Changes to your Group Critical Illness coverage effective February 1, 2015

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As an industry leader, Sun Life Financial is always looking for ways to make a great plan even better. To do this, we will be making a number of enhancements to your Group critical illness (CI) product effective February 1, 2015.

Canadian Life and Health Insurance Association’s (CLHIA) new benchmark definitions

The CLHIA released new benchmark definitions, and in order to comply with the new guidelines, your CI 3 and 11 illness products have been enhanced to include these new definitions.

The comparison chart has been included for your reference: CI 3 illness product and CI 11 illness product.

New contract wording

In an effort to ensure that our contract wording is clear and easy to understand, some revisions were made to the general provisions regarding coverage and eligibility. We have also added details concerning changes to CI coverage. You will receive updated documents at the next revision to your plan.

Pre-existing conditions clause change

We have standardized our pre-existing provision clause. For any coverage that has been in effect for less than 12 months under the employer's Critical Illness plan, no benefits are payable for any covered condition that results from any injury, sickness or medical condition (whether or not diagnosed) for which the covered person, during the 12 months prior to the effective date of such amount of coverage:

  • had signs, symptoms, consulted a physician or other health care practitioner; or
  • were provided any health-related care, advice or treatment; or
  • would have consulted a physician or other health care practitioner, acting as a reasonably prudent person with such injury, sickness, medical condition, signs or symptoms.

Enrolment age change

If the plan termination is age 70 for the plan member and their covered dependent, the enrolment age limitation of age 65 is being revised to allow enrolment up to age 69 and 364 days.

Sun Life Financial Choices Critical Illness Insurance

As a new feature of our Choices CI insurance, existing child CI coverage will now be allowed to transition like the plan member’s and spouse’s CI coverage in most instances. The Choices coverage will also be adopting the new definitions, the new contract wording and will be subject to a maximum amount. These changes to the Choices product will be available as of February 1, 2015.

Sharing this information

We have prepared a plan member Focus Update that you must share with your plan members.

Questions?

Please contact your Client Service Administrator at 1-877-786-7227.