Group Critical Illness Insurance Plan

Group Critical Illness Insurance Plan  

Overview

The Critical Illness Insurance Plan is designed to pay a fixed cash sum, straight to you, when diagnosed with a covered critical illness.

 

The lump sum cash benefit you receive can help you and your family pay out-of-pocket medical and non-medical expenses not covered by your basic health insurance. This way you may worry less about paying bills so you can focus on getting well!

 

Advantages of the Critical Illness Insurance Plan include:

  • Guaranteed acceptance—no medical exams required.
  • Select among 3 different Plans to fit your family's needs and budget.
  • Choice of benefit amounts for each Plan ($5,000, $10,000 or $15,000).
  • Cash Benefits paid regardless of any other insurance.
  • Coverage for you, your spouse or domestic partner and children.
  • Affordable group rates.

 

 

 

How it works

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Enroll and choose your benefit amount and plan

doctor

You’re diagnosed with a covered critical illness

medical papers

You submit a claim to receive benefits

hand giving cash

Your benefit amount is paid to you to use however you want

Forms

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

 
Contact Us

We're here to help! Please contact us in whatever manner is most convenient for you.

 Address
AMBA
4050 114th Street
Urbandale, Iowa 50322
 Phone
1-800-233-5764
 Hours
 M-F 7:30a-5p CT
 Email
[email protected]

 

Insurance Company:

Chubb
P.O. Box 1600
Whitehouse Station, NJ  08889-1600

Tell Me More

Guaranteed Acceptance:

As a member age 60 or under, you are guaranteed acceptance for up to $15,000 in covered Critical Illness benefits. Your spouse or domestic partner age 60 or under and dependent children under age 26 are also guaranteed coverage. No medical exams required! 

 

Members are subject to a waiting period identified below and a 12-month Pre-Existing Condition Limitation. Pre-Existing Condition means any illness, disease, injury, mental illness or condition for which medical advice, Diagnosis, care or treatment: 1) was received by an Insured Person; 2) was recommended to an Insured Person; or 3) would have been sought by a reasonably prudent person, during the twelve (12) month period before becoming insured under this policy. No Benefit Amount will be paid under this policy for a Covered Condition caused by or resulting from, directly or indirectly, a Pre-Existing Condition. This Pre-Existing Condition exclusion only applies for twelve (12) months, beginning with the effective date of the Insured Person’s insurance.

 

Choice of 3 Plans:

You can choose among three plans to fit your needs. Plan 1 covers Type 1 Cancer only, Plan 2 covers Type 1 Cancer plus a few more critical illnesses and Plan 3 covers Type 1 and 2 Cancer and even more critical illnesses. Please see below for the type of plan, conditions covered and benefit amounts paid.

 

Plan 1: Good  
Plan 2: Better
  Plan 3: Best
Critical Condition
Benefit Amount
Critical Condition
Benefit Amount
Critical Condition
Benefit Amount
Type 1 Cancer 100% Type 1 Cancer 100% Skin Cancer $250
  Heart Attack 100% Type 1 Cancer 100%
Stroke 100% Type 2 Cancer 25%
Major Organ Transplant 100% Coronary Artery
By-Pass Surgery
25%
Renal Failure 100% Heart Attack 100%
  Heart Valve Repair/
Replacement Surgery
25%
Stroke 100%
Blindness (Either Eye) 100%
Coma 100%
Paralysis 100%
Major Organ Transplant 100%
Renal Failure 100%

 

Your benefit will be paid on the date you are diagnosed and after the waiting period has been satisfied. Diagnosis of a chronic condition must be confirmed by a licensed physician. Additional eligibility may be required based on the condition. The total benefits payable will not exceed the Maximum Lifetime Benefit amount. Please see the certificate of insurance for complete details.

