Open Enrollment 2022 - Shawnee State University
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Open Enrollment 2022
Voluntary Benefits
Voluntary Benefits by ManhattanLifeTM
2
Accident
3
Accident Who is Eligible?
• Employees Ages 18 – 70
• Spouses Ages 18 – 70
• Children 0 – 25 (covered until age 26)
ü Employee - 20 Hours Per Week
ü SP and CH Coverage Requires EE Participation
4
Accident Base Benefits
Level 2
Accident Medical Expense $1,000
Bone Fracture and Dislocation* $1,500
Ground Ambulance $150
Air Ambulance $300
First Hospitalization $500
Hospital Indemnity** $150 per day
AD&D – Loss of Life* $50,000
Common Carrier $100,000
*Payable according to schedule in policy. 5
**Payable for a maximum of 30 daysAccident Bone Fracture and Dislocation Benefit
Bone Fracture and Dislocation Benefit – Pays a benefit when a covered person suffers one of the fractures or dislocations listed.
Fractures Dislocations
Hip bone 100% Hip 100%
Vertebra 75% Knee 50%
Skull (depressed) 65% Foot 35%
Leg 50% Ankle, shoulder 35%
Foot, ankle, kneecap, hand, wrist, forearm 40% Hand 20%
Lower jaw, shoulder blade, collar bone 35% Lower jaw 20%
Upper arm, upper jaw, skull (simple) 25% Wrist, elbow 20%
Facial bones 20% Finger, toe 6%
Finger, toe, rib, coccyx 6%
If two or more fractures or dislocations are suffered, we will pay 150% of the highest benefit.
6Accident How it Works
Example #1 - Laceration – 1.5”
• Cause – Cooking/Carving Accident
• Actual Charges up to $2,000 Benefit (level 3)
• Urgent Care Visit, Doctor with Stitches) $375.00
Claim Paid $375.00
Example #2 – Compression Fracture - Vertebrae
• Cause – Child Tree Climbing
• Actual Charges up to $2,000 Benefit $2,000.00
(ER Visit, X-Rays, Doctor)
• Hospital Admission + 3 Days Hospitalization $1,900.00
• Fracture/Dislocation Benefit $2,250.00
• Ambulance $300.00
Claim Paid $6,450.00
7Accident Consideration Points
• No limit to the number of accidents
• Pays based on the bill, not a scheduled benefit
payout
• Designed to address the most common accident-
related claims
• Always Guarantee Issue
8Critical
Illness
9Critical Illness What is Covered?
• Critical Illness plans can be customized to meet your family’s needs.
- Critical Illness and Cancer (Vascular, Cancer, and Other Critical Illnesses coverage)
• Benefit amount may be used at the insured’s discretion.
• Employee – Guarantee Issue Coverage $5,000 to $30,000 (INCREASE FOR 2022).
• Spouse – 50% of EE amount up to $15,000 / Children - $5,000
• Pays one lump sum benefit to the insured for each covered category:
Vascular Critical Illness Cancer
Pays 100% of benefit amount for covered and • Transplant, other than heart • Pays 100% of benefit amount at initial
confirmed critical illnesses • Severe burns diagnosis of internal cancer or malignant
• Stroke • End stage renal failure melanoma
• Heart attack • Coma • Pays 25% of benefit amount at initial
• Transplant as a result of heart failure • Loss of sight, speech or hearing diagnosis of carcinoma in situ
• Bypass surgery as a result of coronary artery • Occupational HIV
disease (pays 25% of benefit amount selected) • Permanent paralysis due to an accident
*Recurrence pays an additional benefit for same condition if insured has been treatment free for 12 months.
10Critical Illness Benefit Recurrence
• Provides an additional benefit payable for
the same condition if the Insured has been
treatment free for 12 months – 100%
• Benefit reloads once per Insured
• Dependent can use benefit if Employee has
exhausted his or her benefit
11Critical Illness Health Screening Benefit
• Pays an annual benefit for one of 18 different
health screening procedures per calendar
year per covered person
• $100 benefit
• Coverage is the same for all Insureds
• No waiting period
12Critical Illness Health Screening Benefit – Covered Screens
• Bone Marrow Testing • CA-15-3 (blood test for Breast Cancer)
• CA-125 (Blood test for Ovarian Cancer) • CEA (blood test for Colon Cancer)
• Chest x-ray • Colonoscopy
• Flexible Sigmoidoscopy • Hemocult stool analysis
• Mammography (including breast ultrasound) • Pap Smear (including Thin Prep Pap Test)
• PSA (blood test for Prostate Cancer) • Serum Protein Electrophoresis (test for myeloma)
• Biopsy for Skin Cancer • Stress test (bike or treadmill)
• Electrocardiogram (EKG) including stress • Lipid Panel (total cholesterol count)
EKG
• Oral Cancer Screen using ViziLite, OraTest or other
• Blood test for Triglycerides Current Dental Terminology© Code D0431
13Critical Illness How it Works
• The Torres family has a high deductible medical plan with a
$5,000 annual deductible
• They have a Critical Illness plan with a $15,000* benefit.
