Voluntary Critical Illness Products

Cost: $3,000; published 2016

Voluntary critical illness continues to be a dynamic and growing part of the voluntary/worksite market with double-digit sales increases for the last four years, according to Eastbridge’s U.S. Voluntary/Worksite Sales Report. It has quickly become a “core” voluntary product offering for voluntary carriers, along with voluntary term life, disability, dental and accident coverage. With the ever-changing structure, pricing and flexibility of critical illness in response to competitive and regulatory pressures, however, those that want to capitalize on the product’s growth will need to stay abreast of the overall market dynamics as well as the strategies, products and processes being employed by top players and competitors in the market.

The purpose of this report, Voluntary Critical Illness Products, is to review the current and future state of the critical illness marketplace and profile 27 voluntary critical illness products of 20 carriers active in the market. The following information is reported for each carrier:

  • Product structure and benefits
  • Scope of coverage and portability
  • Rates and commissions
  • Underwriting and claims
  • Competition and results
  • Future trends

The data is designed to help insurance carriers better understand the competitiveness of their critical illness product compared to others in the market.

View Table of Contents

1. Executive Summary

A. Report Objectives

B. Methodology

C. Key Findings

2. Market Overview and Competition

A. Market Overview

1. The Overall Voluntary Critical Illness Market

2. Employer Perspective

3. Employee Perspective

4. Broker Perspective

B. Key Competetitors

3. Product Details by Carrier

A. Product Structure and Specifics

1. Definition of Voluntary/Worksite

2. Employer Contribution Allowed

3. Benefit Type

4. Covered Conditions

5. Options for Removing Certain Conditions

6. Covered Conditions for Children Only

7. Categories of Coverage

8. Payment Basis and Lifetime Maximum

9. Partial Benefits

10. Minimum/Maximum Amounts Available

11. Elimination or Waiting Periods

12. Pre-Existing Conditions Exclusion

13. Wellness Benefit

14. Additional Occurrence Benefit

15. Re-occurrence Benefit

16. Additional Benefits, Riders or Unique Features

B. Scope of Coverage and Portability

1. Coverage for Others Besides Employee

2. Portability/Conversion Options and Rates

3. Rates and Commissions

a. Published or Census Rates

b. Issue or Attained Age Rates

c. Age-Rated or Composite Rates

d. Rate Structure for Family Coverage

e. Tobacco/Non-tobacco or Smoker/Non-Smoker Rates

f. Premium Guarantees Offered

g. Premium Rate Comparisons

h. Commissions

4. Underwriting

a. Employee Eligibility Guidelines

b. Types of Underwriting Used

c. Guaranteed Issue Guidelines

d. Simplified Issue Guidelines

e. Full Underwriting Guidelines

f. Spouse/Child Underwriting

5. Claims

a. Claims Problems/Issues

b. Top Three Claims Conditions

c. Average Speed of Claims Payment/Denial

d. Percent of Claims Denied

e. Anti-Selection Experience

4. Competition, Results and Future Trends

A. Competition and 2015 Results

1. Product Differentiators

2. Critical Illness Sales for 2015

3. Product Profitability

4. Length of Time in Market

5. Average Participation Percentage

6. Typical Policyholder and Account Demographics

7. Average Amount of Coverage

8. Average Annual Premium per Employee

9. Persistency/Lapse Rate

10. Takeovers vs Virgin Cases

11. Current Loss Ratio Comparison

B. Challenges and Trends

1. Product Challenges

2. Current and Future Product Trends


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