Humana Workplace Voluntary Benefits
Humana’s voluntary
benefits include:
• Disability
• Life
• Accident
• Critical illness
• Cancer
• Supplemental health
VOL8040
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Help protect your employees’ savings
Many American workers fail to plan for expenses, such as loss of income and
childcare, not covered by health insurance. In fact, unexpected illnesses and
injuries cause 350,000 personal bankruptcies each year.*
Humana’s voluntary benefits can help protect your employees’ savings if they
can’t work due to an illness or injury. By offering these benefits you can help
your employees be more financially prepared for the unexpected.
How you benefit
Expand your benefit options without breaking the budget – voluntary
benefits are 100 percent employee paid
Opportunity to possibly reduce your payroll tax for each enrolled employee
Minimize disruption to business with custom enrollment options
Provide a range of benefits to help keep employees productive and loyal
How employees benefit
Choose the benefits that match their needs and concerns
Directly receive benefits when they need it most
Don’t have to rely solely on savings or incur additional debt to cover
expenses such as childcare, transportation, and medical bills
Save money on premiums because benefits purchased through the employer
are typically less expensive than purchasing on their own
Pay premiums through payroll deduction, many on a pre-tax basis
Contact your broker for more information about Humana’s workplace
voluntary benefits.
* Council for Disability Awareness
Humana Accident
Accident coverage can protect
your whole family
Nearly 40 percent of self-reported
episodes of injury leading to
hospitalization occurred during
sports or leisure activities, and
44 percent occurred in or around
the home.
- National Center for Health Statistics
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.
A voluntary accident plan offers coverage for accidents, injuries, ambulance
services, and accidental death in addition to your primary medical insurance.
It’s also available to your spouse and children – a plan that can protect your
whole family.
Why do I need accident coverage?
Here are a few facts to consider from the National Center for Health Statistics:
Nearly 40 percent of self-reported episodes of injury leading to
hospitalization occurred during sports or leisure activities, and 44 percent
occurred in or around the home
Where the external cause of nonfatal injuries is specified, falls are the
leading cause of inpatient and outpatient care in emergency rooms,
outpatient clinics and doctors’ offices
Injuries due to motor vehicle traffic accidents, overexertion and strenuous
movements, and striking against or being struck accidentally by objects
also make up a large portion of injuries
What does accident coverage do?
Accident insurance provides you with valuable primary benefits as well as any
optional benefits selected by your employer. Features include:
Accident Medical Expense: pays actual charges, up to the amount
selected, for physician’s treatment or other emergency treatment
Ambulance Benefit: pays actual charges, up to policy amount, for ground
ambulance service and emergency air transportation in 100-mile radius
Hospital Confinement: pays a daily benefit for hospital room charge for a
maximum of 30 days, up to the amount selected, when the injury is a
result of a covered accident
Optional riders offered by your employer may include 24-hour coverage,
coverage for spouse and children, and bone fracture and dislocation
Protect your financial security
Payroll deduction makes it easy for you to pay for accident coverage. You’ll
feel good knowing benefits are paid up to the amount selected for each
accident, and is in addition to any other coverage you may have. Coverage
starts at "zero" with each new accident. There’s no calendar-year maximum.
Group Trust product base
Humana Accident
Illinois Lumber & IL
Material
Dealers
Association
Lumbar
& Material
Illinois
This policy offers the flexibility to vary your coverage by selecting one of four benefit levels. There are no annual
maximums. Benefits start all over with each accident, and are paid in addition to any other coverage in place.
Payroll deduction for your premiums makes it easy, too.
Product base
Group Trust
Coverage type
Accident Insurance that provides expense reimbursement for actual charges up to
policy maximum. Covers off-the-job coverage for accidental injuries, hospital care,
and accidental death benefits. There is no coverage for sickness. Coverage is available
to the insured, spouse, and children, and is renewable to age 70.
Level One
Benefit amount
Level Two
Level Three
Level Four
Accident medical expense: Pays the actual expenses up to the
amount selected for diagnosis or treatment by a physician or in
an emergency room. ER subject to a $50 deductible.
$ 500
$ 1,000
$ 1,500
$ 2,000
Ambulance: Pays actual expenses up to the
amount selected if injury requires ground or air
ambulance transportation.
$ 250
$ 500
$ 750
$ 1,000
Hospital indemnity: Pays a benefit equal to the amount
selected if an injury requires inpatient hospital confinement,
including a room charge, that starts within 30 days after the
accident. The benefit is limited to 30 days per accident.
