How do I join Missouri Fire Fighters Critical Illness Pool (MFFCIP)?

If you would like to become a member today, review the checklist for joining MFFCIP.

What are the annual costs per firefighter and coverage limits?

For pricing information, visit the Cancer Program page.

What is the purpose of the MFFCIP?

The purpose of MFFCIP is to put forth a program that equitably ends numerous years of contentious discussion at the legislature—due to conflicting studies on numerous carcinogens in the workplace and their causal relationship to 17 identified cancers—between labor and management interests over the presumption of cancer for firefighters.

Cancer rates are high for the general public without the added exposure caused by firefighting. It appears reasonable, on the surface, to have a rebuttable presumption where the burden of proof is on the employer to disprove a cancer is job related. Several states currently do just that, including Colorado. Unfortunately, those states’ firefighters and their operation’s management—even with presumptive legislation—often see two-thirds of their cases denied or stalled in litigation, sometimes for years, while employers gather evidence to disprove the cancer was job related. This often accompanies a tentative notice of denial and an invasive three-to-six month investigation which can further tax the firefighter’s physical and mental health as well as their families. As it currently stands, in these states with rebuttal presumptions, the Workers’ Compensation system and subsequent legal battles do not benefit firefighters as they diagnose, treat, and recover from cancer.

For employers in states that see non-rebuttable presumptions, employers pay for more claims than are actually job-related. Such claims are primarily due to heredity, lifestyle, hobbies, or environmental exposures outside of work. Continuing with this approach is arguable less fiscally feasible especially for firefighters’ employers that lack adequate funding.

While we acknowledge that a presumption without rebuttal has its advantages, it is often viewed as an inaccessible privilege for firefighters employed by fire operations that are often lacking adequate funding.

Cancer claims are already covered under current health plans, disability, and social security. It is also important to note that firefighters, under managed care and adjudication through the Workers’ Compensation system, lack the ability to choose their own doctors for timely treatment as they do under their own medical plans.

What is the Cancer Award Program?

In many states, this program is a nontaxable accident coverage benefit intended to supplement or pay for the out-of-pocket expenses and provide additional compensation for other benefits such as experimental treatment as best determined by the firefighter. The details of this program include the following:

  1. Pool formation will use existing MO enabling statute section 537.620 within the Uniform Individual Accident and Sickness Insurance Law to form the Pool.
  2. Cash awards are paid within 10 days of a completed application to include the attending physician’s diagnosis.
  3. Up to $4,000 disbursements are made semi-monthly based on schedule of benefits.
  4. Payments are made before sick leave and vacation time need to be used.
  5. Diagnosis for the purposes of this program with the employers’ agreement will be treated as an at-work occurrence for the purpose of paying applicable benefits but not prompting a Workers’ Compensation claim.
  6. This program coverage is technically not disability insurance; it is accident coverage.
  7. This benefit does not exclude the filing of a Workers’ Compensation claim; however, any payments made under this program will be offset under Workers’ Compensation.

What is the organizational structure?

MFFCIP is owned and operated by Missouri Fire operations appointed board. Stakeholders from numerous organizations address all issues and provide guidance. An original steering committee of three to five, comprised of representatives from participants, also provides input. Following implementation, the steering committee has the option to expand to include representation from Chiefs, HR, risk managers, finance, and professional firefighter organizations. The Board of Trustees is appointed by the Fire Chiefs Association from member representative nominations.

What cancers are covered?

Seventeen specific cancers are covered including: bladder, brain, breast, colon, esophagus, kidney, lung, melanoma, mesothelioma, multiple myeloma, NHL, prostate, rectal, skin, stomach, testicular, and thyroid.

Others cancers or diseases which adversely affect firefighters can be added by the Board as new studies or findings are published. Smoking, or the use of tobacco products reduces benefits by 25%. The consideration of Breast Cancer and Heart Disease, which have already been implemented in Colorado can be considered.

What are my choice of limits and cost options?

