Specified Disease insurance (New York)

SLPC 26461 01/20 (exp. 01/22)

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

Sun Life's Specified Disease insurance can help employees with serious diagnoses meet out-of-pocket costs.

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 payment for co-pays and deductibles, or everyday expenses like groceries or childcare.

The Specified Disease benefit payable as a lump-sum can range from $5,000 to $50,000 of coverage ($5,000 for children).

We provide a benefit for a variety of covered conditions.

Covered benefits include payments for:

Core conditions – Employer Choice with or without Cancer

The plan pays

Heart Attack

100%

Stroke

100%

Major Organ Failure

100%

End-Stage Kidney Disease

100%

Coronary Artery Disease

25%

Cancer conditions—Employer Choice with or without Core

The plan pays

Invasive Cancer

100%

Non-Invasive Cancer

25%

Skin Cancer

5%

This benefit is easy to offer

  • 100% employee-paid option
  • Policies issued with a minimum of only 5 enrolled employees
  • Benefits payable regardless of other coverages
  • Guaranteed issue is available
  • Full enrollment support available
  • Flexible enrollment options

Insured dependent children are covered for each category/condition applicable to the plan elected. Childhood conditions apply only to dependent children.

Wellness benefit available.

If permitted by the Employer’s employee benefit plan and not prohibited by state law, the term “spouse” in this benefit includes any individual who is either recognized as a spouse, a registered domestic partner, or a partner in a civil union, or otherwise accorded the same rights as a spouse.

Subject to policy terms, portability or continuation may be available when employment terminates. Coverage is subject to state variations. Refer to your certificate for specific conditions.

"Specified Disease" is a limited benefit policy. It does NOT provide basic hospital, basic medical, or major medical insurance 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. This overview is preliminary to the issuance of the policy and certificate. The policy, certificate, and rider, if applicable, may not be available in all states and may vary based on state laws and regulations.

Note to employees covered or considering coverage under Health Savings Accounts (HSAs) established in connection with a High Deductible Health Plan (HDHP): Based on the limited available regulatory guidance, Sun Life believes its “Specified Disease” is appropriate for use with an HSA and may be purchased when the employee and/or his or her family members are covered under an HDHP. However, Sun Life cannot provide legal or tax advice. If there are legal or tax questions, we suggest that you consult your own legal or tax advisor before purchasing this insurance.

In New York, Specified Disease insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Lansing, MI) under Policy Form Series 15-GP-01, 15-SD-GP-01, 12-GP-SD-01, 13-SD-C-01, 12-GPPort-01 and 13-SDPort-C-01.

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