$ 75
$ 150
$ 225
$ 300
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Accidental death, dismemberment and loss of sight (AD&D):
Loss of life
Any combination of two or more hands, feet, or eyes
Loss of single hand, foot or eye
Multiple fingers and/or toes
Single finger or toe
Additional included benefits
5,000
5,000
2,500
500
250
10,000
10,000
5,000
1,000
500
15,000
15,000
7,500
1,500
750
20,000
20,000
10,000
2,000
1,000
Total disability premium waiver: If the insured becomes disabled before age 60
and as the result of injuries suffered in an accident, premiums will be waived after
six months of total and continuous disability.
Fracture and dislocation: Pays a benefit when a covered person suffers one of the
fractures or dislocations listed. The benefit payable will equal the percentage
shown, of the unit selected, for the injury. Pays 150% of the larger loss of two or
more covered losses.
$1,500
Fractures
Hip bone (pelvis) or femur
• Vertebra
• Skull (depressed or ping-pong fracture)
• Leg (tibia or fibula)
• Bones of the foot, ankle, kneecap,
hand, wrist or forearm (radius or ulna)
• Lower jaw, shoulder blade, collar bone
• Upper arm, upper jaw, skull (simple,
non-depressed fracture)
• Facial bones (or nose)
• Finger, toe, rib, coccyx
•
100%
75%
65%
50%
40%
35%
25%
20%
6%
Dislocations
• Hip
• Knee (does not include
dislocation of the patella)
• Foot (does not include
dislocation of the toes),
ankle or shoulder
• Hand (does not include
dislocation of fingers),
lower jaw, wrist or elbow
• Finger, toe
100%
50%
35%
20%
6%
Yes
Portability
Underwritten by Kanawha Insurance Company, a Humana company.
This is not a complete disclosure of plan qualifications and limitations. Please access our website to obtain a completed list for the Workplace Voluntary
Benefit products at Disclosure.Humana.com. Please review this information before applying for coverage. The amount of benefits provided depends on the
plan selected. Premiums will vary according to the selection made.
Policy: 7006 1/04 or 8006 11/04
Underwritten by Kanawha Insurance Company
VOL8040
1-800-327-9728 • HumanaVoluntaryBenefits.com
Group Trust product base
Humana Accident
IL Lumbar & Material
Illinois
Employee issue ages 18-67
Eligibility
Employee Actively at Work Full-time, benefit eligible employees working at least 20
hours per week
Spouse issue ages 18-67; Ineligible if employee is denied.
Child issue ages 0-25; Ineligible if employee is denied.
If applying for the disability rider, the benefit will be reduced to a combined maximum
of 60 percent of income when the applicant is applying for or has another
disability-based benefit benefit in force with Kanawha Insurance Company or another
company. Local, state, or federal disability benefits are considered to be other in force
coverage when determining the maximum issue amount of accident disability benefits
available when applying for the Accident Total Disability rider.
Product restrictions
Underwritten by Kanawha Insurance Company, a Humana company.
This is not a complete disclosure of plan qualifications and limitations. Please access our website to obtain a completed list for the Workplace Voluntary
Benefit products at Disclosure.Humana.com. Please review this information before applying for coverage. The amount of benefits provided depends on the
plan selected. Premiums will vary according to the selection made.
Policy: 7006 1/04 or 8006 11/04
Underwritten by Kanawha Insurance Company
VOL8040
1-800-327-9728 • HumanaVoluntaryBenefits.com
Humana Accident rates
Illinois Lumber & Material
Dealers
IL Lumbar
& Association
Material
1378504-01-002
Illinois
Humana Accident rates
Displaying weekly payroll deductions based on monthly premium calculation including $1,500.00 Bone Fracture and Dislocation.
Level One Benefit
Benefit:
Age
Employee
Employee & Spouse
Employee & Children
Family
18-50
$2.68
$5.35
$6.26
$8.93
51-67
$3.11
$6.21
$6.69
$9.79
.
Level Two Benefit
Benefit:
Age
Employee
Employee & Spouse
Employee & Children
Family
18-50
$3.25
$6.49
$7.61
$10.85
51-67
$3.67
$7.34
$8.04
$11.71
.
Level Three Benefit
Benefit:
Age
Employee
Employee & Spouse
Employee & Children
Family
18-50
$3.72
$7.43
$9.10
$12.81
51-67
$4.15
$8.29
$9.52
$13.67
.
Level Four Benefit
Benefit:
Age
Employee
Employee & Spouse
Employee & Children
Family
18-50
$4.15
$8.29
$10.26
$14.40
51-67
$4.57
$9.14
$10.69
$15.26
.
The proposed rates are for an effective date no later than June 1, 2012.
