Critical Illness

Here's what you need to know

What it does for you
Why it's important
When you can enroll
Forms & resources

Critical Illness Insurance helps provide financial support if diagnosed with a covered critical illness.

If you’re diagnosed with a critical illness like a heart attack or stroke, your life can change quickly. In addition to the emotional and physical toll, there may be strain on your personal finances. That’s because while a major medical plan may pay for some of the costs associated with treatment, out-of-pocket expenses like co-pays and deductibles can still put a strain on your savings.

However, once you’re enrolled in Critical Illness Insurance, you’ll have extra financial protection if you have a covered critical illness. With this plan, you receive cash benefits paid directly to you (unless otherwise assigned) to use however you choose.

Pays a lump-sum benefit payment to use however you see fit
The payment is made directly to you (unless otherwise assigned)
It can help pay out-of-pocket expenses related to medical care associated with covered illnesses
In addition to medical care, you may use it to pay for things like childcare, lodging, or over-the-counter medication

This payment is in addition to your employer’s medical plan – and in addition to any other type of medical coverage, disability coverage, or other benefits you may be eligible for or collect. However, it is NOT a substitute for these coverages and does not meet minimum essential coverage as defined by federal law.

Dealing with a critical illness can be costly to you in 2 ways:

Medical bills. It’s not unusual for a critical illness to result in out-of-pocket expenses. It starts with the usual, deductibles and copays, but it doesn’t end there. You might decide to go to a doctor or facility that’s “out of network.” You might decide to get a second opinion or type of treatment that isn’t covered at all. When your health is at stake, it's important to feel like you have control and choices.
Lost income. Treatment and focus on recovery may require extra time away from work. That can impact the paycheck your family may rely on to keep everything on track. Or you might discover you have added expenses because you need more help around the house, extra childcare, or additional lodging near treatment. These costs can subtract from your wages or savings.

The advantage of this coverage is simple: you can use your critical illness benefit any way you choose. You can use it to help pay for medical expenses like deductibles and copays, as well as any non-medical expenses. You can also use this money to help pay daily living expenses such as grocery bills, mortgage payments, childcare, and transportation – all of which can be an added worry if you lose income while you’re out of work.

Access to this benefit helps you have more control over your finances and ultimately your health care options, too. Less stress about money and added peace of mind are both great ways to support your recovery.

These are the periods when you are eligible to enroll for Critical Illness Insurance:

Within your new hire enrollment period
If you have a qualifying life event (you get married, have a baby, etc.)
During your employer’s annual enrollment

Check with your employer’s human resources/benefits team for specifics about these timeframes.

Keep in mind: If you enroll during these timeframes, you have what is called "guaranteed issue," which means you may qualify for coverage without answering health questions. You must have coverage in place before a covered critical illness occurs in order to be eligible to collect the benefit when you need it.

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

Accident Insurance - Plan Overview

Who is Aflac?

Aflac

Aflac helps provide financial protection and peace of mind to millions of policyholders in the U.S. and Japan – allowing customers to focus more on recovery, not financial stress. When an insured gets sick or hurt, Aflac pays cash benefits fairly and promptly directly to the insured (unless otherwise assigned).

When is a benefit paid under the plan?

Once your coverage is in effect, you’ll collect benefits for a variety of events related to a covered critical illnesses. These benefits vary by state and may have other limitations and exclusions that may affect what’s payable. Refer to the plan documents for complete details.

Who in my family is eligible for this program?
Members of your family who are considered eligible to enroll for coverage include:
- You – if you are an active employee working 16+ hours per week
- Your spouse – age 18 and older
- Your child(ren) – under age 26
You must be enrolled in coverage for members of your family to also enroll.

How much does coverage cost?

Do I have to answer health questions or take a medical exam?

What if my employment status changes?

Good news! If you leave or retire from your current employer, you can continue your coverage without interruption (subject to applicable law and the plan’s terms and conditions). Although payroll deduction will no longer be available, you can opt for other payment methods such as direct bank account deduction, credit card billing or home billing. Higher rates may apply.

When would my coverage start?

For annual enrollment, coverage is effective on the date shown on the Certificate after the application is received and approved. You must be actively at work on the coverage effective date.

For new hires and qualifying life events, coverage is effective the first of the month following the enrollment form approval date, provided the eligibility requirements are met.

Am I really free to use the payment any way I choose?

Yes, you are! There are no restrictions or requirements about how you can use your critical illness cash benefit. When you’re facing a critical illness, you want to be able to focus your time and energy on treatment and recovery. This plan can help you do just that. You’re free to use your benefit on medical expenses and/or non-medical expenses. Having that kind of flexibility can help you feel more in control over your care and your finances at a very stressful time.

Legal Disclaimers

Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. This is a brief product overview only. Products and benefits vary by state and may not be available in some states. Plan design and optional benefits are selected at the employer level. The plan has limitations and exclusions that may affect benefits payable. Refer to the plan for complete details, limitations, and exclusions.

For groups sitused in California, group coverage is underwritten by Continental American Life Insurance Company. For groups sitused in New York, coverage is underwritten by American Family Life Assurance Company of New York.

Columbia, South Carolina

AGC2300434 EXP 4/24

Mercer's Role & Compensation

Critical Illness | Aflac

Critical Illness Insurance

Helps you alleviate the expenses that comes with a covered critical illness.

Here's what you need to know

How It Works

Doctor's test results indicate a heart attack diagnosis.

Doctor's test results indicate a heart attack diagnosis.

That’s when Critical Illness Insurance comes in.

Frequently Asked Questions

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