  • Monthly Rates

    Plan 1:
    Good
    MONTHLY* RATES
    $5,000 Benefit Amount
    Age Member Only Member & Spouse Member & Child Member & Family
    18-24 $ 0.45 $ 0.85 $ 0.85 $ 1.40
    25-29 $ 0.65 $ 1.35 $ 1.10 $ 1.85
    30-34 $ 1.00 $ 2.05 $ 1.45 $ 2.55
    35-39 $ 1.55 $ 3.15 $ 2.00 $ 3.70
    40-44 $ 2.55 $ 5.10 $ 3.00 $ 5.65
    45-49 $ 4.05 $ 8.10 $ 4.45 $ 8.60
    50-54 $ 6.20 $ 12.40 $ 6.65 $ 12.95
    55-59 $ 9.20 $ 18.40 $ 9.65 $ 18.95
    60-64 $ 14.10 $ 28.20 $ 14.50 $ 28.70
    65-70 $ 21.45 $ 42.95 $ 21.90 $ 43.50

     

    For all 3 Plan options, to calculate rates for $10,000 benefit amount, multiply by 2. For rates for $15,000 benefit amount, multiply by 3.

     

     

    Plan 2:
    Better
    MONTHLY* RATES
    $5,000 Benefit Amount
    Age Member Only Member & Spouse Member & Child Member & Family
    18-24 $ 0.65 $ 1.30 $ 1.35 $ 2.15
    25-29 $ 1.00 $ 2.00 $ 1.70 $ 2.85
    30-34 $ 1.75 $ 3.50 $ 2.45 $ 4.35
    35-39 $ 2.85 $ 5.70 $ 3.55 $ 6.55
    40-44 $ 5.00 $ 10.00 $ 5.70 $ 10.85
    45-49 $ 8.10 $ 16.20 $ 8.80 $ 17.05
    50-54 $ 12.35 $ 24.70 $ 13.05 $ 25.55
    55-59 $ 17.90 $ 35.80 $ 18.60 $ 36.65
    60-64 $ 26.45 $ 52.95 $ 27.15 $ 53.80
    65-70 $ 39.35 $ 78.65 $ 40.00 $ 79.50

     

    For all 3 Plan options, to calculate rates for $10,000 benefit amount, multiply by 2. For rates for $15,000 benefit amount, multiply by 3.

     

     

    Plan 3:
    Best
    MONTHLY* RATES
    $5,000 Benefit Amount
    Age Member Only Member & Spouse Member & Child Member & Family
    18-24 $ 1.90 $ 3.80 $ 4.20 $ 6.65
    25-29 $ 2.20 $ 4.40 $ 4.50 $ 7.25
    30-34 $ 2.90 $ 5.85 $ 5.25 $ 8.70
    35-39 $ 4.15 $ 8.35 $ 6.50 $ 11.20
    40-44 $ 6.75 $ 13.50 $ 9.05 $ 16.35
    45-49 $ 10.55 $ 21.10 $ 12.85 $ 23.95
    50-54 $ 15.90 $ 31.75 $ 18.20 $ 34.65
    55-59 $ 23.15 $ 46.35 $ 25.50 $ 49.20
    60-64 $ 34.35 $ 68.65 $ 36.65 $ 71.55
    65-70 $ 50.65 $ 101.25 $ 52.95 $ 104.15

     

    For all 3 Plan options, to calculate rates for $10,000 benefit amount, multiply by 2. For rates for $15,000 benefit amount, multiply by 3.

     

    *Note: You will be billed quarterly for this coverage. If applicable, an additional $2 billing fee will be included on your billing notice payable to the plan administrator. To avoid the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.

     

    Your benefit will be paid on the date you are diagnosed and after the waiting period has been satisfied. Diagnosis of a chronic condition must be confirmed by a licensed physician. Additional eligibility may be required based on the condition. The total benefits payable will not exceed the Maximum Lifetime Benefit amount. Please see the certificate of insurance for complete details.

  • Additional Plan Details

    Waiting period:

    This policy includes a 90 day Waiting Period from the date of enrollment for all categories of Critical Conditions. Benefits will not be paid for a Critical Condition if the diagnosis is made or treatment is recommended during this 90 day period, or if you exhibit symptoms during this 90 day period that would cause a person to seek medical treatment for the critical condition.