Policy: 7006 1/04 or 8006 11/04
Underwritten by Kanawha Insurance Company
VOL8040
1-800-327-9728 • HumanaVoluntaryBenefits.com
Humana Critical Illness/Cancer
Critical illness/cancer voluntary
coverages pay benefits however you want
U.S. men have slightly less
than a 1 in 2 risk of developing
cancer; for women, the risk is a
little more than 1 in 3.
- American Cancer Society
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With our critical illness and cancer plans, you’ll receive a benefit after a
serious illness or a condition such as a heart attack, stroke, coronary artery
disease, or cancer is diagnosed. During your recovery, you and your loved
ones can rest a little easier knowing you won’t have to deplete your bank
accounts or take on additional debt to cover day-to-day living expenses.
Why do I need critical illness and cancer coverages?
These plans can assist you with a variety of expenses so you can focus on
getting better. You can spend the benefits however you want, on direct or
indirect costs associated with the illness:
Make your mortgage payments
Hire extra help for around the house, such as in-home caregivers
Help cover medical bills as well as therapy and training
Pay for travel to treatment facilities away from home – and
for family visits
In addition to the physical and emotional effects, people who are diagnosed
with a serious condition may see a costly impact on their expenses. You may
need additional help to absorb the expense of paying for drugs and other
direct and indirect costs associated with these diseases.
Here’s how it works
All benefit payments are made directly to you in most cases, placing you in
control at a time when you may feel that your options are limited. Some or all
of the benefit is available to you after your initial diagnosis, so it’s there when
you need it most. You’ll save on your premiums because coverage through
your employer typically is less expensive than purchasing on your own. And
you can pay premiums through automatic payroll deduction. You can
continue the coverage even if you change employers.
Act now
You’ve probably taken some steps to protect your assets and future financial
stability with a health plan, life insurance, savings, etc. Take an additional step
to round out your coverage and help you and your loved ones in the event of
an unexpected critical illness or cancer.
Humana Critical Illness and Cancer
Illinois Lumber & Material
Dealers
Association
IL Lumbar
& Material
Illinois
Consider coverage that helps protect you, your family, and your assets in the event of a critical illness. It offers
specialized benefits to supplement other health insurance when you and your family may be most vulnerable:
during the working years. Benefit payments can assist in covering a variety of expenses associated with a critical
illness: out-of-pocket medical care costs, home healthcare, travel to and from treatment facilities, rehabilitation,
and other expenses.
Coverage type
Voluntary Critical Illness insurance is a group policy form that includes coverage for
heart/stroke, cancer, and other critical illnesses.
Benefit amount
Benefit amounts are available at various levels. You can choose:
$5,000 to $50,000 for employees
You can also add coverage for your dependents:
Spouse: $2,500 to $25,000. Spouse coverage benefit is equal to exactly half of the
employee’s coverage
Child: $2,500 to $5,000 for each eligible child
Coverage for vascular conditions
Coverage for cancer conditions
30 day waiting period
Coverage for other critical illnesses
Additional included benefits
Percent of benefit amount paid at initial diagnosis:
Heart attack
Transplant as a result of heart failure
Stroke
Coronary artery bypass surgery as a result of coronary
artery disease
100%
100%
100%
25%
Percent of benefit amount paid at initial diagnosis:
First diagnosis of internal cancer or malignant melanoma
Carcinoma in situ
100%
25%
Percent of benefit amount paid at initial diagnosis:
Transplant, other than heart
End-stage renal failure
Loss of sight, speech, or hearing
Coma
Severe burns
Permanent paralysis due to an accident
Occupational HIV
100%
100%
100%
100%
100%
100%
100%
Waiver of premium for disability: This waives an employee’s premium if he or she
becomes totally disabled for at least 180 days after the effective date of coverage. For
employees ages 18-55.
Health screening: Benefit pays per calendar year for covered health screenings.
There are 18 covered tests including mammograms, colonoscopies, and stress
tests.There is a 90-day waiting period.
> Indemnity based and payable once per calendar year per insured
> Employer selects this optional benefit and the benefit amount; Employee may
decline the benefit if he/she chooses
> Coverage is same for all insureds on the certificate
$150
Underwritten by Kanawha Insurance Company, a Humana company.
This is not a complete disclosure of plan qualifications and limitations. Please access our website to obtain a completed list for the Workplace Voluntary
Benefit products at Disclosure.Humana.com. Please review this information before applying for coverage. The amount of benefits provided depends on the
plan selected. Premiums will vary according to the selection made.
