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Group Voluntary Cancer Insurance

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Presentation on theme: "Group Voluntary Cancer Insurance"— Presentation transcript:

1 Group Voluntary Cancer Insurance
CancerSelect PlusSM Group Voluntary Cancer Insurance Underwritten by Transamerica Life Insurance Company, Home Office, Cedar Rapids, Iowa Policy Form Series CPCI0400 and CCI00400.

2 CancerSelect PlusSM “Cancer strikes millions of people—one in two men, and one in three women.” * While survival rates are high, the direct medical and indirect non-medical costs of treatment are expensive. Non-medical costs include loss of income, living expenses, transportation, special diets, family care, and so on. In fact, out-of –pocket costs average $712 a month for employees.** Employer sponsored health plans usually cover only the direct medical costs. *American Cancer Society. Cancer Facts & Figures Atlanta: American Cancer Society; 2011. ** Duke University Medical Center and Dana-Farber Cancer Institute, The study consisted of 216 patients, mostly breast cancer victims.

3 CancerSelect PlusSM Importance Group Voluntary Cancer Insurance at the workplace Flexible plan Conveniently payroll deductible Provides eligible employees, spouses, and dependent children with benefits for costs associated with cancer No physical exams or blood tests are required Coverage is portable Benefits are paid to employee in addition to other insurance

4 CancerSelect PlusSM CancerSelect Plus pays benefits associated with:
Medical benefits for hospital room, drugs and medicine, physician fees, anesthesia, surgery, radiation/chemotherapy, bone marrow and stem cell transplants, blood and plasma, prosthesis, physical therapy, hospice care and wellness and more. Non-medical benefits for transportation, family member lodging, outpatient lodging, and waiver of premiums.

5 CancerSelect PlusSM Plan Highlights:
Benefits are paid directly to the insured or whomever chosen. Individual and family coverage is available. No physical exams or blood tests are required. The premiums will be waived after 60 days of disability due to cancer, for as long as you're disabled.

6 CancerSelect PlusSM Employer/Producer designs the Plan options (up to 2 options may be offered.) Employer/Producer selects number of units for each of the 5 modules and number of units for each of the 3 optional riders.

7 CancerSelect PlusSM Benefit Modules
Hospital Benefits (Module #1) 1 to 5 units Hospital Confinement: Pays $100 per unit per day for up to 90 days Extended Benefits: Beginning with the 91st day of continuous confinement, pays $200 per unit per day Inpatient Drugs and Medicines: Pays $15 per unit per day for covered person Attending Physician (other than the surgeon): Pays $20 per unit per day during hospital confinement Private-duty Nurse: Pays $100 per unit per day during hospital confinement. Ambulance: Pays $100 per unit per continuous confinement for service This benefit is paid in addition to the outpatient surgery benefit

8 CancerSelect PlusSM Benefit Modules
Hospital Benefits (Module #1) 1 to 5 units continued Extended Care Facility: Pays $100 per unit per day, up to the number of days of the hospital stay when admitted to the extended care facility within 14 days of hospital discharge Government or Charity Hospital: Pays $100 per unit per day —in lieu of all other benefits—for hospital treatment where the insured is not required to pay for most services. Hospice Care: Pays $100 per unit per day when confined in a hospice center or for hospice care at home by a hospice team

9 CancerSelect PlusSM Benefit Modules
Surgery Benefits (Module #2) 1 to 5 units Surgery: Pays up to $1,000 per unit for in-hospital surgery as scheduled in the certificate Anesthesia: Pays 25% of Surgery Benefit per unit as scheduled in the certificate Prosthesis: Pays actual charges* not to exceed $500 per unit for a prosthetic device and its implementation Hair Prosthesis: Pays actual expenses* of up to $50 per unit for wig or hair piece Reconstructive Surgery: Pays up to $250 per unit for reconstructive surgery within two years after cancer removal 2nd Surgical Opinion: Pays $100 per unit for a second opinion

10 CancerSelect PlusSM Benefit Modules
Surgery Benefits (Module #2) 1 to 5 units continued Ambulatory Surgical Center: Pays up to $150 per unit per day for surgery performed at an ambulatory surgical center or hospital as an outpatient. This benefit is paid in addition to the outpatient surgery benefit Outpatient Surgery: Pays up to $1,500 per unit for outpatient surgery as scheduled in the certificate Skin Cancer: Pays $75 per unit per diagnosis for one removal of skin cancer; $35 per unit for each additional removal

11 CancerSelect PlusSM Benefit Modules
Radiation/Chemotherapy Benefits (Module #3) 1 to 4 units Radiation and Chemotherapy: Pays actual charges* not to exceed $5,000 per unit for radiation and chemotherapy treatments per 12 month period Associated Radiation and Chemotherapy Expenses: Pays $250 per unit per 12 month period for treatment consultation and planning, radiation management, physical exams, checkups, laboratory or diagnostic tests when authorized by a radiologist, chemotherapist, or oncologist Blood, Plasma, Platelets, Bone Marrow and Stem Cell Transplant: Pays actual charges* not to exceed $5,000 per unit per 12 month period for bone marrow and stem cell transplants, blood, plasma, and blood components

12 CancerSelect PlusSM Benefit Modules
Radiation/Chemotherapy Benefits (Module #3) 1 to 4 units continued Associated Blood, Plasma, and Platelets Expenses: Pays $250 per unit per 12 month period for treatment consultation and planning, administration of blood plasma and blood components; transfusions, processing and procurement, cross-matching, physical exams, checkups, and laboratory or diagnostic tests and authorized by the covered person’s physician New or Experimental Treatment: Pays actual charges* not to exceed $5,000 per unit for experimental or investigational treatment

