Voluntary Critical Illness Products

Cost: $3,000; published 2022

Voluntary critical illness products are in demand by brokers, employers and employees and have quickly become a fundamental part of every carrier’s voluntary product portfolio. The demand for these products was already increasing before the emergence of COVID-19, but their value has been magnified in light of the pandemic. And keeping up with the growing demand to add new covered conditions with higher benefit amounts — while still keeping pricing low and offering guaranteed issue underwriting — as well as staying abreast of changing regulatory requirements creates a complex and fast-changing market for carriers to navigate.

The purpose of this Voluntary Critical Illness Products Spotlight™ report is to review the current and future state of the critical illness marketplace and existing products so carriers can better understand the market opportunities and how their products compare to the competition. The specific topics covered include:

  • Market overview for critical illness products
  • Product structure and benefits (conditions covered, benefit amounts available, etc.)
  • Underwriting/eligibility guidelines
  • Sample rates
  • Commissions
  • Product results (sales, participation, average premium, etc.)
  • Product differentiators, challenges and future trends

View Table of Contents

1. Executive Summary

A. Report Objectives

B. Methodology

C. Key Findings

2. Market Overview

1. The Overall Market

2. Employer Perspective

3. Employee Perspective

4. Broker Perspective

5. Key Competitors

3. Product Details by Carrier

A. Product Structure and Specifics

1. Product Platform

2. Definition of Voluntary for Critical Illness Products

3. Employer Contributions

4. Years in the Critical Illness Market and Last Product Revision

5. Standard Plan Design and Offering

6. Customized Product Options

7. Covered Conditions

8. Carve-Out/Excluded Covered Conditions

9. Additional Covered Adult Conditions

10. Covered Conditions for Children Only

11. Payment of Benefits

12. Partial Benefits

13. Lifetime Maximum

14. Minimum/Maximum Benefit Amounts Available

15. Elimination or Waiting Periods

16. Pre-Existing Conditions Exclusion

17. Wellness Benefit

18. Additional Occurrence Benefit

19. Reoccurrence Benefit

20. Infectious Disease Benefit

21. Additional Benefits, Riders or Unique Features

22. Age-Based Reductions and/or Termination

23. Exclusions

24. Spouse and Dependent Coverage

 

B. Product Portability and Conversion

1. Group Product Portability and Ported Coverage and Rates

C. Rates and Commissions

1. Published or Census Rates

2. Issue-age or Attained-age Rates

3. Composite Rate Options

4. Rate Structure for Family Coverage

5. Tobacco/Non-Tobacco or Uni-Tobacco Rates

6. Re-rating

7. Renewability

8. Premium Guarantees

9. Monthly Premium Comparisons

10. Multi-Line Discount Offers

11. Critical Illness Commissions

D. Underwriting

1. Account Eligibility Guidelines

2. Employee Eligibility Guidelines

3. Type(s) of Underwriting Used

4. Guaranteed Issue Guidelines

5. Simplified Issue Guidelines

6. Simplified Issue Health Questions

7. Other Questions

8. MIB, APS, Pharmacy Checks for Simplified Issue

9. Full Underwriting Guidelines

10.Spouse and Dependent Underwriting

11.MEC Plan Requirement

12.Coverage Increases

13.Annual Open Enrollment

14.Previously Offered Employee Guidelines

15.Perpetural Guaranteed Issue

E. Claims

1. Types of Claims Problems

2. Average Speed of Claims Payment or Denial

3. Percent of Claims Denied and Most Common Reasons for Denial

4. Proof for Wellness Claims

4. Differentiators, Results, Challenges and Future Trends

A. Product Differentiators and 2021 Results

1. Product Differentiators

2. 2021 Critical Illness Sales

3. Product Profitability

4. Average Participation Percentage

5. Typical Policyholder and Account Demographics

6. Average Amount of Coverage Purchased

7. Average Annual Premium per Employee

8. Persistency/Retention

9. Takeovers vs. Virgin Case

10. Original Age vs. Current Age for Replacement Plans

11. Current vs. Expected Loss Ratios

B. Challenges and Future Trends

1. Unique Product Challenges

2. Current and Future Product Trends

 

 


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