Guardian Group Critical Illness Insurance for employees
More workforce well-being
You can bring added ease and financial support to employees to help keep them going in life and in work, especially during times of serious illness. We can help make it simple.
Provide broader preventive and family care coverage
First-of-its kind coverage for preventive measures taken as a result of a BRCA1 or BRCA2 genetic mutation. And expanded coverage for childhood conditions and disorders such as autism and congenital heart defect. Plus, family planning benefits are also available.1
Fast-track access to financial support
At the onset of a covered critical illness, employees receive a lump-sum payment benefit. No deductible and no lifetime maximum cap on benefits. Also, get employees earlier payouts for earlier stages of progressive diseases such as Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease.
Get customized, easy-to-understand plans
You choose what’s covered and the rates. Plus, you’ll get simplified contract language that's employer- and employee-centric. And if you’d like to get employees benefits for completing certain health screenings, there are options for that, too.2
In a recent fertility and family benefits survey, 41% of respondents feel that their employer could better support their family and reproductive health needs.4
Fertility issues affect approximately 1 in 6 people, according to the World Health Organization.3
How can Guardian Critical Illness Insurance impact employee quality of life?
Tyler was diagnosed with Parkinson’s disease and had to deal with multiple life changes. The lump-sum payout he received from Guardian after his diagnosis helped him cover extra out-of-pocket expenses and new, additional daily living costs.5
What can save employees valuable time and effort, too?
Unlock a more effective employee experience that eliminates the need to file multiple claims when you offer Guardian Critical Illness Insurance along with Guardian short-term disability benefits.
1 Currently available in the following states: AK, AL, AR, AZ, CT, DC, DE, GA, HI, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI*, MN, MO, MS, MT, NC, ND, NE, NH, NV, OH, OK, OR, RI, SC, SD, TN, TX, UT, VA, VT, WI, WV, WY.
MI* 51+ eligible lives.
Infertility benefits available only for groups with 100+ eligible lives.
2 One wellness benefit per calendar year per covered person if a covered person has a wellness test or procedure performed while coverage is in force. See your plan details for benefit amounts.
4 The State of Fertility & Family Benefits in 2023, Maven Clinic
5Hypothetical example for illustrative purposes only.
Guardian’s Group Critical Illness Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. This is a limited plan of supplemental health insurance that provides the specified financial support, as a lump sum or indemnity payment, following the diagnosis of a critical illness. This is not minimum essential coverage as defined by federal law. This coverage will not reimburse for hospital or medical expenses. Generic Policy Form # GP-1-CI-14; CI-23-P; GP-1-Cl-15-WA. The state-approved form is the governing document.
Summary of Plan Limitations and Exclusions (for GP-1-CI-14)
The policy has exclusions and limitations that may impact the eligibility for or entitlement to benefits under each covered condition. There are limitations & special requirements for each condition. See the certificate of coverage or contact your sales representative for full details.
This policy will not pay for a diagnosis of a listed critical illness that is made before the covered person's Critical Illness effective date with Guardian.
We will not pay benefits for the First Occurrence of a Critical Illness if it occurs less than 3 months after the First Occurrence of a related Critical Illness for which this Plan paid benefits. By related we mean either: (a) both Critical Illnesses are contained within the Cancer Related Conditions category; or (b) both Critical Illnesses are contained within the Vascular Conditions category.
We will not pay benefits for a second occurrence (recurrence) of a Critical Illness unless the Covered Person has not exhibited symptoms or received care or treatment for that Critical Illness for at least 12 months in a row prior to the recurrence. For purposes of this exclusion, care or treatment does not include: (1) preventive medications in the absence of disease; and (2) routine scheduled follow-up visits to a Doctor.
We do not pay for a third or later occurrence of a critical illness.
First & second occurrence refers to the first & second time an insured experiences or is diagnosed with a covered critical illness while covered under Guardian Critical Illness insurance.
A pre-existing condition includes any condition for which an employee, in the specified period of time prior to coverage in this plan, consults with a physician, receives treatment, or takes prescribed drugs. Please refer to the plan documents for specific time periods.
If the plan is new (not transferred): During the exclusion period, this critical illness plan does not pay charges relating to a preexisting condition. If this plan is transferred from another insurance carrier, the time an insured is covered under that plan will count toward satisfying Guardian’s pre-existing condition limitation period. Please refer to the plan details for specific time periods. State variations may apply.
We do not pay benefits for charges relating to a covered person: taking part in any war or act of war (including service in the armed forces), committing a felony or taking part in any riot or other civil disorder or intentionally injuring themselves or attempting suicide while sane, or insane.
In order to be eligible for coverage: Employees must be legally working: (a) in the United States or (b) outside the United States, for a US based employer, in a country or region approved by Guardian. Subject to state specific variations.
