Critical illness insurance

Critical illness insurance: Coverage for serious health events

Voluntary critical illness insurance from The Standard pays you a lump sum if you or your covered dependents are diagnosed with one of 20 major illnesses, or 21 major childhood illnesses, covered by the policy.

The benefit payment can be used for whatever you need most as you recover. That includes personal expenses such as medical plan deductibles, coinsurance, groceries, rent, lost income replacement, or any financial obligations that may come up. There are no stipulations on how you spend the funds once they are paid out.

Eligibility & coverage options

If you’re a full-time academic or staff employee at IU working at least 75% FTE, you’re eligible to enroll in the plan. This includes IU residents as long as you're actively employed. You can also add your spouse and dependent children (up to age 25) to your coverage. However, if both you and your spouse work at IU, you can’t cover each other. Instead, each of you must enroll in individual plans.

Coverage is available in the following amounts:

  • Employees: $10,000 – $50,000 in increments of $10,000.

  • Spouses: $5,000 – $25,000 in increments of $5,000 (cannot exceed 50% of the employee’s benefit).

  • Children (through age 25): Automatically covered at 50% of the employee’s coverage amount.

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 syndrome
  • Gastroschisis
  • Hirschsprung’s disease
  • Hypoplastic left heart syndrome
  • Infantile hypertrophic pyloric stenosis
  • Muscular dystrophy
  • Omphalocele
  • Patent ductus arteriosis
  • Spina Bifida Cystica with Myelomeningocele
  • Tetralogy of fallot
  • Transposition of the great arteries

Coverage will start the day after you complete one full day of work as an eligible employee. If you’re unable to work because you’re sick, injured, or pregnant right before your insurance or coverage increase is set to kick in, it won’t take effect until after your first full day of work.

Active at work means performing the material duties of your job. 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.

A one-time reoccurrence benefit is payable if an initial critical illness benefit amount is paid and then you are re-diagnosed with the same critical illness. However, for this reoccurrence benefit to be paid, you have to 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
  • 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.

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 period, enrollment is only possible during the annual Open Enrollment period or within 30 days of an IRS-qualifying life event. 

Dependent coverage

Critical illness coverage is separate from your IU health insurance. Your dependents don’t need to be on an IU medical plan to enroll, but you’ll need to enroll yourself first to add your spouse or children. Their coverage will end once they no longer qualify as dependents.

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.

  • 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 you've taken your health screening, you can receive your incentive by filing a claim with The Standard.

Each covered family member must submit their own claim. 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).

How to file a claim

To get cash benefits, set up an account and file a claim with The Standard for approval. Benefits are only paid if you’re diagnosed after your coverage starts. If you pass away, your benefits go to your surviving family. A covered spouse may be able to convert to an individual policy by contacting The Standard.

  1. Log in to standard.com
  2. Go to the Critical Illness Benefits or Health Maintenance Screening section and click Start a New Claim.
  3. This will take you to the Set Up Your Claim page. Choose the insurance that applies to your claim and follow the instructions.

Reference group policy number 135262 when filing your 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: SupplementalNewClaim@standard.com
    • Please include the following:
      • Indiana University
      • policy number 135262
      • insured’s name
      • claim number
    • Note: 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

When coverage ends

Participants can only voluntarily terminate their coverage during the annual Open Enrollment period, or within 30 days of certain IRS-qualifying life events. Otherwise, coverage 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 +1-800-634-1743 for details.

Plan documents

Get in touch with The Standard

Phone: +1-800-378-4668

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