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In an increasingly competitive labor market, employers are reevaluating their benefits plans through the lens of attracting and retaining talent and keeping employees healthy and productive.
With Sun Life Supplemental Health plans, you can help your health plan work better
- Employers have the flexibility to expand how they meet their employee population healthcare access needs
- Employees can increase their financial ability to pay out-of-pocket medical and non-medical expenses (see below scenarios)
Together, Sun Life's Accident, Critical Illness, Hospital Indemnity, and Cancer Insurance plans offer a holistic suite of coverages. Select all four plans or combine those most relevant to your workforce.
FAST FACTS
- The average family deductible amount for U.S. employees in employer-based health insurance was $3,811 in 2022. (KFF)
- Excluding retirement savings, the median savings of Americans under 35 is just $3,240. (MarketWatch)
- 22% of U.S. adults have no emergency savings. (Bankrate)
- 100 million Americans have healthcare debt. (KFF)
- One-third of childhood injuries occur in sports. (Yale Medicine)
Gain insight from one family’s journey as Hospital Indemnity insurance helped during a time of immense hardship.
SCENARIOS: Sun Life Supplemental Health benefit payments help employees meet out-of-pocket expenses.
Sample workplace medical plan
Deductible: $2,000 for family plan | Co-pay: $25 primary care; $40 specialty; $250 emergency room | Out-of-pocket maximum: $5,000
Scenario: A child with a sports injury resulting in a torn ACL and dislocated knee.
The Sun Life Accident Plan may pay:
- $200 Urgent Care
- $200 Imaging (MRI)
- $750 Outpatient surgery (arthroscopy with ACL reconstruction)
- $600 Specialty care (6 visits)
- $35 Generic medications
- $400 Durable medical equipment
- $500 Physical therapy (10 visits)
Totaling $2,685 in addition to medical plan coverage.
Scenario: Routine childbirth
The Sun Life Hospital Indemnity plan may pay:
- High plan: $2,000 admission benefit plus $400 for a 2-night stay.
- Low plan: $1,000 admission benefit plus $200 for a 2-night stay.
- If the Newborn Nursery Benefit option is selected, additional benefits are paid.
Totaling up to $2,400 in addition to medical plan coverage.
Scenario: A cancer diagnosis
The Sun Life Critical Illness plan may pay a benefit of $10,000 to $40,000 to help pay medical or other expenses including travel to appointments.
The Sun Life Cancer plan may pay benefits for covered treatments, like chemotherapy, radiation, and surgery.
Members can use their Supplemental Health benefits however they want:
- To pay out-of-pocket medical expenses not covered by health insurance, including deductible, co-pay and co-insurance amounts
- To pay non-medical expenses associated with their injury or illness, like travel costs to medical appointments, or additional childcare expenses
- Other ways, like a family trip that they don’t want to delay any longer
Hypothetical examples are provided for illustrative use only. Payments are provided for covered conditions and vary by plan.
RESEARCH: Read the top reasons for medical-related claims across Sun Life’s health-aligned portfolio. These same reasons may pay Supplemental Health benefits that complement your medical plans and wellness initiatives. Except where noted, all data reflects 2022 Sun Life claims.
WELLNESS: Sun Life plans offer Wellness Benefits that encourage preventive health, early identification and diagnosis of medical conditions.
- Payments may be paid once annually when a member submits a claim for a covered wellness screening, and may be payable even for Dental and Vision exams.
- Payments are available per covered member; a family of four could submit a claim for each person, helping pay their premium or expenses.
- Read the most common health screenings that pay a wellness benefit
EASY CLAIMS SUBMISSION: Talk with us about easy claims submissions online for members, medical file feed, Wellness Benefit bulk submissions, and our automated outreach.
Online claims management for employees
Employers can enable automated payments with medical file feeds
Bulk wellness submissions
Integrated benefits platform checks for other eligible benefits
EDUCATION AND ENROLLMENT: We make employee education and enrollment easy with Benefits Explorer, our streamlined digital experience customized to your employee population. Set-up is a snap and implemented by our experts. Live benefits counselors can provide support to complement the intuitive, easy-to-understand and engaging online experience. You can also use your own HCM/benefits platforms.
According to LIMRA BEAT Study, 2023, employees who understand their benefits well are the most confident in their decisions.
Help your health plan work better – a focus on Critical Illness
In addition to important financial benefits, our Critical Illness insurance helps expand access to care, reduce costs, and improve outcomes.