Employees must be working full-time on the effective date of coverage; otherwise, coverage becomes effective after the completion of the specific waiting period.
Health questions are required for all late enrollees. Benefit increases may require underwriting.
This coverage will not be effective until approved by a Guardian underwriter. This proposal is subject to satisfactory financial evaluation. Please refer to certificate of coverage for full plan description; plan documents are the final arbiter of coverage.
Summary of Plan Limitations and Exclusions (for CI-23-P)
No benefits are payable for the following:
An illness that’s not listed in the Covered illnesses section.
An illness that’s diagnosed after your death unless there’s an exception specifically listed in this guide that we’ll accept a death certificate or autopsy report confirming the diagnosis of that illness.
An illness that’s diagnosed when you’re not covered by this Plan.
Any care, service or treatment that’s received when this coverage isn’t in place.
An illness or condition that’s contributed to or results from any of the following:
Participating in a felony, riot, or insurrection
Intentionally causing a self-inflicted injury
Suicide or attempted suicide while sane or insane
Engaging in any illegal activity
Serving in the armed forces or any auxiliary unit of the armed forces of any country (This exclusion doesn’t apply to the PTSD benefit.)
The voluntary use of any poison, chemical, substance defined as a controlled substance by Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, or prescription drug, unless prescribed by a physician and used as prescribed
The voluntary use of a non-prescription drug inconsistent with package instructions
War or act of war, even if war isn’t declared 2[(This exclusion doesn’t apply to the PTSD benefit.)
An illness or condition that’s diagnosed outside the United States unless the diagnosis is confirmed in the United States. If the diagnosis is confirmed in the United States, the diagnosis will be considered to have been made on the date it was made outside the United States.
Any care, treatment or service received outside the United States.
Any illness, care, treatment, or service that violates local, state or federal law or for which our paying a benefit would violate local, state or federal law.
Any claim for a benefit that isn’t specifically listed as an available benefit under the member guide.
An illness that’s diagnosed by you or a member of your immediate family or a business associate.*
Immediate family includes the following:
Your spouse or anyone with whom you live and share financial assets and obligations.
Your child
Your parents, including stepparents and mother-in-law and father-in-law
Your siblings, including stepbrothers and stepsisters
Your brothers-in-law and sisters-in-law
Your grandparents, including step-grandparents
Your grandchildren, including step-grandchildren
Any relative living with you
Immediate family also includes the spouse of anyone listed above.
*This exclusion is not included for Arizona.
This policy will not pay for a diagnosis of a listed critical illness that is made before the covered person's Critical Illness effective date with Guardian.
A pre-existing condition includes any condition for which an employee, in the specified period of time prior to coverage in this plan, consults with a physician, receives treatment, or takes prescribed drugs.
Benefits for the second occurrence (recurrence) of that same illness will be available only if the illness occurs again after a period of at least 6 months in a row during which: 1) This coverage was in place without interruption; 2) No symptoms were exhibited; 3) No care or treatment was received for the illness. For the purposes of this limitation, care or treatment doesn’t include preventive medications taken in the absence of disease. Care or treatment also doesn’t include any routine, regularly scheduled follow-up visits with a physician.
This advertising content is not currently intended for anyone in the state of New Mexico.
1 Currently available in the following states: AK, AL, AR, AZ, CT, DC, DE, GA, HI, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI*, MN, MO, MS, MT, NC, ND, NE, NH, NV, OH, OK, OR, RI, SC, SD, TN, TX, UT, VA, VT, WI, WV, WY.
MI* 51+ eligible lives.
Infertility benefits available only for groups with 100+ eligible lives.
2 One wellness benefit per calendar year per covered person if a covered person has a wellness test or procedure performed while coverage is in force. See your plan details for benefit amounts.
4 The State of Fertility & Family Benefits in 2023, Maven Clinic
5Hypothetical example for illustrative purposes only.
Guardian’s Group Critical Illness Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. This is a limited plan of supplemental health insurance that provides the specified financial support, as a lump sum or indemnity payment, following the diagnosis of a critical illness. This is not minimum essential coverage as defined by federal law. This coverage will not reimburse for hospital or medical expenses. Generic Policy Form # GP-1-CI-14; CI-23-P; GP-1-Cl-15-WA. The state-approved form is the governing document.
Summary of Plan Limitations and Exclusions (for GP-1-CI-14)
The policy has exclusions and limitations that may impact the eligibility for or entitlement to benefits under each covered condition. There are limitations & special requirements for each condition. See the certificate of coverage or contact your sales representative for full details.
This policy will not pay for a diagnosis of a listed critical illness that is made before the covered person's Critical Illness effective date with Guardian.
We will not pay benefits for the First Occurrence of a Critical Illness if it occurs less than 3 months after the First Occurrence of a related Critical Illness for which this Plan paid benefits. By related we mean either: (a) both Critical Illnesses are contained within the Cancer Related Conditions category; or (b) both Critical Illnesses are contained within the Vascular Conditions category.
