An additional amount of 50% for each category is provided for occurrences inside the same category, OR a total of 150% of the Principal Sum in each category
Example: A $30,000 Principal Sum of Benefit Elected By Insured
50% Benefit provides $45,000 of Lifetime maximum Payout in each category
Yes, Same Benefit Category Occurrence – 180 days
Separate Category Occurrence – 90 days
Yes, LINCOLN will pay benefit for the same event/illness as long as the event/illness was separated by 180 days and there is a balance remaining for that category.
Example: Heart Category- $25,000 Principal Sum and 50% Recurrent Benefit = $37,500 Lifetime Max Benefit.
Jan 1 – Heart Attack – Principal Sum benefit Payment – $25,000
Oct 1- Heart Attack- Recurrent Benefit Payment – $12, 500
Total Benefit Paid = $37,500 and category benefit is exhausted and the category is removed from the plan and the premiums are reduced.
|Arteriosclerosis (limit 2)||10%|
|Carcinoma in Situ||25%|
|ESRD (End Stage Renal Failure)||100%|
|Major Organ Transplant (Excluding heart)||100%|
|Paralysis (due to accident)||100%|
|Blindness (termed loss of sight)||25%|
|Advanced Multiple Sclerosis||25%|
|Benign Brain Tumor||25%|
|ALS/Lou Gehrig’s Disease||100%|
|Bone Marrow Transplant||25%|
|Acute Respiratory Distress||25%|
If additional premium is required to add a new dependent, coverage for the new dependent will become effective on the date the dependent is acquired
UMass Employees must be actively at work on the effective date, work a minimum of 20 hours per week
Critical Illness Assessment Benefit (i.e., Screening Benefit)
(1) abdominal aortic aneurysm ultrasonography;
(2) blood test for triglycerides;
(3) bone marrow testing;
(4) bone density screening;
(5) breast ultrasound;
(6) CA 15-3 (blood test for breast cancer);
(7) CA125 (blood test for ovarian cancer);
(8) carotid ultrasound;
(9) CEA (blood test for colon cancer);
(10) chest X-ray;
(13) double contrast barium enema;
(14) fasting blood glucose test;
(15) flexible sigmoidoscopy;
(16) hemoccult stool analysis;
(18) pap smear;
(19) PSA (blood test for prostate cancer);
(20) serum cholesterol test to determined level of HDL and LDL;
(21) serum protein electrophoresis (blood test for myeloma);
(22) stress test;
(24) CT Angiography
Insured is put on the UNOS- United Network for Organ Sharing list the benefit will be paid.
Insured is determined to be too ill for the transplant but otherwise meets the criteria for being on the list. Then the insured receives the transplant prior to placement on the list.
Cancer cells confined to the surface tissues (epithelium) without invasion of the basement membrane and with no spread to regional lymph nodes or other tissues. The contract defines it as follows:
Basal cell carcinoma and squamous cell carcinoma of the skin; and Melanoma that is diagnosed as Clark’s level I or II, or Breslow less than 0.75 mm.
QUALITY OF LIFE CATEGORY