Critical Illness Insurance
A major illness can blindside anyone, even if you have health insurance. Voluntary critical illness insurance from The Standard pays you a lump sum if you or your covered spouse / children are diagnosed with one of 20 major illnesses covered by the policy (or one of 22 covered childhood illnesses). The benefit payment can be used for whatever you need most as you recover—for personal expenses such as medical plan deductibles, coinsurance, groceries, or rent; to replace lost income; or to cover any other financial obligations that may come up. There are no requirements as to what the funds must be spent on.
Eligibility
Full-time (75% FTE or greater) appointed academic and staff employees (including IU residents) actively employed by the university are eligible to enroll in the plan.
Employees can also insure their spouse and dependent children through age 25. IU spouses cannot cover each other and must enroll in employee only coverage.
File a Claim
How to file Health Screening Incentive or Critical Illness Claims
Resources
Customer Service
Coverage Options
Coverage is available for you, your spouse, and your eligible children in the following amounts:
- Employee: $10,000 – $50,000 in increments of $10,000.
- Spouse: $5,000 – $25,000 in increments of $5,000 (cannot exceed 50% of employee benefit).
- Children through age 25: Automatically covered at 50% of employee’s coverage.
Covered Illnesses
Covered Illnesses
Receive 100% of your coverage amount following a diagnosis of:
- Heart Attack
- Stroke
- Cancer
- End-Stage Renal Failure
- Major Organ Failure
- Coma
- Paralysis
- Loss of Sight
- Occupational Hepatitis
- Occupational HIV
- Amyotrophic Lateral Sclerosis (ALS)
- Advanced Alzheimer’s Disease
- Advanced Multiple Sclerosis
- Advanced Parkinson’s Disease
- Benign Brain Tumor
- Bone Marrow Transplant
- Loss of Hearing
- Loss of Speech
- 22 Childhood Diseases (see next)
Receive 25% of your coverage amount following a diagnosis of:
- Severe Coronary Artery Disease with Recommendation of Bypass Surgery
- Carcinoma in Situ
Covered Childhood Illnesses
Your eligible children are covered for the 20 critical illnesses for adults, as well as the following additional childhood illnesses:
- Anal Atresia
- Anencephaly
- Biliary Atresia
- Cerebral Palsy
- Cleft Lip
- Cleft Palate
- Club Foot
- Coarctation of the Aorta
- Cystic Fibrosis
- Diaphragmatic Hernia
- Down's Syndrome
- Gastroschisis
- Hirschsprung's Disease
- Hypoplastic Left Heart Syndrome
- Infantile Hypertrophic Pyloric Stenosis
- Muscular Dystrophy
- Omphalocele
- Patent Ductus Arteriosis
- Spina Bifida
- Custica with Myelomeningocele
- Tetralogy of Fallot
- Transposition of the Great Arteries
Active Work Requirement
If you are incapable of active work because of sickness, injury, or pregnancy on the day before the scheduled effective date of insurance or increase in coverage, the policy will not become effective until the day after you complete 1 (one) full day of active work as an eligible member.
Active at work means performing the material duties of your own occupation. You will also meet the active work requirement if you meet all of the requirements shown below:
- You were absent from work because of a regularly scheduled day off, holiday, or vacation day.
- You were actively at work on your last scheduled workday before the date of your absence.
- You were capable of active work on the day before the scheduled effective day of your insurance.
Reoccurrence Benefit
A one-time reoccurrence benefit is payable if an initial critical illness benefit amount is paid, then the member is re-diagnosed with the same critical illness. However, for this reoccurrence benefit to be paid, you must have been continuously covered since the first diagnosis and payout, and you must experience a six-month treatment-free period while continuously insured.
A "treatment-free period" means you have not:
- Consulted a physician or other licensed medical professional;
- Received medical treatment, services, or advice;
- Undergone diagnostic procedures, including self-administered procedures; or
- Taken prescribed drugs or medications.