We will not pay benefits for a second occurrence (recurrence) of a Critical Illness unless the Covered Person has not exhibited symptoms or received care or treatment for that Critical Illness for at least 12 months in a row prior to the recurrence. For purposes of this exclusion, care or treatment does not include: (1) preventive medications in the absence of disease; and (2) routine scheduled follow-up visits to a Doctor.
We do not pay for a third or later occurrence of a critical illness.
First & second occurrence refers to the first & second time an insured experiences or is diagnosed with a covered critical illness while covered under Guardian Critical Illness insurance.
A pre-existing condition includes any condition for which an employee, in the specified period of time prior to coverage in this plan, consults with a physician, receives treatment, or takes prescribed drugs. Please refer to the plan documents for specific time periods.
If the plan is new (not transferred): During the exclusion period, this critical illness plan does not pay charges relating to a preexisting condition. If this plan is transferred from another insurance carrier, the time an insured is covered under that plan will count toward satisfying Guardian’s pre-existing condition limitation period. Please refer to the plan details for specific time periods. State variations may apply.
We do not pay benefits for charges relating to a covered person: taking part in any war or act of war (including service in the armed forces), committing a felony or taking part in any riot or other civil disorder or intentionally injuring themselves or attempting suicide while sane, or insane.
In order to be eligible for coverage: Employees must be legally working: (a) in the United States or (b) outside the United States, for a US based employer, in a country or region approved by Guardian. Subject to state specific variations.
Employees must be working full-time on the effective date of coverage; otherwise, coverage becomes effective after the completion of the specific waiting period.
Health questions are required for all late enrollees. Benefit increases may require underwriting.
This coverage will not be effective until approved by a Guardian underwriter. This proposal is subject to satisfactory financial evaluation. Please refer to certificate of coverage for full plan description; plan documents are the final arbiter of coverage.
Summary of Plan Limitations and Exclusions (for CI-23-P)
No benefits are payable for the following:
An illness that’s not listed in the Covered illnesses section.
An illness that’s diagnosed after your death unless there’s an exception specifically listed in this guide that we’ll accept a death certificate or autopsy report confirming the diagnosis of that illness.
An illness that’s diagnosed when you’re not covered by this Plan.
Any care, service or treatment that’s received when this coverage isn’t in place.
An illness or condition that’s contributed to or results from any of the following:
Participating in a felony, riot, or insurrection
Intentionally causing a self-inflicted injury
Suicide or attempted suicide while sane or insane
Engaging in any illegal activity
Serving in the armed forces or any auxiliary unit of the armed forces of any country (This exclusion doesn’t apply to the PTSD benefit.)
The voluntary use of any poison, chemical, substance defined as a controlled substance by Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, or prescription drug, unless prescribed by a physician and used as prescribed
The voluntary use of a non-prescription drug inconsistent with package instructions
War or act of war, even if war isn’t declared 2[(This exclusion doesn’t apply to the PTSD benefit.)
An illness or condition that’s diagnosed outside the United States unless the diagnosis is confirmed in the United States. If the diagnosis is confirmed in the United States, the diagnosis will be considered to have been made on the date it was made outside the United States.
Any care, treatment or service received outside the United States.
Any illness, care, treatment, or service that violates local, state or federal law or for which our paying a benefit would violate local, state or federal law.
Any claim for a benefit that isn’t specifically listed as an available benefit under the member guide.
An illness that’s diagnosed by you or a member of your immediate family or a business associate.*
Immediate family includes the following:
Your spouse or anyone with whom you live and share financial assets and obligations.
Your child
Your parents, including stepparents and mother-in-law and father-in-law
Your siblings, including stepbrothers and stepsisters
Your brothers-in-law and sisters-in-law
Your grandparents, including step-grandparents
Your grandchildren, including step-grandchildren
Any relative living with you
Immediate family also includes the spouse of anyone listed above.
*This exclusion is not included for Arizona.
This policy will not pay for a diagnosis of a listed critical illness that is made before the covered person's Critical Illness effective date with Guardian.
A pre-existing condition includes any condition for which an employee, in the specified period of time prior to coverage in this plan, consults with a physician, receives treatment, or takes prescribed drugs.
Benefits for the second occurrence (recurrence) of that same illness will be available only if the illness occurs again after a period of at least 6 months in a row during which: 1) This coverage was in place without interruption; 2) No symptoms were exhibited; 3) No care or treatment was received for the illness. For the purposes of this limitation, care or treatment doesn’t include preventive medications taken in the absence of disease. Care or treatment also doesn’t include any routine, regularly scheduled follow-up visits with a physician.
This advertising content is not currently intended for anyone in the state of New Mexico.