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MetLife's Critical Illness plan can supplement existing medical coverage and help provide financial support to pay for out-of-pocket expenses such as mortgage payments, college tuition, hiring household help, or treatment not covered by medical insurance. Benefits are paid regardless of what is covered by medical insurance. Payments are made directly to the covered employee to spend as they choose.

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Autism Spectrum Disorder Diagnosis
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: None
Benign Brain Tumor
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Invasive Cancer
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Non-Invasive Cancer
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Skin Cancer
Initial Benefit: 5% of Benefit Amount (not less than $250)
Recurrence Benefit: 100% of Initial Benefit (not less than $250)
Coronary Artery Bypass Graft (CABG)
Initial Benefit: 50% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit Amount
Where surgery involving either a median sternotomy or minimally invasive procedure is performed.
Childhood Cerebral Palsy
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Childhood Cleft Lip or Cleft Palate
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Childhood Cystic Fibrosis
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Childhood Diabetes (Type 1)
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Childhood Downs Syndrome
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Childhood Sickle Cell Anemia
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Childhood Spina Bifida
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Coma
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Loss of: Ability to Speak; Hearing; or Sight
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Paralysis of 2 or More Limbs
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Heart Attack
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Sudden Cardiac Arrest
Initial Benefit: 50% of Benefit Amount
Recurrence Benefit: None
Bacterial Cerebrospinal Meningitis*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
COVID-19 *
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Diphtheria*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Encephalitis*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Legionnaire's Disease*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Malaria*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Necrotizing Fasciitis*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Osteomyeltsis*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Rabies*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: None
Tetanus*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Tuberculosis*
Initial Benefit: 25% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Kidney Failure
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Major Organ Transplant
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
For Bone Marrow, Heart, Lung, Pancreas & Liver
ALS
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Alzheimer's Disease
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Multiple Sclerosis
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Muscular Dystrophy
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Parkinson's Disease (Advanced)
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Systemic Lupus Erythematosus (SLE)
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: None
Sever Burn
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Stroke
Initial Benefit: 100% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
Transient Ischemic Attack
Initial Benefit: 10% of Benefit Amount
Recurrence Benefit: 100% of Initial Benefit
* Payable after 3 Consecutive Days of Hospitalization
Health Screening Benefit
Benefit Amount: $50
Payable if an eligible covered person takes one of the screening/prevention measures listed below. Times Payable per Calendar Year: 1 time per Employee, 1 time per Spouse/Domestic Partner, 1 time per Dependent Child. Eligible Screening / Prevention Measures:
  Routine Health Check-Up Exam
  Biopsies For Cancer
  Blood Chemistry Panel
  Blood Test To Determine Total Cholesterol
  Blood Test To Determine Triglycerides
  Bone Marrow Testing
  Breast MRI
  Breast Ultrasound
  Breast Sonogram
  Cancer Antigen 15-3 Blood Test For Breast Cancer (CA 15-3)
  Cancer Antigen 125 Blood Test For Ovarian Cancer (CA 125)
  Carcinoembryonic Antigen Blood Test For Colon Cancer (CEA)
  Carotid Doppler
  Chest X-Rays
  Clinical Testicular Exam
  Colonoscopy
  Complete Blood Count (CBC)
  Coronavirus Testing Skin Exam
  Dental Exam
  Digital Rectal Exam (DRE)
  Doppler Screening For Cancer
  Doppler Screening For Peripheral Vascular Disease
  Echocardiogram
  Electrocardiogram (EKG)
  Electroencephalogram (EEG)
  Endoscopy
  Fasting Plasma Glucose Test
  Fasting Blood Glucose Test
  Flexible Sigmoidoscopy
  Hearing Test
  Hemoccult Stool Specimen
  Hemoglobin A1c
  Human Papillomavirus (HPV) Vaccination
  Immunizations
  Lipid Panel
  Mammogram
  Oral Cancer Screening
  PAP Smears Or Thin Prep PAP Test
  Prostate-Specific Antigen (PSA) Test
  Serum Cholesterol Test To Determine Ldl And Hdl Levels
  Serum Protein Electrophoresis
  Skin Cancer Biopsy
  Skin Cancer Screening
  Stress Test On Bicycle Or Treadmill
  Successful Completion Of Smoking Cessation Program
  Tests For Sexually Transmitted Infections (STI's)
  Thermography
  Two-Hour Post-Load Plasma Glucose Test
  Ultrasounds For Cancer Detection
  Ultrasound Screening Of The Abdominal Aorta For Abdominal Aortic Aneurysms
  Virtual Colonoscopy
Coverage & Rates shown are for the 2025/26 Plan Year, effective 7/1/2025 through 6/30/2026.
  Choose from 2 Coverage Options: $15,000 or $30,000
 
$15,000 of Coverage
Attained Employee Employee Employee Employee, Spouse
Age Only & Spouse & Child(ren) & Child(ren)
Younger than 25 6.60 10.95 11.10 15.45
25 -29 7.50 12.30 12.00 16.80
30 - 34 9.00 14.40 13.50 19.05
35 - 39 12.00 19.35 16.50 23.85
40 - 49 16.35 25.80 20.85 30.30
50 - 54 22.50 34.95 27.00 39.60
55 - 59 31.50 48.00 36.15 52.50
60 - 64 58.95 87.45 63.45 91.95
65 - 69 74.70 110.55 79.35 115.05
70 - 74 97.65 144.30 102.30 148.80
75 & Older 132.90 197.10 137.40 201.75
$30,000 of Coverage
Attained Employee Employee Employee Employee, Spouse
Age Only & Spouse & Child(ren) & Child(ren)
Younger than 25 13.20 21.90 22.20 30.90
25 -29 15.00 24.60 24.00 33.60
30 - 34 18.00 28.80 27.00 38.10
35 - 39 24.00 38.70 33.00 47.70
40 - 49 32.70 51.60 41.70 60.60
50 - 54 63.00 96.00 72.30 105.00
55 - 59 88.80 132.90 97.80 141.90
60 - 64 117.90 174.90 126.90 183.90
65 - 69 149.40 221.10 158.70 230.10
70 - 74 195.30 288.60 204.60 297.60
75 & Older 265.80 394.20 274.80 403.50

  Eligibility:
      For eligible active employee members only.
      Only available if Employer group allows this coverage to be offered.
  Opportunities:
      OPEH&W Initial Enrollment.
      OPEH&W Annual Open Enrollment.
      First Offering from OPEH&W.