MetLife’s Critical Illness Insurance pays a lump-sum benefit if you are diagnosed with a covered illness or condition on or after your coverage effective date. Critical Illness Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. *Critical Illness is referred to as Specified Disease in some states.

Associates will be offered a choice of $10,000, $20,000 or $30,000 Guaranteed Issue Coverage. Your Spouse/Domestic Partner and child(ren) will be offered 100% of your associate benefit amount. Benefits are paid directly to the associate based on flat schedule (not reimbursement) and there is no coordination with other insurance coverage. An assignment of benefits to a hospital or healthcare facility will be available when required by applicable law.

22 Additional Covered Conditions

MetLife Critical Illness Insurance will pay 25% of the initial benefit amount for each of the 22 listed conditions until the total benefit amount
is reached. A covered person may only receive one payment for each listed condition in his/her lifetime. The listed conditions are adrenal hypofunction (Addison’s disease); amyotrophic lateral sclerosis (Lou Gehrig’s disease); cerebrospinal meningitis (bacterial); cerebral palsy; cystic fibrosis; diphtheria; encephalitis; Huntington’s disease (Huntington’s chorea); Legionnaire’s disease; malaria; multiple sclerosis (definitive diagnosis); muscular dystrophy; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE); systemic sclerosis (scleroderma); tetanus; and tuberculosis.

Health Screening Benefit

The Health Screening Benefit is not available in all states. See your certificate for any applicable waiting periods. There is a separate mammogram benefit for MT residents and for cases situated in CA and MT.

Benefits for Covered Conditions Initial Benefit Recurrence Benefit
Alzheimer’s 100% of benefit amount not applicable
Coronary Artery Bypass Graft 100% of benefit amount 100% of benefit amount
Full Benefit Cancer 100% of benefit amount 100% of benefit amount
Partial Benefit Cancer 25% of benefit amount 25% of benefit amount
Heart Attack 100% of benefit amount 100% of benefit amount
Kidney Failure 100% of benefit amount not applicable
Major Organ Transplant 100% of benefit amount not applicable
Stroke 100% of benefit amount 100% of benefit amount
22 Listed Conditions 100% of benefit amount not applicable

Effective immediately, MetLife will provide an annual benefit of $50 per calendar year for taking one of the eligible screening/prevention measures. MetLife will pay only one health screening benefit per covered person per calendar year. For a complete list of eligible screening/prevention measures, please refer to the Disclosure Statement/Outline of Coverage.