Maintenance drug therapy such as immunotherapy that is intended to decrease the risk of your critical illness reoccurring, or having routine follow-ups to verify whether or not the condition has reoccurred does not count as "treatment" for this reoccurrence benefit.
Review the Plan Certificate for full plan provisions.
Health Maintenance Screening
Regular checkups are important for your overall health and well-being. Each calendar year, you and your covered family members can each earn a $100 cash incentive for completing one of 22 eligible wellness screenings.
Eligible Screening Tests
- Abdominal Aortic Aneurysm ultrasound
- Ankle Brachial Index (ABI) screening for peripheral vascular disease
- Biopsies for cancer
- Bone density screening
- Breast ultrasound
- Cancer antigen (CA 125) blood test for ovarian cancer
- Cancer antigen (CA 15-3) for breast cancer
- Carcinoembryonic antigen (CEA) blood test for colon cancer
- Colonoscopy
- Complete Blood Count (CBC)
- Comprehensive Metabolic Panel (CMP)
- COVID-19 testing and antibody testing for COVID-19
- Electrocardiogram (EKG)
- Hemocult stool analysis
- Hemoglobin A1C
- Human Papillomavirus (HPV) vaccination
- Lipid panel
- Mammography
- Mental health Assessment
- Pap smears or thin prep pap test
- Prostate Specific (PSA) test
- Stress test on a bicycle or treadmill
Claim Your Health Screening Incentive
Once the test has been performed, you can receive your incentive by filing a claim with The Standard.
You must submit a separate claim for each covered family member. The incentive is limited to one $100 incentive per covered member per year, and the screening must be completed during the plan year (between January 1 and December 31).
Cost
The premiums for Critical Illness coverage are paid by the employee through after-tax payroll deductions.
Monthly Premium Rates
Monthly Contribution | ||||||
---|---|---|---|---|---|---|
Benefit Amount | Age 18–29 | Age 30–39 | Age 40–49 | Age 50–59 | Age 60–69 | Age 70+ |
Employee Coverage* | ||||||
$10,000 | $2.10 | $3.00 | $5.70 | $11.40 | $20.70 | $52.10 |
$20,000 | $4.20 | $6.00 | $11.40 | $22.80 | $41.40 | $104.20 |
$30,000 | $6.30 | $9.00 | $17.10 | $34.20 | $62.10 | $156.30 |
$40,000 | $8.40 | $12.00 | $22.80 | $45.60 | $82.80 | $208.40 |
$50,000 | $10.50 | $15.00 | $28.50 | $57.00 | $103.50 | $260.50 |
Spouse Coverage** | ||||||
$5,000 | $1.05 | $1.50 | $2.85 | $5.70 | $10.35 | $26.05 |
$10,000 | $2.10 | $3.00 | $5.70 | $11.40 | $20.70 | $52.10 |
$15,000 | $3.15 | $4.50 | $8.55 | $17.10 | $31.05 | $78.15 |
$20,000 | $4.20 | $6.00 | $11.40 | $22.80 | $41.40 | $104.20 |
$25,000 | $5.25 | $7.50 | $14.25 | $28.50 | $51.75 | $130.25 |
*Eligible children through age 25 are automatically covered at 50% of the employee's benefit amount for no additional cost. **Premium for spouse coverage is calculated based on the employee's age. |
Enrollment
Employees can sign up for Critical Illness coverage within 30 days of becoming eligible (typically your date of hire or date of transfer into an eligible position). After this initial enrollment period, enrollment is only possible during the annual Open Enrollment period. Outside of these enrollment periods, changes can only be made within 30 days of an IRS-qualifying life event.
Enrollment continues as long as the employee remains eligible and pays the premium. Coverage for dependents ends when they no longer qualify as dependents.
When Coverage Ends
Participants can voluntarily terminate their coverage only during the annual Open Enrollment period, or within 30 days of certain IRS-qualifying life events. Coverage otherwise ends when benefit eligibility ends, usually due to separation from IU employment or transferring to an ineligible position. A covered employee or dependent may be eligible to convert their coverage to an individual policy. Contact The Standard at 800-634-1743 for details.
