Specified Disease insurance (New York)

SLPC 26461 04/15 (exp. 04/17)

No one wants to think about what can go wrong. While more people than ever are surviving specified diseases like heart disease, stroke, and cancer, such medical setbacks can affect a person's financial health.

Sun Life's Specified Disease insurance gives employees the coverage they need if they become sick so they can protect themselves from financial losses caused by out-of-pocket costs.

How does it work?

Our plan pays a lump-sum cash payment and employees decide how to spend the money. Employees can use this money however they want, including as a payment for:

  • Out-of-pocket medical expenses
  • Alternative therapies
  • Everyday expenses, like groceries, transportation, or child care

Understanding what's covered

We provide a full or partial benefit for a variety of covered conditions:

  • Heart attack (100%)
  • Stroke (100%)
  • End-stage heart failure (100%)
  • Coronary artery disease (25%)
  • Cancer (100%)
  • Non-life threatening cancer (25%)
  • Skin cancer ($250)
  • Major organ transplant (100%)

The maximum benefit payable is once per covered condition, up to 200% for all covered conditions.

For more information, please contact your Sun Life Employee Benefits Representative.

In New York, to be eligible for Specified Disease coverage, the Insured must also be covered under major medical, or at least basic hospital and basic medical insurance. This is a limited benefit policy. This coverage does not constitute comprehensive health insurance (often referred to as “major medical coverage”) and does not satisfy the requirement for Minimum Essential Coverage under the Affordable Care Act. The expected benefit ratio for this policy is 70%. This ratio is the portion of future premiums which the Company expects to return as benefits, when averaged over all people with the policy.

The certificate has exclusions and limitations for certain conditions that may affect any benefits payable. Benefits payable are subject to all terms and conditions of the certificate.

In New York, Specified Disease insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) under Policy Form Series 12-GP-SD-01, 13-SD-C-01, 12-GPPort-01 and 13-SDPort-C-01.