Marketed by Cancer, Heart Attack & Stroke Coverage FOCUS ON RECOVERY, NOT EXPENSES ADH13-14 REV. (R 6/14) Insurance Coverage underwritten by Guarantee Trust Life Insurance Company
Lump Sum Benefit 30,000 * CANCER for diagnosis of internal cancer or cancer in-situ 30,000 * HEART ATTACK OR STROKE Reoccurrence Benefit After you recover, your Lump Sum Benefits start to restore! Limited to one payment per insured for each listed condition. 3,000 * ANGIOPLASTY if angioplasty or coronary bypass is performed without diagnosis of a heart attack 30,000 Benefits are paid directly to you to help with medical insurance shortfalls and out-of-pocket expenses: Deductibles Co-payments Special diets Transportation Lodging Loss of income Mortgage/rent Family care Utilities Groceries So you can focus on recovery instead of expenses. *Benefit amounts listed are based on the Plan F benefit plan. Other benefit plans are available. Premiums will vary by plan. **The Reoccurrence Benefit is a percentage of the Lump Sum Benefit paid when cancer reoccurs after you have been in remission for at least one full year and for which benefits have been paid. For the Lump Sum Heart Attack or Stroke Benefit, reoccurrence must be at least one full year from payment of the Lump Sum Benefit. Percentage of Lump Sum Benefit restored over 5 years 100% 15,000 7,500 50% 3,000 25% 10% 1 Year 2-3 Years 4 Years 5 Years YEARS BETWEEN OCCURENCES
Benefits All benefits on this page are paid as a direct result of cancer, heart attack and/or stroke. Hospital Confinement // 1,500/day* Pays this amount per day of your covered confinement** Drugs and Medicine // 600/day* Pays per day for FDA-approved medication received during a covered hospital confinement. Attending Doctor // 300/day* Pays per day during a covered hospital confinement for a doctor s services received (other than your surgeon). Transfusions // (Cancer) 450/day* (Heart Attack/Stroke) // 900/day* Pays per day for blood, plasma and platelet transfusions you receive for covered treatments. Surgical Procedures // Up to 45,000/surgery* Pays per surgery, based upon the surgical schedule required. Benefits vary by surgical procedure. Anesthesia // Up to 13,500/surgery* Pays per surgery, 30% of benefits paid for the surgery performed. The Benefit amounts listed below do not vary by plan. 2nd and 3rd Surgical Opinions // 300/opinion Pays for the opinion of other physicians before you decide to have surgery. Private Nurse // 250/day Pays per day during a covered hospital confinement for the full-time services of a licensed private nurse who performs duties other than those regularly furnished by the hospital. Skilled Nursing Facility // 250/day Pays per day when you are confined to a skilled nursing facility within 14 days after a covered inpatient hospital stay. This benefit is payable for up to the same number of days you received the Hospital Confinement Benefit. Lodging // 100/day UP TO 120 DAYS PER CALENDAR YEAR Pays lodging per day for the insured or an adult companion when insured is receiving treatment from a medical facility located more than 50 miles from the insured s home. Ambulance Pays per trip to or from a hospital where you are confined as an inpatient. Ground // 250/trip LIMITED TO 4 TIMES PER CALENDAR YEAR Air // 1,500/trip LIMITED TO 1 TRIP PER CALENDAR YEAR Transportation PAYS ACTUAL CHARGES UP TO THE BENEFIT AMOUNT Pays for the insured and an adult companion to travel to a facility located more than 50 miles from your home for treatment: Air, Rail or Bus // 2,000/trip LIMITED TO 2 ROUND TRIPS PER PERSON, PER CALENDAR YEAR. Private Vehicle // 2,000/trip 0.60/MILE UP TO THE BENEFIT AMOUNT PAYS FOR UNLIMITED TRIPS. *Benefit amounts listed are based on the Plan F benefit plan. Other benefit plans are available. Premiums will vary by plan. **Period of Confinement means a period which begins on or after the Effective Date, and during which an insured person is confined as an inpatient to a Hospital or Skilled Nursing Facility. If an insured person is reconfined within thirty (30) days of discharge from a Hospital or Skilled Nursing Facility, then the later period will be considered a continuation of the prior Period of Confinement. If the Insured person is reconfined more than thirty (30) days after discharge from a Hospital or Skilled Nursing Facility, we will treat the later confinement as a new Period of Confinement.
