
65-69 $19.82 $38.45
70+ $24.92 $48.65

 

Children Coverage
Bi-Weekly Rates (26 pay periods)
Includes Wellness Benefit Rider

Coverage Amount

Rate

$5,000.00 $0.82
$10,000.00 $1.65

 

*http://www.criticalillnessinsuranceinfo.org/learning-center/critical-illness-coverage-facts.php

**Critical Illness is referred to as Specified Disease in some states.

Enrollment

Add critical illness insurance to help offset expenses that may not be covered under your employer's existing medical insurance and disability plans.


2020 Annual Enrollment
ENROLL NOW

Contact Us

 Address
Mercer Consumer
12421 Meredith Drive
Urbandale, IA 50398
 Phone
1-855-290-5661
 Hours
 M-F 9a-6p ET
 Email
customer.service@mercer.com

How It Works

FAQs

Answers about the plan, including eligibility, options, enrollment, customer service and more.

  • Can I meet with someone one-on-one to get a better understanding of this insurance product?

    Yes, Baystate Health has partnered with the Farmington company during benefits open enrollment. Specially trained Licensed Agents are available onsite at Baystate throughout the open enrollment period, to assist with questions and help you make informed decisions.
  • Who is the provider?

    Critical Illness Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Voya Employee Benefits is a division of ReliaStar Life Insurance Company.
  • How can this help me?

    Gives you the comfort to recover in confidence while avoiding the financial strain a serious illness can cause. Critical Illness Insurance pays a lump-sum benefit if you are diagnosed with a covered illness or condition, on or after your coverage effective date.
  • Who is eligible?

    All Baystate and Baycare employees who work at least 16 hours/wk or BVNAH employees who work at least 15 hours/week.

  • Who can enroll?

    You, your spouse and eligible children qualify for this coverage.

    • All active employees (a minimum hours working per week requirement may be required).
    • Your spouse*— under age 70. Coverage is available only if employee coverage is elected.
    • Your children— to age 26. Coverage is available only if employee coverage is elected.

     

    *The use of “spouse” means a person insured as a spouse as described in the certificate of insurance or rider.

  • When can I enroll?

    You can enroll in this benefit during Baystate’s benefits open enrollment each Oct-Nov timeframe. If you are a new hire or have a “qualifying change in life status”, you can enroll within 15 days of your hire date.
  • When is my coverage effective?

    The effective date of coverage is the date you are eligible to begin filing claims. The condition or illness must occur on or after the coverage effective date.

     

    OPEN ENROLLMENT

    • Your coverage becomes effective on January 1 following the election of coverage. Coverage for your spouse and/or children becomes effective on the same date as your coverage.

     

    New Hires

    • Coverage becomes effective at 12:01 AM on the latest of the following:
      • First of the following month after you complete your enrollment.
      • The first day of the month following the date you return to active employment, if you are not in active employment when your coverage would otherwise become effective.

    • Coverage for your spouse and/or children becomes effective on the same date as your coverage.

  • When/how can I cancel my coverage and when would it take effect?

    You can cancel your coverage at any time by contacting Mercer at 855-290-5661 or selecting the Current Benefit Elections option at www.BHBenefitsplus.com, logging in, and declining the benefit(s) you wish to cancel (leave others unchanged). The cancellation would become effective the first day of the month after the request and you would not be able to re-enroll until a subsequent annual enrollment. Your first or second paycheck after the cancellation is processed would reflect the change and a refund should be issued by Voya within 30 days of the date the cancellation is processed, if applicable.
  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your coverage without interruption, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available if you retire or leave your company, you will be billed directly by the insurance carrier.

  • How do I pay for this benefit?

    Payments are made via Baystate Health payroll deduction.

  • What serious illnesses and diseases am I covered for?

    For a full list, please see the Critical Illness Benefits Guide in the "Forms" section of the page. For a complete description of your benefits, along with applicable provisions, conditions on benefit determination, exclusions and limitations, see your certificate of insurance and any riders.
  • Will my rates increase as I get older or if I file a claim?

    Your rates will not increase due to age, health or individual claims.
  • What happens if I recover and then I’m diagnosed again?