Policy: 8011
Underwritten by Kanawha Insurance Company
VOL8040
1-800-327-9728 • HumanaVoluntaryBenefits.com
Humana Critical Illness and Cancer rates
Illinois Lumber & Material
Dealers&Association
IL Lumbar
Material
Illinois
1378504-01-002
Employee rates
Displaying weekly payroll deductions based on monthly premium calculation including $150 Health Screening Benefit.
Age
Employee NTU
Employee TU
$5,000
$10,000
$20,000
$5,000
$10,000
$20,000
18-29
$1.67
$2.16
$3.13
$1.89
$2.60
$4.00
30-39
$2.09
$2.99
$4.79
$2.69
$4.19
$7.19
40-49
$2.70
$4.21
$7.23
$3.84
$6.50
$11.80
50-55
$3.67
$6.15
$11.11
$5.61
$10.03
$18.86
56-59
$3.67
$6.15
$11.11
$5.61
$10.03
$18.86
60-64
$4.44
$7.70
$14.20
$7.05
$12.91
$24.63
65-69
$4.83
$8.48
$15.77
$7.51
$13.83
$26.48
Benefit
a
Spouse rates
Monthly premiums with weekly deductions including $150 Health Screening Benefit.
Age
Spouse NTU
Spouse TU
Benefit
18-29
$2,500
$0.96
$5,000
$1.23
$10,000
$1.76
$2,500
$1.09
$5,000
$1.47
$10,000
$2.24
30-39
$1.19
$1.68
$2.66
$1.52
$2.35
$4.00
40-49
$1.53
$2.36
$4.02
$2.16
$3.62
$6.54
50-55
$2.06
$3.42
$6.14
$3.13
$5.56
$10.41
56-59
$2.06
$3.42
$6.14
$3.13
$5.56
$10.41
60-64
$2.49
$4.27
$7.85
$3.92
$7.15
$13.60
65-69
$2.71
$4.71
$8.73
$4.18
$7.66
$14.61
a
NTU: Non-tobacco user; TU; Tobacco user
Children rates
Displaying weekly payroll deductions based on monthly premium calculation including $150 Health Screening Benefit.
Age
Benefit
0-24
Children
$2,500
$5,000
$0.62
$0.88
a
Policy: 8011
Underwritten by Kanawha Insurance Company
VOL8040
1-800-327-9728 • HumanaVoluntaryBenefits.com
Health screening benefit
We’ve made it easy for you to see what specific tests are included in your health screening
benefit. Below are the covered screens – typically used to detect critical or serious illnesses
or conditions. Please note that this benefit is not a “well care check” and cannot be used for
routine physicals. The benefit only applies to the 18 approved screenings listed.
Health screening benefit
We will pay the amount shown on the Schedule if, during a Calendar Year, a Covered
Person has one or more of the following tests performed more than 90 days after the
Date of Certificate.
❯❯ Bone Marrow Testing
❯❯ PSA (blood test for prostate cancer)
❯❯ CA 15-3 (blood test for breast cancer)
❯❯ Serum Protein Electrophoresis (test for myeloma)
❯❯ CA-125 (blood test for ovarian cancer)
❯❯ Biopsy for Skin Cancer
❯❯ CEA (blood test for colon cancer)
❯❯ Stress test (bike or treadmill)
❯❯ Chest x-ray
❯❯ Electrocardiogram (EKG) (including stress EKG)
❯❯ Colonoscopy
❯❯ Lipid Panel (total cholesterol count)
❯❯ Flexible Sigmoidoscopy
❯❯ Blood Test for Triglycerides
❯❯ Hemocult stool analysis
❯❯ Oral Cancer Screening using ViziLite, OraTest or
other Current Dental Terminology © Code D0431
❯❯ Mammography (including breast ultrasound)
❯❯ Pap Smear (including ThinPrep Pap Test)
Because of the nature of the screenings listed it’s unlikely that your dependent child will
utilize this benefit often, however they are covered should the need arise. Children are
covered until age 24 or as determined by state laws.
GCA08PGHH 0610
Group
Sales Rep
Offer Date
Illinois Lumber & Material Dealers Association
Chris Wiley
Tina Sheedy
Underwriter
03/29/2012
Valid Through 05/29/2012
PLAN PROVISIONS
Policy
Policy Form
Availability
Humana Critical Illness/Cancer
8011
IL Situs
Underwriting
Base Plan
Employee Benefit
Spouse Benefit
Child Benefit
Guarantee Issue
Simplified Issue
Vascular/Other Illness/Cancer
Vascular/Other Illness/Cancer
$10,000
$50,000
Simplified Issue: 50% of employee benefit to a max of $25,000
Simplified Issue: 50% of employee benefit to a max of $5,000
Optional Benefit
Health Screening Benefit
Available $150
Pre-existing Condition Limitation – Unless explicitly indicated in the product contingencies all pre-existing exclusions apply.