     

    Lifetime Maximum Benefit:

    The Lifetime Maximum Benefit Amount that will be paid for each Insured Person under this policy is 100% of the Benefit Amount for all occurrences combined for all Covered Conditions. Coverage under this policy ceases when the Lifetime Maximum Amount has been reached. If you receive benefits for a Critical Illness less than 100% of the Maximum Lifetime Benefit and later receive a diagnosis for a different critical illness, you will receive the percentage of Maximum Lifetime Benefit amount shown, less any prior benefits received. If one critical illness causes another condition, only one benefit will be paid—the largest amount.
    If you receive benefits for a Critical Illness less than 100% of the Maximum Lifetime Benefit and later receive a diagnosis for a different critical illness, you will receive the percentage of Maximum Lifetime Benefit amount shown, less any prior benefits received. If one critical illness causes another condition, only one benefit will be paid—the largest amount.

     

    When coverage begins and ends:

    The policy will become effective on the first day of the month following receipt of the enrollment form and premium payment. You have 30 days to review the Certificate, and if you are not satisfied, you can return the Certificate for a full refund. Coverage ends when the policy terminates, you are no longer eligible, premiums are not paid, the Lifetime Maximum Benefit has been met, or upon attaining age 70.

     

    Read Your Description of Coverage Carefully – This outline of coverage provides a very brief description of the important features of Your Description of Coverage. This is not the insurance contract and only the actual policy provisions will control. The policy itself sets forth in detail the rights and obligations of both You and Us.

     

  • Exclusions and Limitations

    Alcoholism, Drug or Substance Abuse

    This insurance does not apply to a Covered Condition caused by or resulting from, directly or indirectly, the Insured Person’s alcoholism or drug or substance abuse. In addition, the insurance does not apply to any confinement in a detoxification facility or drug or alcohol rehabilitation facility that is not also a Hospital or part of a Hospital.

     

    Congenital Conditions

    This insurance does not apply to a Covered Condition caused by or resulting from, directly or indirectly a congenital condition as Diagnosed by a licensed Physician.

     

    Cosmetic Surgery

    This insurance does not apply to cosmetic surgery or care or treatment solely for cosmetic purposes or complications therefrom. This exclusion does not apply to cosmetic surgery resulting from an Accident if initial treatment of the Insured Person is begun within twelve (12) months of the date of the Accident or to treat congenital defects in covered newborns.

     

    Experimental or Investigational

    This insurance does not apply to any service, supply or Covered Condition that is experimental or investigational.

     

    Intoxication Exclusion

    This insurance does not apply to any Accident caused by or resulting from, directly or indirectly, the Insured Person being intoxicated, at the time of an Accident. Intoxication is defined by the laws of the jurisdiction where such Accident occurs.

     

    Narcotic Exclusion

    This insurance does not apply to any Sickness or Accident caused by or resulting from, directly or indirectly, the Insured Person being under the influence of any narcotic or other controlled substance at the time of the loss. This exclusion does not apply if any narcotic or other controlled substance is taken and used as prescribed by a licensed Physician.

     

    Pregnancy

    This insurance does not apply to normal pregnancy. Complications of Pregnancy are covered as any other Sickness.

     

    Pre-Existing Condition

    No Benefit Amount will be paid under this policy for a Covered Condition caused by or resulting from, directly or indirectly, a Pre-Existing Condition. This Pre-Existing Condition exclusion only applies for twelve (12) months, beginning with the effective date of the Insured Person's insurance. A Pre-Existing Condition means any illness, disease, injury, physical condition, or mental condition for which medical advice, diagnosis, care or treatment was received by an Insured Person; was recommended to an Insured Person; or would have been sought by a reasonably prudent person, during the twelve (12) month period before becoming insured under this policy.

     

    Procedures and Diagnosis Outside the US or its Territories

    This insurance does not apply to a Covered Condition that has been Diagnosed or to any surgical procedures that have been performed outside of the United States or its Territories.

     

    Rest care or custodial care treatment

    This insurance does not apply to any rest care or custodial care or treatment for any Sickness or Accident.