Benefits Paid as a direct result of cancer, heart attack and/or stroke. Skin Cancer 2 // 1,800/surgery* Pays per surgical removal of skin cancer. Injected Chemo/Radiation // 600/day* Pays per day for covered injected chemotherapy and radiation treatments. Oral Chemo (per medication) // 600/month* LIMITED TO 36 MONTHS MAXIMUM OF 3 MEDICATIONS PER MONTH Anti-Nausea Drugs // 300/month* Pays per month for prescribed anti-nausea drugs while an insured person is receiving chemotherapy, radiation, or experimental treatment on an outpatient basis. Supportive Drugs // 150/month* Pays per month for supportive or protective care drugs prescribed in connection or conjunction with injected chemotherapy. Prosthetic Devices Pays for prosthetic devices needed as a direct result of cancer (Surgical) // 15,000/device* (Non-surgical) // 3,750/device* Diagnostic Testing // 3,000/test* LIMITED TO TWICE PER CALENDAR YEAR Pays per test for diagnostic/lab tests which diagnose cancer, heart attack or stroke. Additional Benefits Immunotherapy // 750/month* 2,500/lifetime Immunotherapy is a type of cancer treatment that targets specific molecules of the body s own immune system in order to disrupt the growth of cancer cells. Examples include antibodies, growth factors and vaccines. This benefit pays per month for immunotherapy prescribed by a doctor as part of a treatment regimen for cancer. Experimental Treatment // 30,000* per lifetime Pays for FDA-approved experimental drugs and chemicals, surgery or therapy endorsed by either the NCI or ACS for experimental studies in the treatment of cancer. Hospice Benefit LIMITED TO 6 MONTHS First 90 Days // 750/day* After 90 Days // 1,500/day* Pays per day that a terminally ill individual receives hospice care as a direct result of cancer, heart attack or stroke. Catastrophic Hospital Confinement Benefit 90,000/Month * Pays beginning on the 91st day of being continuously confined to a hospital or a U.S. Government hospital. Pays in addition to all other benefits except the Hospital Confinement Benefit. Annual Check-Up // 1,500/year* LIMITED TO FIRST 5 YEARS AFTER DIAGNOSIS Pays for annual check-ups for each insured person once per year for 5 years after a positive diagnosis of internal cancer, heart attack or stroke. *Benefit amounts listed are based on the Plan F benefit plan. Other benefit plans are available. Premiums will vary by plan. 2 Benefits for skin cancer other than a malignant melanoma are limited to surgical removal benefits.
Intensive Care Unit Benefit LIMITED TO 30 DAYS PER HOSPITAL ADMISSION INTENSIVE CARE BENEFITS REDUCE BY 50% AT AGE 70 Confined for Illness or Injury // 900/day* Pays for confinement in an intensive care unit due to sickness or injury. Confined for Motor Vehicle Accident // 1,800/day* Pays for confinement in an intensive care unit that occurs within 48 hours of a motor vehicle accident. Step Down Unit // 450/day* Pays for confinement in a step down unit. Transplant Benefit The benefits listed below increase by 5% every year, for 10 years. Bone Marrow // 75,000 Grows to approximately 125,000 in 10 Years* Paid as a lump sum if you receive a bone marrow transplant. Human Organ // 75,000 Grows to approximately 125,000 in 10 Years* Heart*** Kidney Liver Lung, etc. Paid as a lump sum if you are the recipient of a human organ transplant. This benefit is payable only once per insured. Stem Cell // 30,000 Grows to approximately 50,000 in 10 Years* Paid as a lump sum if you receive a stem cell transplant. Donor Benefit // 37,500 Grows to approximately 62,500 in 10 Years* To help pay toward donor expenses that are incurred on behalf of the insured person when a transplant covered under this Rider is performed. The Donor Benefit will be equal to fifty percent (50%) of the corresponding transplant benefit amount paid. *Benefit amounts listed are based on the Plan F benefit plan. Other benefit plans are available. Premiums will vary by plan. *** A human heart transplant benefit is only available if the Heart Attack and Stroke Benefit Policy/Rider is applied for and insured is eligible.