Maximum Limits available will be $100K, $200K, or $300K. The estimated cost per full-time firefighter is roughly $100, $200, or $300 annually. Part-time and volunteer rates are roughly 40% the cost of full-time rate. Total number of eligible firefighters in Missouri: 7,000 career and 16,000 volunteer. Cost of Living Adjustment (COLA) on limits and contributions applicable annually.

Is MFFCIP financially stable to fulfill claim obligations?

The cancer benefit plan places an aggregate limit of $300,000 for a covered cancer type. The annual rates are developed based on the CDC, Cancer Society, and the Colorado program’s statewide claims data for ten years. MFFCIP funds to the recommendations of its actuary. The Pool expects to have the capacity to finance multiple full-limit claims every year. Full limit payouts are spread out over three years to allow for rate adjustments going forward if necessary. Funding is expected for MFFCIP at a 95% confidence level.

How much is paid-out under MFFCIP?

Awards are organized into eleven award levels. Limits available are $100,000, $200,000 or $300,000 depending on both the plan limit selected as well as the covered individual’s type and stage of cancer. Awards under $4,000 are paid-out in a lump sum while amounts over this will pay $4,000 every two weeks.

Can we cancel coverage or opt-out during the coverage period?

No; however, you may choose not to renew your annual coverage when it expires.

What are the eligibility requirements for firefighters?

Firefighters are eligible under the following criteria:

  1. The firefighter’s employer must elect to join the Pool and pay their annual contribution.
  2. Firefighter must have been active for five years with a minimum of 24 hours of training.
  3. Firefighter must have been exposed to hazardous duty as defined in MO statute
  4. Firefighter must be listed on the roster and a contribution paid

If a covered individual has cancer that resurfaces, are they eligible again?

They would be eligible for a different type of covered cancer or an advancement of the same previously covered cancer to the next stage. For an advancement of the same cancer, the only difference is in the amount of benefits that will be awarded.

Can an employee still file a Workers’ Compensation claim?

Yes; however, it may not make sense to do so. The legislation, as currently proposed, has financial offsets.

Worker’s compensation statute still gives firefighters the right to file a claim for a work-related disease, but the burden of a preponderance of evidence is on the firefighter to prove that the cancer was job-related. If a claimant does receive an award under Workers’ Compensation, it would be offset by any payments issued under the Cancer Award Program.

What happens with claims already filed under Workers’ Compensation?

The cancer claims that were already/previously filed under Workers’ Compensation will continue to be handled by the Workers’ Compensation system. Only future cancer claims will be considered by the Cancer Award Program as long as the fire entity is a member of MFFCIP. In case the fire entity decides to opt-out of the Cancer Award Program in the future, it will fall back under Workers’ Compensation statute for any new claims. Existing claims filed under the Cancer Award Program at the time of diagnosis are handled by the MFFCIP. Offsets exist as to not duplicate benefits paid.

Is the award considered disability coverage or medical coverage?

Neither. It is a cash award based solely on diagnosis. The reimbursement is set for the covered firefighters’ anticipated out-of-pocket expenses due to cancer for an indefinite period in the future.

Do employers face unlimited liability under the Cancer Award Program?

No, the coverage is limited to fifteen years after the last day of employment or hazardous service as long as your department is in the Cancer Award Program. Most cancers take 5-7 years to manifest from workplace exposure.

Are retirees covered under the Cancer Award Program?

Yes. After you opt-in to the Cancer Award Program, retirees are automatically covered for fifteen years up to the age 70 from the last day of hazardous duty, provided that the initial diagnosis is made after the employer joins MFFCIP and they have met the other eligibility requirements, including that the department continues participation in the Cancer Award Program.

What happens to claims if we opt-out a few years later?

The claims already filed under the Cancer Award Program will continue to be handled by MFFCIP.

Is there a Coverage Plan Document available?

Yes, it is available for view here. Our diagnosis-based coverage form works like an accident policy, with cash awards set to cover many of the out-of-pocket expenses or deficiencies between an employer’s current medical benefits, retirement, short and long-term disability, and post-employment medical benefits.