• Miguel Torres went for a jog and experienced chest pain – he
was having a heart attack
• After multiple tests at the ER, it was discovered that he also
had renal carcinoma in situ
• Here is how the ManhattanLife Critical Illness plan helped
Miguel and his family:
$15,000 + $3,750 = $18,750
100% benefit 25% benefit Payments received from
coverage for coverage for their Critical Illness plan to
heart attack carcinoma in situ help with their $5,000
health plan deductible and
other family expenses due
to his illness.
*Spouse benefit is $7,500 and child benefit is $5,000. Information displayed is for illustrative purposes only.
14Critical Illness Who is Eligible?
• Employees Ages 18 – 69
• Spouses Ages 18 – 69
• Children 0 days – 25 (covered until age 26)
ü Employee - 20 Hours Per Week
ü SP and CH Coverage Requires EE Participation
Additional Information
ü 12/12 Pre-existing Condition Limitation
ü Ported coverage terminates at age 70
15Critical Illness Consideration Points
ü Puts you in control of your treatment path!
ü Three benefit “buckets” from which to claim
ü No waiting period between multiple diagnosis
ü Benefit Recurrence - PAYS 100%
ü Health Screening Benefit pays $100 for up to 18
screens (one per year per covered family member)
16Whole Life
17Whole Life What is Covered?
Whole Life offers employees the opportunity to purchase
up to $75,000 of long-term protection on a Guarantee
Issue basis.
ü Spouse coverage available up to $25,000/CGI.
ü Child coverage available up to $10,000.
• All product elements are guaranteed
ü Guaranteed death benefit.
ü Guaranteed cash value with no surrender
charge.
• Individually owned and fully portable policy.
• Loans available against cash value.
• Accelerated benefit for terminal illness.
• Built-in facility care acceleration benefit.
18Whole Life Employee Policy
Individual Whole Life Policy
• Life Paid Up at Age 99
• Issue Ages: 18-70
Issue Amounts
• Guarantee Issue - $75,000
• Minimum - $2,500
• Maximum - $300,000
19Whole Life Spouse & Children Stand Alone Coverage
Spouse Stand Alone Policy
• Issue Ages: 18-70
• Issue Amounts: $5,000 - $50,000
• Unisex/Uni-tobacco rates
• Conditional Guarantee Issue - $25,000
Child Stand Alone Policy
• Issue Ages: 14 days to 25 years
• Paid Up @ 65
• Issue Amounts: $5,000 - $25,000
• Unisex/Uni-tobacco rates
• Conditional Guarantee Issue - $10,000
20Whole Life Embedded Benefits
Accelerated Benefit for Terminal Illness
• On primary insured, an acceleration of up to 50% of the face
amount of the base policy or $100,000 whichever is less.
• Physician certification of less than 12 months life expectancy
• Limit of one per lifetime, once paid, the death benefit is
reduced by the amount paid for the Terminal Illness Benefit.
Facility Care Acceleration Benefit
• Accelerated insured death benefit to pay for nursing home,
assisted living, and (in some states) adult day care.
• Covers a percentage per month up to 36% of the policy
face amount.
• Can be taken on a monthly basis or in one lump up to a
maximum of $72,000, depending on the amount of
coverage selected.
21Whole Life Facility Care Acceleration Benefit
• Provides a monthly benefit amount of the lesser of 2% of
the Face Amount or $4,000 for Nursing Home or Assisted
Living Facility Care
• The Lifetime Maximum benefit amount is equal to the least
of:
36% of the Face Amount,
$72,000; or
The Face Amount less your Policy’s cash value
• Insured has an option for a ONE-TIME lump sum payment.
• Requires Insured’s continuous confinement in an
Appropriate Facility Care Center for Appropriate Facility
Care, and the Insured is expected to remain there for the
rest of his or her life.
22Whole Life Optional Riders
Accidental Death & Dismemberment
• Available on Employee and Spouse policies
through Age 60
• Coverage is equal to policy death benefits to
a maximum of $100,000
• Additional benefits for seat belt, coma,
occupational assault and paralysis
23Whole Life Consideration Points
• Policy values are guaranteed
• Post retirement life insurance solution
• No surrender charges
• Insured may borrow against the policy
• Embedded terminal illness and Facility Care
Benefits
24Online / Call Center Enrollment
Open Enrollment Information (October 25th - November 5th)
Enroll Online: https://enrollonline.manhattanlife.com/shawneestateuniversity
Your pin is the last 4 digits of your social security number and last 2 digits of your birth year. For example, if the last 4 digits
of your SSN are 3214 and you were born on September 21, 1968, your Pin would be “321468“.
Please make sure to complete your enrollment by electing or waiving coverage. You will receive a completed message at
the end of enrollment. Please do not leave your enrollment incomplete.
If you have any questions or would like to review your options with a benefits counselor, please contact Enrollment Benefit
Concepts at (937) 401-3739.
Enroll by phone: (937) 401-3739
8:30 AM – 5:00 PM EST Monday - Friday
25Questions?
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