State Bar of Wisconsin Critical Illness

You can be financially prepared to tackle a life-changing illness.
Coverage is issued by The Prudential Insurance Company of America.

Flexible Coverage Amounts

State Bar of Wisconsin members who are 64 years old or younger may apply for up to $100,000 of coverage, in $10,000 increments, allowing you to select the right level of insurance protection for yourself. You can keep your coverage even if you change jobs, as long as you remain a member of the State Bar of Wisconsin. You can enroll your dependents only if you’re enrolled.

Spouse/Domestic Partner, through age 64, may elect up to $50,000, in increments of $5,000, but cannot exceed 50% of the member amount.* Children, through age 26, $5,000 increments, but not more than the lesser of $15,000 or 50% of the member amount.

In order to be eligible for Critical Illness Insurance, prospective participants must be enrolled in a Major Medical Plan to ensure that they do not misinterpret the policy as a Medical Plan.*Subject to state of residence.

Even with health insurance, out-of-pocket medical and non-medical expenses such as deductibles or co-pays can really cause financial strain. With Critical Illness, there is no limitation in how you use your benefit payments. The money can be used for anything from home care and treatment, recuperation aid, mortgage payments or rent, child care, over-the-counter medications, groceries, college tuition, or travel to a treatment center.

Benefits are payable directly to you, as per the terms of the policy.

A reoccurence benefit is a part of our standard offering and allows an insured to receive additional benefits for the second diagnosis of a previously covered condition, up to a maximum benefit amount.

The amount payable for a Reoccurrence of a Critical Illness or Procedure is 50% of the amount paid to the person for the First Occurrence of the Critical Illness or Procedure. All benefits are subject to the Lifetime Maximum Benefit below.

Reoccurrence of a Critical Illness or Procedure means:

(1) A person is positively diagnosed by a Doctor as having an additional occurrence or reoccurrence of a Critical Illness or Procedure for which a benefit was paid under this Coverage; and

(2) The date of the diagnosis of the additional occurrence or reoccurrence is more than 180 days after the date of such prior benefit payment.

Lifetime Maximum Benefit: No more than the Lifetime Maximum Benefit will be paid for all of a Covered Person’s Critical Illnesses or Procedures. The Lifetime Maximum Benefit for a Covered Person is 200% of the person’s Amount of Insurance.

The coverage is designed to mitigate financial struggles when unexpectedly diagnosed with the following life-threatening conditions. All are subject to Lifetime Maximum Benefit of $200. The amount of insurance for skin cancer is $0.

100% of the Amount of Insurance payable for:

  • Alzheimer’s Disease
  • Heart Attack
  • Invasive Cancer
  • Major Organ Transplant
  • Renal (Kidney) Failure
  • Stroke

25% of the Amount of Insurance payable for:

  • Severe Coronary Artery Disease or Severe Heart Valve Malfunction
  • Coma
  • Cancer in Situ (partial)
  • Parkinson’s Disease

Additional Benefits

National Cancer Institute (NCI) Evaluation

$500 when a covered person seeks evaluation or consultation at an NCI- sponsored cancer center for cancer diagnosis.

$250 for the transportation and lodging of the covered person who is receiving the evaluation/consultation. The cancer center must be more than 100 miles from the covered person’s residence.

Payable once per covered person’s lifetime.

Transportation Benefit

Benefit for transportation expenses for the roundtrip travel between the hospital or medical facility and the residence of the covered person for treatment of Covered Illness:

  • $0.50/mile for noncommercial travel; actual charges for commercial travel
  • Limited to $1,500 per round trip
  • Payable once per calendar year per covered person receiving treatment
  • Excludes hospitals or medical facilities within a 100 mile radius from the covered person’s primary residence.

Lodging Benefit

Benefit for lodging in connection with the treatment of Critical Illness:

  • $60 per day
  • Limited to 60 days per calendar year per covered person receiving treatment
  • Excludes hospitals or medical facilities within a 100 mile radius from the covered person’s primary residence
  • Not payable for lodging occurring more than 24 hours prior to treatment for lodging occurring more than 24 hours following treatment

A lump sum is paid to the policyholder if he or she is diagnosed with a specific illness stated on The Prudential Insurance Company of America’s predetermined list.

Guaranteed Issue Limit on the Amount of Member Insurance

There is a limit on the amount for which you may be insured without submitting evidence of insurability. This is called Guaranteed Issue Limit. Your Guaranteed Issue Limit is $20,000. The Guaranteed Issue Limit for Dependent Spouse, Civil Union Partner, or Domestic Partner Amounts is $10,000.

This coverage is not health insurance coverage (often referred to as “Major Medical Coverage”).

This type of plan is NOT considered “minimum essential coverage” under the Affordable Care Act and therefore does NOT satisfy the individual mandate that you have health insurance coverage.

Group Critical Illness Insurance coverage is a limited benefit policy issued by The Prudential Insurance Company of America, a Prudential Financial company, Newark, NJ. Prudential’s Critical Illness Insurance is not a substitute for medical coverage that provides benefits for medical treatment, including hospital, surgical, and medical expenses, and it does not provide reimbursement for such expenses. The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The Prudential Insurance Company of America, the Group Contract will govern. A more detailed description of the benefits, limitations, and exclusions applicable are contained in the Outline of Coverage provided at time of enrollment. Please contact Prudential for more information. Contract provisions may vary by state. Contract Series: 114774.

© 2020 Prudential Financial, Inc. and its related entities

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March 4th, 2020 by Bultman Financial Services