Page 21 - Proof-1058-333441-11102020105143.PDF

Using your cash benefits Benefits (subject to maximums as listed on the attached rate insert)
Cash benefits provide you with
options, because you decide Benefit paid upon diagnosis of one of the following conditions
how to use them. INITIAL CRITICAL ILLNESS BENEFITS*
Finances Heart Attack -^ the death of a portion of the heart muscle due to inadequate blood supply. Established (old) myocardial
Can help protect HSAs, infarction and cardiac arrest are not covered
savings, retirement Stroke -^ the death of a portion of the brain producing neurological sequelae including infarction of brain tissue,
plans and 401(k)s hemorrhage and embolization from an extra-cranial source. Transient ischemic attacks (TIAs), head injury, chronic
from being depleted. cerebrovascular insufficiency and reversible ischemic neurological deficits are not covered
Travel Major Organ Transplant -^ transplant of heart, lung, liver, pancreas or kidneys. Transplanted organ must come from a
human donor
Can help pay for expenses
while receiving treatment End Stage Renal Failure -^ irreversible failure of both kidneys, resulting in peritoneal dialysis or hemodialysis. Renal
failure caused by traumatic events, including surgical trauma, are not covered
in another city. Coronary Artery Bypass Surgery -^ to correct narrowing or blockage of one or more coronary arteries with bypass
Home graft. Abdominal aortic bypass, balloon angioplasty, laser embolectomy, atherectomy, stent placement and non-surgical
Can help pay the procedures are not covered
mortgage, continue Waiver of Premium (employee only) -^ premiums waived if disabled for 90 consecutive days due to a critical illness
rental payments, or
perform needed home CANCER CRITICAL ILLNESS BENEFITS*
repairs for after care. Invasive Cancer -^ malignant tumor with uncontrolled growth, including Leukemia and Lymphoma. Carcinoma in situ,
non-invasive or metastasized skin cancer and early prostate cancer are not covered
Expenses Carcinoma In Situ -^ non-invasive cancer, including early prostate cancer (stages A, I, II) and melanoma that has not
Can help pay your family’s invaded the dermis. Other skin malignancies, pre-malignant lesions (such as intraepithelial neoplasia), benign tumors and
living expenses such as polyps are not covered
bills, electricity, and gas.
SECOND EVENT BENEFITS*
Second Event Initial Critical Illness -^ second diagnosis more than 12 months after the first date of diagnosis for
which an Initial Critical Illness benefit was paid
Second Event Cancer Critical Illness -^ second diagnosis more than 12 months after the last date treatment was
received for which a Cancer Critical Illness benefit was paid
SUPPLEMENTAL CRITICAL ILLNESS II BENEFITS*
Advanced Alzheimer’s Disease -^ must exhibit impaired memory and judgment and be certified unable to perform
MyBenefits: 24/7 Access two or more daily activities without adult assistance
1
allstatebenefits.com/mybenefits Advanced Parkinson’s Disease -^ must exhibit two or more of the following: muscle rigidity, tremor, or bradykinesis
1
An easy-to-use website that (slowness in physical and mental responses); and be certified unable to perform at least three daily activities without
adult assistance
offers 24/7 access to important
information about your benefits. Benign Brain Tumor -^ a non-cancerous tumor confirmed by biopsy or surgical excision, or specific neuroradiological
Plus, you can submit and check examination, and persistent neurological deficits including but not limited to: loss of vision; loss of hearing; or balance
disruption. Tumors of the skull, pituitary adenomas, and germinomas are not covered
your claims (including claim
history), request your cash Coma -^ unconsciousness due to sickness or traumatic brain injury, with severe neurologic dysfunction and
benefit to be direct deposited, unresponsiveness for 14 consecutive days. Requires significant medical intervention and life support. Medically induced
make changes to personal Coma is not covered
information, and more. Complete Blindness -^ irreversible reduction of sight in both eyes
Complete Loss of Hearing -^ total and irreversible loss of hearing in both ears
Wellness -^ Biopsy for skin cancer; Paralysis -^ total and permanent loss of voluntary movement or motor function of 2 or more limbs
Bone Marrow Testing; Blood tests for OPTIONAL/ADDITIONAL BENEFIT
triglycerides, CA15-3 (breast cancer),
CA125 (ovarian cancer), CEA (colon Wellness Benefit -^ 23 exams. Once per person, per calendar year; see left for list of wellness services and tests
cancer), PSA (prostate cancer); Chest *Benefits paid once per covered person. When all benefits have been used, the coverage terminates.
X-ray; Colonoscopy; Doppler screening 1 Daily activities include: bathing, dressing, toileting, bladder and bowel continence, transferring and eating.
for carotids or peripheral vascular
disease; Echocardiogram; EKG; Flexible
sigmoidoscopy; Hemoccult stool
analysis; HPV (Human Papillomavirus)
Vaccination; Lipid panel (total cholesterol
count); Mammography, including
Breast Ultrasound; Pap Smear, including
ThinPrep Pap Test; Serum Protein
Electrophoresis (test for myeloma);
Stress test on bike or treadmill;
Thermography; Ultrasound screening for
abdominal aortic aneurysms.

GVCIP2BFL 3 POD86608