How to File a Claim
To receive cash benefits from your plan, you need to file a claim with The Standard for approval.
Filing a claim online
- Log in to standard.com
- After logging in, go to the Critical Illness Benefits or Health Maintenance Screening section and click Start a New Claim.
- This will take you to the Set Up Your Claim page. Choose the insurance that applies to your claim and follow the instructions.
- Don't have an account? You'll need to create an account to file your claim and log in.
Filing a paper claim
Download and complete the appropriate PDF form.
Completed, signed, and dated forms, including supporting documentation, can be filed by one of the following methods.
- Mail: Standard Insurance Company
PO Box 2800
Portland, OR 97208 - Email:
Please include the following: Indiana University, Policy number 135262, Insured's Name and Claim Number.
Keep in mind that communications via email are not secure. While unlikely, there is a possibility that information can be intercepted or misdirected and read by other parties besides the recipient to whom it is addressed. - Fax: 1-833-289-5001
Frequently Asked Questions
What is critical illness insurance?
Critical illness insurance is a voluntary policy offered by The Standard that makes a lump-sum payment to the member following the diagnosis of a serious illness or medical condition that is covered by the plan. The benefit payment can be used to cover expenses such as medical care, groceries, or rent, replace lost income, or pay for other financial obligations during a time of illness.
Is medical underwriting required to enroll?
No. Enrollment is allowed during Open Enrollment or within 30 days of hire. Medical underwriting (providing proof of good health) is never required to enroll. However, to be eligible for a benefit payout, the diagnosis of the covered critical illness must occur AFTER the effective date of coverage. This is regardless if it is the first time the condition was diagnosed or if it is a return of a condition after a period of remission.
Who is eligible for coverage?
The following individuals are eligible for coverage under the plan:
- Full-time (75% FTE or greater) appointed academic and staff employees (including IU medical and optometry residents) actively employed by IU.
- The enrolled employee or resident's legal spouse.
- The enrolled employee or resident's dependent children (through age 25) are automatically covered at 50% of the employee's coverage.
Important notes:
- IU spouses cannot enroll each other and must enroll in the employee coverage option.
- Dependents cannot be full-time members of the armed forces of any country, cannot be insured by more than one employee, and cannot be insured as both an employee and a dependent.
- Coverage for disabled dependents may be kept in force beyond age 25 if proof of total disability is provided within 31 days of the date when coverage would have ended due to the age limit.
What illnesses does the plan cover?
Receive 100% of your coverage amount following a diagnosis of:
- Heart Attack
- Stroke
- Cancer
- End-Stage Renal Failure
- Major Organ Failure
- Coma
- Paralysis
- Loss of Sight
- Occupational Hepatitis
- Occupational HIV
- Amyotrophic Lateral Sclerosis (ALS)
- Advanced Alzheimer’s Disease
- Advanced Multiple Sclerosis
- Advanced Parkinson’s Disease
- Benign Brain Tumor
- Bone Marrow Transplant
- Loss of Hearing
- Loss of Speech
- 21 Childhood Diseases (see next question)
Receive 25% of your coverage amount following a diagnosis of:
- Severe Coronary Artery Disease with Recommendation of Bypass Surgery
- Carcinoma in Situ
What other illnesses does this plan cover?
The member must be diagnosed with a specific named condition from the list above to be eligible for benefits. For example, pneumonia is a serious illness but is not payable under the benefit as it is not named by the plan.
What childhood illnesses does the plan cover?
Your eligible children are covered for the 20 critical illnesses for adults, as well as the following additional childhood illnesses:
- Anal Atresia
- Anencephaly
- Biliary Atresia
- Cerebral Palsy
- Cleft Lip
- Cleft Palate
- Club Foot
- Coarctation of the Aorta
- Cystic Fibrosis
- Diaphragmatic Hernia
- Down's Syndrome
- Gastroschisis
- Hirschsprung's Disease
- Hypoplastic Left Heart Syndrome
- Infantile Hypertrophic Pyloric Stenosis
- Muscular Dystrophy
- Omphalocele
- Patent Ductus Arteriosis
- Spina Bifida
- Custica with Myelomeningocele
- Tetralogy of Fallot
- Transposition of the Great Arteries
What other illnesses does this plan cover?
