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Critical Illness Insurance

Group Name: BMO Financial Corp.
Group Number: 29316-4

Get benefits for covered illnesses and conditions.

Critical Illness Insurance pays a lump-sum benefit if you are diagnosed with a covered illness or condition that happens on or after your coverage effective date. Critical Illness Insurance is a limited benefit policy. This is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. 


For a complete description of benefits, exclusions and limitations, refer to your certificate of insurance and riders.

Your Critical Illness Insurance includes the following benefits:

Specified Conditions Rider – Specified Condition Diagnosis Benefit and Specified Condition Facility Confinement Benefit

A Specified Condition Diagnosis Benefit is paid for the diagnosis of a covered specified condition on or after your coverage effective date. A Specified Condition Facility Confinement benefit is paid if you are diagnosed with a covered specified condition that results in a confinement to a Hospital*, Rehabilitation Facility or Transitional Care Facility that occurs on or after the coverage effective date regardless of when the Specified Condition is diagnosed. Being admitted to an Observation Unit for 20 hours or more also meets the definition of Confined or Confinement. Benefits are payable up to the Annual and Total Maximums per Covered Person as indicated in your Certificate. The policy, certificate and riders should be reviewed for complete provisions, conditions on benefit determination, exclusions and limitations.


*Hospital means an institution that is run for the care and treatment of sick or injured persons as in-patients and which, on its premises or in facilities available to the Hospital on a pre-arranged basis, fully meets each of the following requirements:
• It is operated in accordance with the laws pertaining to hospitals in the jurisdiction in which it is located;
• It is under the supervision of a medical staff and has one or more Doctors available at all times;
• It provides 24 hours a day service by registered graduate nurses (RNs); and
• It is not an institution, or any part of an institution used as: a hospice unit, including any bed designated as a hospice or a swing bed; a convalescent home; a rest or nursing facility; a free-standing surgical center; an extended-care facility; a skilled nursing facility; or a facility primarily affording custodial, educational care or care for the aged.

Wellness Benefit

This is an annual benefit you and everyone covered on your certificate can earn by completing an eligible health screening test.

Additional services:
Voya Cares®

Voya Cares® is not insurance coverage. It is a service offered through the Voya family of companies.

 
We are committed to being a leader in making a positive difference in the lives of individuals with special needs and disabilities - as well as their families, caregivers and other providers - by offering a depth of resources focused on education, planning and solutions through Voya Cares®.

Certificates
Review this document for a complete overview of benefits

Certificate of Coverage

What is Critical Illness Insurance?

Critical Illness Insurance pays a lump sum benefit if you are diagnosed with a covered illness or condition on or after your coverage effective date. Critical Illness Insurance is a limited benefit policy. This is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.

How can Critical Illness Insurance help?

Below are a few examples of how your Critical Illness Insurance benefit could be used (coverage amounts may vary):

  • Out of pocket medical expenses, such as deductibles and co-pays
  • Child care
  • Mortgage payment/rent and home maintenance
  • Everyday expenses like utilities and groceries

Why should I enroll through my employer?

Premium amounts are deducted from your paycheck, so you don’t have to worry about paying another bill.

Can I purchase coverage for my spouse and child?

Coverage is available for your eligible spouse and your eligible children up to age 26* as defined in the certificate of insurance and riders, if employee coverage is elected.

*Standard ages may vary.

How much does it cost?

The cost of Critical Illness Insurance varies based on your age and the amount of coverage. Please refer to your enrollment materials or contact your employer. 

Do I need to provide health information?

Critical Illness Insurance coverage is available on a guaranteed issue basis. Pre-existing condition limitation may apply. See the Certificate of Insurance and any riders for a complete list of available benefits along with applicable provisions, exclusions and limitations.

This is a summary of benefits only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern. To keep coverage in force, premiums are payable up to the date of coverage termination. Critical Illness Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Policy form #RL-CI4-POL-16; Certificate form #RL-CI4-CERT2-20; and Rider forms: Spouse Critical Illness Rider Form #RL-CI4-SPR2-20; Children's Critical Illness Rider Form #RL-CI4-CHR2-20; Wellness Benefit Rider Form #RL-CI4-WELL2-20; Absence of Employment Rider #RL-AEPW-20; Additional Services Rider #RL-ASPR-20; Continuation of Insurance Rider #RL-CNT2-20; Infectious Condition Additional Benefit Rider Form #RL-CI4-ICBR-22; Specified Conditions Rider Form: RL-CI4-SCR-23; Benefit Enhancement Rider Form: RL-CI4-BER-23.

Benefit Basics video
Real Life Example

Mike hadn’t expected to have a heart attack in his early forties but when he did, he was grateful he had Critical Illness Insurance. While Mike is expected to make a full recovery, his recuperation could have been more challenging had it not been for the benefit paid by his Critical Illness Insurance.

Example out-of-pocket expenses

Medical expenses (Deductible/co-pay) $5,000
Everyday expenses $2,000
Mortgage payments $2,800
Car payment + $800
Total out-of-pocket expenses $10,600

Maximum Critical Illness benefit paid

$20,000
Total benefit paid $20,000

This is shown for illustrative purposes only. Actual results may vary. Average Critical Illness Insurance claim paid from 1/1/2023 – 9/15/2023 was $11,847.06. For a complete description of your available benefits, exclusions and limitations, see your certificate of insurance and any riders.

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