13 CancerSelect PlusSM Benefit Modules
Wellness and Miscellaneous Benefits (Module #4) 1 to 3 units Wellness Benefit: Pays $50 per unit per calendar year for covered cancer screening tests Magnetic Resolution Imaging (MRI) Scans: In addition to Wellness Benefit, pays $50 per unit per calendar year for an MRI Scan when used as a diagnostic tool for breast cancer Non-Local Transportation: When prescribed treatment is not available locally and non-local hospital confinement is required, we will pay either the actual round-trip charges by a common carrier or a private vehicle allowance of $.40 per mile for covered person and an adult, immediate family member Family Member Lodging: When non-local hospital confinement is required, we will pay lodging expenses for an adult member of the insured’s immediate family of $50 per unit per day Outpatient Lodging: Pays $50 per unit per day for a maximum of 50 days per 12 month period at a motel, hotel or other accommodations, provided treatment is authorized by the attending physician and cannot be obtained locally

14 CancerSelect PlusSM Benefit Modules
Wellness and Miscellaneous Benefits (Module #4) 1 to 3 units continued Physical Therapy and Speech Therapy: Pays $25 per treatment (limited to one session per day) At Home Nursing: Pays $50 per unit per day, up to the number of days of the prior hospital confinement when admitted within 14 days of hospital discharge Waiver of Premium: We will waive each premium due during a period of total disability after 60 consecutive days of the insured employee’s total disability due to cancer

15 CancerSelect PlusSM Benefit Modules
Cancer Maintenance Therapy Benefits (Module #5) 1 to 5 units Pays actual charges* not to exceed $1,000 per unit per 12 month period for any combination of the below listed drug-related expenses: Cancer Suppressive Therapy: Benefits for treatment to keep cancer in check or after acute chemotherapy treatment Hematological Drugs: Benefits for drugs aimed to boost cell lines such as white blood cell counts, red blood cell counts, and platelets Anti-Nausea Drugs: Benefits for drugs used to reduce the symptoms brought about as a result of chemotherapy or radiation Motility Agents: Benefits for drugs used to improve motility or treat side effects caused by chemotherapy or radiation

16 CancerSelect PlusSM Employer Options
First Occurrence Rider (1 to 10 units) Provides a lump-sum benefit of $1,000 per unit when cancer is first positively diagnosed (not skin cancer) Specified Illness and Disease Rider (1 to 5 units) Pays Daily Hospital confinement of $100 per unit for up to 90 days and provides 12 specific additional per unit benefits for losses that are the direct result of 45 covered diseases Intensive Care Rider (1 to 10 units) Daily Benefit: Pays $100 per unit for each day of confinement in an intensive care unit Step-Down Unit: Pays one-half the Daily Benefit for progressive care, sub-acute care, and intermediate care in a step-down unit for any covered accident or sickness Ambulance: Pays actual charges by a licensed professional ambulance service, not to exceed $200 per unit per period of intensive care confinement

17 CancerSelect PlusSM Issue Ages* Tiers of Coverage Employee Only
Employee: 18 and up Spouse: 18 and up Dependent Children: Birth through 25 *18 through 64 in California. Tiers of Coverage Employee Only Employee + Child(ren) Employee + Spouse/Family

18 CancerSelect PlusSM Sample Plan Designs
CancerSelect Plus Benefits Plan 1 Plan 2 Daily Hospital $100 $200 Surgery $2000 $3000 Radiation/Chemotherapy* $5,000 $20,000 Wellness Cancer Maintenance Therapy $2,000 First Occurrence Rider N/A $1,000 Monthly Premium Employee Employee + Child(ren) Employee, Spouse, and Child(ren) $13.74 $16.17 $25.65 $18.55 $21.46 $34.20

19 CancerSelect PlusSM Underwriting Guidelines Guarantee Issue
Eligible Employees Participation Target (full comp) Participation Minimum (reduced comp) < 50 10 Apps NA 50 – 99 20% 15% 100 – 499 500 – 999 10%

20 Contact Home Office for groups with more than 5,000 lives
CancerSelect PlusSM Eligible Employees Underwriting Guidelines Simplified Issue Eligible Employees Minimum Participation < 50 2 Apps 50 – 99 100 – 499 5 Apps 500 – 999 Contact Home Office for groups with more than 5,000 lives

21 CancerSelect PlusSM Why Sell CancerSelect Plus? Guaranteed Issue
Multi-Plan Options Available Within Groups Availability Down To 100 lives Fully Portable 3 Year Rate Guarantee Available Group Chassis for easy multi-state enrollments LIVESTRONG affiliation offers stronger participation, comprehensive wellness benefits and valuable educational resources Wellness up to $150 Radiation/Chemotherapy up to $20,000 Non age/tobacco rates First Occurrence Benefit up to $10,000 No Waiting Period Multi-Plan Options Available

22 CancerSelect PlusSM Contact a Regional Vice President or
a Client Relationship Manager at 866-TRANSAMERICA or Visit our Transamerica Employee Benefits website

23 CancerSelect PlusSM This is a brief summary of CancerSelect PlusSM Group Voluntary Cancer Insurance. Some of the features highlighted are subject to certain limitations and exclusions. Please refer to your policy and/or sales literature for costs and further details, including specific limitations and exclusions. Availability of benefits varies by jurisdiction. Refer to the contract for complete information.


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