Please refer to your policy for specific pre-existing limitations.
Benefit Waiting Period – 30 calendar day waiting period on cancer benefit, 90 calendar day waiting period from the effective
date on the Health Screening Benefit.
Eligibility
Number of Eligible Employees
Participation Requirement
Service Waiting Period
Issue Ages
20 hours per week
5000
5 participants or 15% whichever is greater
Will Match Employer Service Waiting Period
18-69 – Employee, 18-69 – Spouse, 14 days -24 years - Child
PRODUCT QUALIFICATIONS AND CONTINGENCIES
Total amount of Critical Illness in force with all carriers cannot to exceed $100,000. This limit excludes the
Accelerated Living Benefit Rider for Individual or Group Aegis.
Total amount of Critical Illness in force with all Humana cannot to exceed $100,000. This limit excludes the
Accelerated Living Benefit Rider for Individual or Group Aegis.
Total amount of Cancer coverage in force with all carriers cannot exceed $100,000. This limit excludes the
Accelerated Living Benefit Rider for Individual or Group Aegis.
Total amount of Cancer coverage in force with Humana cannot exceed $100,000. This limit excludes the
Accelerated Living Benefit Rider for Individual or Group Aegis.
Group
Sales Rep
Offer Date
Illinois Lumber & Material Dealers Association
Chris Wiley
Tina Sheedy
Underwriter
03/29/2012
Valid Through 05/29/2012
PLAN PROVISIONS
Policy
Policy Form
Availability
Humana Group Accident
7006 1/04
IL Situs
Underwriting
Guarantee Issue
Employee Base Benefit
1 Unit
Optional Riders/Benefits
Fracture & Dislocation Benefits
Spouse & Child Coverage
Available 2 Units
Available
2 Units
3 Units
Benefit Waiting Period – NONE
Eligibility
Number of Eligible Employees
Participation Requirements
Service Waiting Period
Issue Age
20 hours per week
5000
5 Participants
Will Match Employer Service Waiting Period
18-67 – Employee, 18-67 - Spouse
4 Units
Group
Sales Rep
Offer Date
Illinois Lumber & Material Dealers Association
Chris Wiley
Tina Sheedy
Underwriter
03/29/2012
Valid Through 05/29/2012
Producer Agreement
Develops an enrollment plan ensuring all eligible employees are presented plan
benefits;
Assists Employer with questions related to Humana's insurance plan and
administrative practices;
Provides billing instructions to person designated by the Employer as the plan
administrator;
Reviews account periodically for minimum requirements.
This offer is valid contingent on the agent having a valid active license with Humana.
4413 form is not required.
Employer Agreement
Makes available Humana's voluntary insurance plan to all eligible employees;
Agrees to deduct premiums for voluntary insurance plan and remit to Humana in a
timely manner.
Enrollment Conditions
Mandatory enrollment will be a face to face.
It is expected that at least 75% of all eligible employees will be seen.
Only groups that are in the Illinois Lumbar & Material Dealers Association may be
represented under this offering.
There are 140 groups to equal the 5000 eligible members. Monthly tracking report
must be submitted to underwriting as groups enroll.
This offer is available until May 31, 2013 at which time participation and loss ratio
will be reviewed. Participation expected is 15% of total association members for
each product.
PROPOSAL QUALIFICATIONS AND CONTINGENCIES
All eligible employees must be actively at work at the time of enrollment.
All employees are U.S. citizens or resident legal aliens.
This offer excludes temporary or seasonal employees.
Unless otherwise noted, the Service Waiting Period will be waived for the open enrollment.
If more than one Workplace Voluntary Benefit is offered, participation will be set per product.
Humana reserves the right to withdraw or modify this offer upon renewal. Factors such as, but not limited to, experience,
non-adherence to offer terms or plan design, or availability of contract type could make this necessary.
This offer may be renewed annually, at Humana’s discretion, based on Humana’s review of the plan design, persistency
and overall success.
Riders may only be added at issue, not at subsequent renewals.
If the initial participation is achieved, this offer will be in effect for one year from the date of acceptance.
This offer is valid for a period of 60 calendar days. Applications will not be accepted under this offer until written
acceptance of this offer and the Employer Agreement and Participation Request are received in Humana’s New
Business Department.
EMPLOYER
SIGNATURE OF OFFICER AND TITLE
DATE
AGENT OF RECORD
SIGNATURE OF OFFICER AND TITLE
DATE