     

    Refusal of Medical Treatment

    This insurance does not apply to a Covered Condition caused by or resulting from, directly or indirectly, the Insured Person's refusal of the following recommended medical treatment:

    a. a Physician has recommended treatment with angioplasty or Coronary Artery By-Pass Graft for coronary artery disease, the Insured Person refuses treatment, and the Insured Person suffers a Heart Attack; or

    b. a Physician has recommended treatment for a brain aneurysm or carotid artery stenosis, the Insured Person refuses treatment, and the Insured Person suffers a Stroke; or

    c. a Physician has recommended a Diagnostic biopsy or Diagnostic/therapeutic excision of a mass or lesion suspected of being Cancer, the Insured Person refuses and the Insured Person develops Type 1 Cancer, Skin Cancer, or Type 2 Cancer.

     

    Suicide or Intentional Injury

    This insurance does not apply to a Covered Condition caused by or resulting from, directly or indirectly, an Insured Person's suicide, or attempted suicide or intentionally self-inflicted injury while the Insured Person is sane or insane.

     

    Uninsured Critical Condition

    This insurance does not apply to any loss caused by or resulting from, directly or indirectly any illness not specifically listed as a Covered Condition shown in Section C, under the Schedule of Eligible Benefits.

     

    Workers Compensation

    This insurance does not cover Sickness or Accident arising out of and in the course of any occupation for compensation, wage or profit for which are payable under Occupational Disease Law, Workers Compensation or similar law, whether or not application for such benefits have been made.

     

    This policy does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit the provision of insurance.

     

    This information is a brief description of the important features of this insurance plan. It is not an insurance contract. Insurance benefits are underwritten by Federal Insurance Company. Coverage may not be available in all states or certain terms may be different where required by state law. Chubb NA is the U.S.-based operating division of the Chubb Group of Companies, headed by Chubb Ltd. (NYSE: CB) Insurance products and services are provided by Chubb Insurance underwriting companies and not by the parent company itself. Please refer to your plan documents for benefit information, definitions and a complete list of exclusions.

     

    THIS POLICY PROVIDES LIMITED BENEFITS ON A FIXED INDEMNITY BASIS. IT DOES NOT CONSTITUTE COMPREHENSIVE HEALTH INSURANCE COVERAGE (OFTEN REFERRED TO AS "MAJOR MEDICAL COVERAGE") AND DOES NOT SATISFY A PERSON’S INDIVIDUAL OBLIGATION TO SECURE THE REQUIREMENT OF MINIMUM ESSENTIAL COVERAGE UNDER THE AFFORDABLE CARE ACT (ACA). FOR MORE INFORMATION ABOUT THE ACA, PLEASE REFER TO HTTPS://WWW.HEALTHCARE.GOV.

     

    Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and shall also be subject to criminal and civil penalties.

     

    Chubb is the marketing name used to refer to subsidiaries of Chubb Limited providing insurance and related services. Insurance provided by Federal Insurance Company and its U.S. based Chubb underwriting company affiliates. All products may not be available in all states. This communication contains product summaries only. Coverage is subject to the language of the policies as actually issued. Chubb, P.O. Box 1600, Whitehouse Station, NJ 08889-1600. Underwritten by: Federal Insurance Company.

     

    Form 44-02-2052 (Ed. 03-14)

Policy #9908-9717

FAQs

Answers about the plan, including eligibility, options, enrollment, customer service and more.
  • Why would I need a Critical Illness Benefit?

    A Critical Illness benefit can help replace some of your income, pay medical and non-medical expenses not covered by your basic health insurance, and help protect your family from financial impact if cancer, a heart attack or other critical illness impacts you.

  • How does it work?

    If you are diagnosed with one of the covered critical illnesses, confirmed by a licensed physician and meet other qualifying criteria, you will be paid the lump sum benefit amount you selected.

  • Is the benefit tax-free?

    Yes, typically critical illness benefits paid are not taxable, but you should consult your tax advisor for complete details.

  • Are there restrictions on how I can use the benefit?

    No, you can use your benefit payment any way you need, including paying for your mortgage or rent, groceries, treatment or other out-of-pocket medical and non-medical expenses.