Members who receive benefits for cancer have access to AbleTo virtual behavioral health therapy and coaching, especially helpful during a time when access to mental healthcare is challenging.
With Health Care Support Services1, members can talk with registered nurses, claims and benefits advocacy specialists for explanations of diagnoses and benefits, claims, and benefits choices.
Sun Life Stop-Loss clients who offer Critical Illness to employees, automatically receive an increased Stop-Loss reimbursement when there is a Stop-Loss claim for cancer—regardless of whether the member elected coverage.
Overcoming financial barriers to healthcare access
by Bryan Burke, AVP, Product Development, Sun Life
We know that lack of healthcare access is a challenge for many Americans. While there are many reasons for this, the primary barriers and drivers of delays in care continues to be cost and affordability. Health plans are the primary financial tool in affording care. Without health insurance, common surgeries and/or periods of confinement in a hospital can cost patients tens to hundreds of thousands of dollars. Yet even those who are covered by health insurance worry about affording care. According to the Kaiser Family Foundation, half of insured adults under the age of 65 say they have postponed getting health care they need due to cost, and more than a third with insurance do not get provider recommended tests or treatment due to cost. Read the full blog here
The AbleTo virtual behavioral health program is available to eligible members receiving short-term disability benefit payments for cancer (provided their employer also has Sun Life LTD) or receiving critical illness cancer benefit. Not available with stand-alone critical illness policies issued in New York. Sun Life is not responsible or liable for the care, services, or advice provided by AbleTo, and reserves the right to discontinue this service at any time.
1. Value-added services are not insurance, are offered only on specific lines of coverage and carry a separate charge, which is added to the cost of the insurance. The cost is included in the total amount billed. HealthChampionSM (a health care support service) is not insurance and is provided by ComPsych®. ComPsych® is a registered trademark of ComPsych Corporation. Healthcare Support Services is not available for policies issued in New York. The entities that provide the value-added services are not subcontractors of Sun Life and Sun Life is not responsible or liable for the care, services, or advice provided by them. Sun Life reserves the right to discontinue any of the Services at any time. Employers who provide group insurance coverage and make available value-added services within an I.R.C. Section 125 cafeteria plan should consult a tax professional to determine whether those services are Qualified Benefits for Section 125 plans.
The Wellness Benefit as applicable to certain coverages provides one Wellness Benefit per calendar year per covered person from the list of covered benefits. See policy for details of covered items and services. Only tests and procedures listed in the policy are eligible for benefit payment. Some policies do not contain the Wellness Benefit.
These coverages do not constitute comprehensive health insurance (often referred to as “major medical coverage”) and do not satisfy the requirement for Minimum Essential Coverage under the Affordable Care Act.
The Supplemental Health Insurance plans described above are limited benefit policies. They do NOT provide basic hospital, basic medical, or major medical insurance. The certificates may have exclusions, limitations, and benefit waiting periods for certain conditions, all of which may affect any benefits payable. Benefits payable are subject to all terms and conditions of the certificates. For more information, please refer to the certificate. The policies, certificates and riders, if applicable, may not be available in all states and may vary based on state laws and regulations.
In New York, to be eligible for Hospital Indemnity insurance or Specified Disease coverage, the Insured must also be covered under major medical, or at least basic hospital and basic medical insurance. The expected benefit ratio for the Specified Disease policy is 70%. The expected benefit ratio for the accident policy is 65%. This ratio is the portion of future premiums which the Company expects to return as benefits, when averaged over all people with the policy.
Group Supplemental Health Insurance products are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) (SLOC)) in all states, except New York, under Policy Form Series 12-GP-01, 15-GP-01, 12-AC-C-01, 16-AC-C-01, 15-GP-01, 13-SD-C-01, 16-SD-C-01, 16-CAN-C-01, 20-HI-C-01. In New York, group insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Lansing, MI) under Policy Form Series 12-GP-01, 15-GP-01, 15-SD-GP-01, 12-GP-SD-01, 13-SD-C-01, 12-AC-C-01, 20-HI-C-01, 12-GPPort-P-01, 20-HIPORT-C-01. Product offerings may not be available in all states and may vary depending on state laws and regulations. All products, brands, and names are the property of their respective owners.
This advertisement is not approved in these states: AZ, GA, OR, WA, WY
Supplemental Health products are not available in NM
Value-added services are not available in NY
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