Page 21 - National Billing 2022
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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
            in another city.            failure caused by traumatic events, including surgical trauma, are not covered
                                        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
                                                         1
      MyBenefits: 24/7 Access           two or more daily activities without adult assistance
      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
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