1 in 2 of us will be diagnosed with cancer during our lifetime. 2 Approximately 60% of the total cost of cancer is non-medical; therefore, not paid for by major medical insurance. 3 35% of the overall costs of strokes are indirect costs, and consequently, not paid for by major medical insurance. 4 How will you pay for these extra expenses? Spend your savings Sell your assets Borrow from your retirement A better solution... Platinum Supplemental Insurance 2 Source: http://seer.cancer.gov/statfacts/html/all.html 3 Source: American Cancer Society, Cancer Facts & Figures 2010 pg 3 4 Source: American Heart Association Circulation, Heart Attack and Stroke Statistics 2010 Update, pg e206
Screening 600 per person/year* 90 DAY WAITING PERIOD, EXCLUDING MISSOURI 30 DAY WAITING PERIOD IN ARKANSAS, TENNESSEE & WYOMING Pays for a doctor visit in which a prescribed diagnostic test is performed to detect cancer, heart attack or stroke. Limited to once per calendar year per insured person. No diagnosis of cancer, heart attack or stroke is required to be eligible for this benefit. Policy Advantages Guaranteed Renewable - Your policy will continue as long as you pay your premiums. Premiums do not increase with age - Premiums can only be increased on a class basis by state. Assured Payments - We will pay what is indicated in your policy, regardless of what other insurance you may have. No Lifetime Maximum - The benefits listed have no lifetime maximum unless otherwise stated in your policy. Waiver of Premium - Premiums waived if the main insured is disabled for 90 consecutive days due to cancer, heart attack or stroke. Return of Premium Return of Premium Rider - RG10ROP20 AVAILABLE TO APPLICANTS AGE 49 AND UNDER. We will return all premiums paid** (less any claims paid) every 20 years. Return of Premium Rider - RG10ROPD AVAILABLE TO APPLICANTS AGE 18 TO 79. We will return all premiums paid** (less any claims paid) if you pass away prior to age 85. If issue age is 76-79, we will return all premiums paid (less any claims paid) if you pass away within 10 years. Base Amount Claim Size Result Example 1 Premium Paid In 250,000 Claims No Refund Example 2 Premium Paid In 2,000 Claims 100% minus 2,000 Example 3 Premium Paid In 0 Claims 100% Refund Policy Options Your Age /Day /Day /Day *Benefit amounts listed are based on the Plan F benefit plan. Other benefit plans are available. Premiums will vary by plan. **Return of Premium does not include annual policy fees
Toll Free 1-800-765-1454 Our Customer Service Specialists are friendly, knowledgeable and licensed! If you have a question, please call us. LIMITATIONS AND EXCLUSIONS PLEASE SEE YOUR INSURANCE CONTRACT FOR SPECIFIC DETAILS. THE EXCLUSIONS AND LIMITATIONS LISTED BELOW ARE TYPICAL, BUT YOUR STATE MAY HAVE SLIGHT DIFFERENCES. Waiting Period: The policy/rider(s) has a 30 day waiting period before benefits will be paid, except the Screening Benefit has a 90 day waiting period. The waiting period begins on the policy/rider(s) effective date. Cancer, Heart Attack or Stroke will not be a covered condition when advice or treatment is received prior to the policy s effective date or within the waiting period, or tissue is extracted prior to the policy s effective date or within the waiting period, and such advice, treatment, or tissue extraction results in the First Diagnosis of Cancer, Heart Attack or Stroke. In Arkansas, Tennessee and Wyoming, the Screening Benefit Rider has a 30-day waiting period. A waiting period does not apply in Missouri. Cancer, Heart Attack or Stroke Coverage: This policy/rider does not pay benefits for any loss due to: injury, disease, sickness, or incapacity not directly related or attributable to Cancer, Heart Attack or Stroke; care received outside the U.S.; experimental drugs or substances not approved by the U.S. Food & Drug Administration for the treatment of Cancer, Heart Attack or