    The number of times you may receive a benefit varies based on the plan selected by your employer. The most common plan limits the Maximum Critical Illness Benefit to one covered illness or disease within each module. Once you have received the Maximum Critical Illness Benefit within each module, you are no longer able to receive benefit payments for another covered condition from that same module. If a partial benefit is paid out, it will not reduce the available maximum benefit amount for the illnesses or diseases in that same coverage module. Some plans will only allow you to receive the full benefit amount for one covered condition, regardless of how many modules are included. Alternatively, your plan may allow you to receive benefits for multiple conditions within each module. Please see your certificate of coverage for details.

     

    For more information, please see the Critical Illness Benefits Guide in the "Forms" section of the page.

  • Exclusions and Limitations

    Benefits are not payable for any critical illness caused in whole or directly by any of the following*:

    • Participation or attempt to participate in a felony or illegal activity.
    • Suicide, attempted suicide or any intentionally self-inflicted injury, while sane or insane.
    • War or any act of war, whether declared or undeclared, other than acts of terrorism.
    • Loss that occurs while on full-time active duty as a member of the armed forces of any nation. We will refund, upon written notice of such service, any premium which has been accepted for any period not covered as a result of this exclusion.
    • Alcoholism, drug abuse, or misuse of alcohol or taking of drugs, other than under the direction of a doctor.
    • Benefits reduce 50% for the employee and/or covered spouse on the policy anniversary following the 70th birthday, however, premiums do not reduce as a result of this benefit change.

     

    *Exclusions and limitations may vary by state. Consult your certificate of insurance for exact language.

  • Are there any pre-existing condition limitations with this plan?

    The Voya Accident, Critical Illness, and Hospital Indemnity Plans do not have a pre-existing condition limitation. 
  • What is the Wellness Benefit, and how do I claim my $100?

    The Wellness Benefit is a rider that is automatically included with your Accident, Critical Illness, and/or Hospital Confinement Indemnity Insurance coverage. It provides an annual benefit payment if you complete a health screening test, whether there is any out-of-pocket cost to you or not. You are eligible to receive one annual benefit of $100, regardless of how many screening tests you may complete. If enrolled, your spouse is eligible to receive the $100 wellness benefit and your children are eligible to receive $50 each, up to a maximum of $200 for all children in a calendar year, if they complete a screening. If you participate in Baystate’s health screenings for employees through the Baystate Healthy program, this screening qualifies for the $100 benefit.

     

    Click here to view more details about what types of screenings qualify on the wellness benefit and here for how to claim it. Personal information provided on a claim form and supporting documentation confirming the name of the person/organization you saw and date of the screening is, generally, what Voya requires. Information regarding other insurance is not needed for this type of claim.

  • I have Voya coverage under more than one plan (Accident, Critical Illness, and/or Hospital Indemnity) that includes a $100.00 wellness benefit. Am I eligible to be reimbursed for that benefit under more than one plan for the same service?

    As long as your coverage under each plan was active on the date of service you are eligible to receive the benefit under each plan.
  • How do I access a claim form and how do file a claim for benefits?

    1. Visit the Voya.com/claims and click on "Get Started".
    2. Complete the questionnaire.
      This generates a custom claim form package for you.
    3. Download your claim form package.
    4. Complete the form package.
      Have each form completed by the appropriate party, as outlined in the claim form package.
    5. Gather additional documents.
      Collect any additional supporting documents, as instructed on the claim form "for you".
    6. Submit.
      Using your preferred submission method, submit your completed and signed forms, as well as any supporting documents.
      • To submit online via a secure upload, visit Voya.com/claims and click on "Upload Documents".
      • To mail or fax your submission, see the top of your custom claims form package.

 

This is a summary of benefits only. Please review your enrollment materials and any applicable brochures prior to enrolling in coverage. A complete description of benefits, limitations, exclusions and terminations of coverage will be provided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there is any discrepancy between this website and the group policy documents, the policy documents will govern. To keep coverage inforce, premiums are payable up to the date of coverage termination. Critical Illness Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Compass Critical Illness Policy Form #: RL-CI3-POL-12. Form numbers, provisions and availability may vary by state.

Forms

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

 

Critical Illness Benefits Guide
Critical Illness Insurance Plan Certificate of Insurance
Critical Illness Plan State Mandated Forms
Mercer's Role & Compensation

Details of Mercer disclosure of the compensation.