Critical Illness insurance works to complement your medical coverage—and pays in addition to what your medical plan may or may not cover. It is coverage that provides financial support when you or a loved one becomes seriously ill. Upon diagnosis of a covered illness, it provides you with a lump-sum payment of $15,000 or $30,000 in initial benefits. The total benefit amount available is 3 times that of the initial benefit amount, which is $45,000 or $90,000, in the event that you or a elgible dependent experience more than one covered condition. The payment you receive is yours to spend however you like.
You can only enroll for the Critical Illness plan as a new hire or during Open Enrollment for the following calendar year.
Who is Eligible?
|Eligible Individual||Initial Benefit Amount|
|Active Employee||$15,000 or $30,000|
|Spouse/DP||50% of Employee's Initial Benefit|
|Dependent Child(ren)||50% of Employee's Initial Benefit|
Your Initial Benefit provides a lump-sum payment upon the first diagnosis of a Covered Condition. The plan also pays a Recurrence Benefit for some Covered Conditions. The maximum amount that you can receive through your Critical Illness Insurance plan is called the Total Benefit and is three (3) times the amount of your Initial Benefit. This means you can receive multiple Initial Benefits and Recurrence Benefit Payments until you reach the maximum of 300% or $45,000 or $90,000.
|Covered Condition||Initial Benefit||Recurrence Benefit|
|Full Benefit Cancer||100%||
|Partial Benefit Cancer||20%||12.5%|
|Coronary Artery Bypass Graft||100%||50%|
|Major Organ Transplant||100%||N/A|
|22 Other Listed Conditions (see Plan Summary)||25%||N/A|
Health Screening Benefit
MetLife will provide an annual benefit of $50 per calendar year for taking one of the eligible screening/prevention measures (one screening benefit per person per calendar year). Eligible screenings include routine exams, mammogram, ultrasounds for cancer detections. Learn more about the Health Screening Benefit on this flyer. Visit the Resources page of this website for the Critical Illness Plan Summary, providing a complete list of eligible screenings for the benefit, along with the Health Screening Benefit claim form.
Filing a Claim
To file a Critical Illness claim, you can either (1) complete the claim form (available on the Resources page of this website) and mail or fax a copy of the completed form and required medical information to MetLife (instructions on page 7 of the claim form); or (2) file a claim on the MetLife MyBenefits website (registration instructions here), where you can also view the status of your claim. Once you've submitted the claim form, MetLife processes over 95% of claims within 3 business days.