Stroke; experimental procedures or treatment methods not endorsed by the American Medical Association or any other appropriate Medical Society except as provided for in the Experimental Treatment Benefit of the policy; courses of treatment available without a doctor s prescription; or services received from a member of your immediate family. The Screening benefit excludes the following tests that are performed in a routine or annual physical examination: (1) an oral cancer examination performed by a dentist, orthodontist, or similar oral care professional; (2) testicular or prostate physical examination; (3) blood pressure; and (4) lipid panel. Cancer does not include pre-malignant tumors or polyps; intraductal noninvasive carcinoma of the breasts; or carcinoid of the appendix. Benefits for non-malignant skin cancer are covered under the Cancer Surgical Procedure Benefit. Heart Attack does not include any other disease or injury involving the cardiovascular system. Cardiac arrest not caused by a myocardial infarction is not a Heart Attack. Stroke does not mean a head injury, transient ischemic attack or chronic cerebrovascular insufficiency. Lump Sum Benefits: This rider does not pay benefits for non-malignant skin cancer (benefits for non-malignant skin cancer are covered under the Cancer Surgical Procedures benefit). It also does not pay benefits for coronary angioplasty or coronary bypass when performed as a direct result of a heart attack (benefits for coronary angioplasty/coronary bypass would then be paid under the Surgical Procedures Benefit, and heart attack benefits would be payable under the Lump Sum Benefit.) Benefits for coronary angioplasty or coronary bypass performed without evidence of a heart attack would be payable under this Lump Sum Benefit. Intensive Care Benefit: The Intensive Care rider will pay benefits for any sickness or injury, except: intentionally self-inflicted Injury, violating or attempting to violate any duly enacted law; injury by acts of war, whether declared or not; attempted suicide while sane or insane (This exclusion does not apply in IL); injury sustained while committing or attempting to commit a felony; injury sustained while voluntarily participating in a riot, or civil commotion or disturbance of any kind; loss resulting from being legally intoxicated or under the influence of alcohol as defined by the laws of the state in which the Injury occurs; or loss resulting from being under the influence of any drugs or narcotic unless administered on the advice of a Doctor. Duplication of Benefits: Where there is an overlap in coverage between: (i) the hospital confinement benefit and the intensive care benefit; or (ii) the diagnostic testing benefit and surgical procedures benefit, the higher of the two applicable benefit amounts will be paid. This brochure is designed as a marketing aid and is not to be construed as a contract for Cancer & Heart Attack & Stroke Insurance. It provides a brief description of the important features of policy form(s) G1030 (and G1031 - in the event the insured is not eligible for the G1030 policy) and rider forms RG11PCLS, RG10CR, RG10CSB, RG10HAS, RG11PHSLS, RG10HSSB, RG10T, RG10IC, RG10ROP20, and RG10ROPD (where available as group insurance: Certificate series GC G1030 and GC G1031 and benefit riders series G RG10CR, G RG10CSB, G RG11PCLS, G RG10HAS, G RG10HSSB, G RG11PHSLS, G RG10T, G RG101C, G RG10ROP20, and G RG10ROPD) Marketed by Platinum Building, 137 Main Street, Dubuque IA 52001 www.pltnm.com 563.557.2504 Fax: 563.557.9180 For customer assistance, call 1.800.765.1454 Rated A+ with the Better Business Bureau Knowledgeable licensed customer service available to help you No automated phones real people providing real service Guarantee Trust Life Insurance Co. 1275 Milwaukee Avenue Glenview, IL 60025 Located in Glenview, Illinois Founded in 1936 Mutual Legal Reserve Company