Critical Illness
Critical Illness insurance offers a lump-sum benefit to provide financial help during challenging health times, such as a heart attack, stroke or cancer diagnosis. It provides a cash benefit to help pay for out-of-pocket costs, such as medical expenses or day-to-day expenses.
Rates will be calculated during enrollment, as cost is based on several factors, including levels of coverage (face amount), age, and coverage tiers (Employee, Employee & Spouse, Children). Spouse age will be based on the Employee’s age.
Coverage Amounts
Covered Conditions
Pre-existing conditions are excluded
- Stroke: 100%
- Heart attack: 100%
- Coronary artery disease (with bypass): 100%
- Coronary artery disease (with coronary intervention): 100%
- Major organ failure: 100%
- End stage (renal) kidney failure: 100%
- Invasive cancer: 100%
- Non-invasive cancer: 25%
- Skin cancer: 2.5%
Health Screening Benefit
Each covered family member can receive $50 per screening per year for getting a covered screening test:
- Annual exams: physicals, well-child visits, or dental and vision exams
- Screenings for cancer: including pap smear and colonoscopy
- Cardiovascular function screenings
- Screenings for cholesterol and diabetes
- Imaging studies, including chest X-ray, mammography
- Immunizations including HPV, MMR, tetanus, influenza
How to File a Claim
1. You've Had a Need to Use Your Benefits
You or a covered loved one has an illness, injury or hospitalization that's covered by your benefits.
2. It's Time to File Your Claim
- You can submit a claim online at myNYLGBS.com. If it’s your first visit to the site, be sure to click “Register here” to set up your online account.
- Please note that in most cases, we’ll need you to include documentation to support your claim, such as medical records, doctor’s notes, or hospital discharge summary.
- Submitting your claim through myNYLGBS.com allows for the fastest claim process. Make sure to have direct deposit or EFT (Electronic Funds Transfer) set up ahead of time, so that you receive your claim payment faster.
- You can also submit by phone at (888) 842-4462 or (866) 562-8421 (español), or by mail (print a claim form and mail it to us).
3. Claim Review
- Once your claim has been received, one of our claim managers carefully reviews it.
- Sometimes, additional information is needed to help us make a claim decision. We will let you know if there’s anything else needed, and you can easily send us any missing documentation through myNYLGBS.com.
4. Claim Decision Notification
- You’ll be notified as soon as we’ve made a decision on your claim.
- Approved claim payments will be issued via direct deposit if you’ve signed up for Electric Funds Transfer or by mailed check.
5. If You Need to File a Claim for Your Health Screening Benefit
Provide the date and type of screening – claims can be approved and paid within 48 hours. Make sure to choose direct deposit to get your money even faster.