The member must be diagnosed with a specific named condition from the list above to be considered for coverage. For example, pneumonia may be a serious illness but would not be payable under the benefit as it is not named.
Who decides which illnesses are covered?
The policy underwriter, The Standard, created the list of covered illnesses under the policy.
How is the benefit paid?
The tax-free benefit is paid directly to you as a lump sum. You can use it for whatever you need most while you recover, such as medical bills, prescriptions, or daily expenses such as rent or groceries. There are no requirements as to what the funds must be spent on.
Can benefits be paid for a diagnosis that occurred prior to the effective date of coverage?
No. The diagnosis of the covered critical illness must occur AFTER the effective date of coverage. This is regardless if it is the first time the condition was diagnosed or if it is a return of a condition after a period of remission.
What is the reoccurrence benefit?
A one-time reoccurrence benefit is payable if an initial critical illness benefit amount is paid, then the member is re-diagnosed with the same critical illness. However, for this reoccurrence benefit to be paid, you must have been continuously covered since the first diagnosis and payout, and you must experience a six-month treatment-free period while continuously insured.
A "treatment-free period" means you have not
- Consulted a physician or other licensed medical professional;
- Received medical treatment, services, or advice;
- Undergone diagnostic procedures, including self-administered procedures; or
- Taken prescribed drugs or medications.
Does the person have to survive the event for the policy to pay?
No. If the covered individual passes away, benefits will be paid in equal shares to the first surviving class of the following: spouse, child(ren), parents, siblings, estate.
Do my spouse and children need to be covered on my IU medical plan to enroll?
No. This policy is separate from IU's medical plans. The only requirement for your spouse and children to be enrolled is that you must be enrolled in critical illness employee coverage.
Can I just enroll my spouse or children in the benefit, and not myself?
No. You must elect employee critical illness coverage to enroll your spouse. Your children are automatically enrolled at 50% of your benefit amount when you enroll in the plan.
How do I enroll my children?
Your employee critical illness coverage automatically includes coverage for your eligible children at 50% of your benefit amount. So, if you are enrolled at the $20,000 coverage level for yourself, and one of your children is diagnosed with a critical illness, you can receive a $10,000 benefit for them.
Can I take this coverage with me if I separate or retire from the university?
A covered employee or dependent may be eligible to convert their coverage to an individual policy. Contact The Standard at 800-634-1743 for details.
Can my covered spouse take this coverage with them if I pass away?
A covered spouse may be eligible to convert their coverage to an individual policy in this situation. Contact The Standard at 800-634-1743 for details.
How do my covered family members and I receive the $100 incentive each year?
You and your covered family members can each receive a $100 incentive once per year when you receive one of the following covered health screening tests:
- Abdominal Aortic Aneurysm ultrasound
- Ankle Brachial Index (ABI) screening for peripheral vascular disease
- Biopsies for cancer
- Bone density screening
- Breast ultrasound
- Cancer antigen (CA 125) blood test for ovarian cancer
- Cancer antigen (CA 15-3) for breast cancer
- Carcinoembryonic antigen (CEA) blood test for colon cancer
- Colonoscopy
- Complete Blood Count (CBC)
- Comprehensive Metabolic Panel (CMP)
- COVID-19 testing and antibody testing for COVID-19
- Electrocardiogram (EKG)
- Hemocult stool analysis
- Hemoglobin A1C
- Human Papillomavirus (HPV) vaccination
- Lipid panel
- Mammography
- Mental health Assessment
- Pap smears or thin prep pap test
- Prostate Specific (PSA) test
- Stress test on a bicycle or treadmill
Once the test has been performed, you submit a claim form directly to The Standard.
Learn more about the Health Maintenance Screening incentive.