Long Term Disability

Most of us think nothing of insuring our cars, homes and other valuables.  But many of us overlook protecting our most valuable asset ... the one that makes all the others possible ... our income.

 

Of course, life insurance takes care of future income loss in the event of death.  But what happens when you lose your earning power while you’re still alive? How would you manage without an income for months, or even years?  It’s easy to say, “It won’t happen to me.” But before you do, consider this -

  • More than 3 out of 7 workers will have a long-term disability before age 65. (Transactions, Society of Actuaries, 1987 Reports)
  • The chances of suffering a long-term disability before retirement are more than twice that of dying. (Transactions, Society of Actuaries, 1987 Reports, and Internal Revenue Code, Section 79, Regulations, Table 1)

Current Sources of Disability Income

 

Right now, you have some disability protection through your accumulated sick days.  But an accident or illness could keep you from working for years, or possibly your entire working life.

 

What about Social Security benefits and our pension plan?

 

Before you feel too secure about those sources of income, take note of these facts -

  • For the average PEF member, Social Security replaces only 30%-42% of income; higher salaried workers may get less than 25%. (1991 Guide to Social Security)
  • To qualify for an early pension, you need at least 10 year’s service.  And even if you do qualify, it takes many service years to generate a decent benefit.
  • Both plans have very strict definitions of what constitutes total disability, and require much red tape before benefits are finally paid out.

The real question is:  Can you afford the wait and the uncertainty of these options?

 

If you’re like most people, probably not. That’s why the PEF Membership Benefits Program has arranged for a Long-Term Disability Insurance Plan from Hartford Life, a leader in group disability benefits. It’s the best way we know for protecting the asset you value most - your ability to earn an income.

 


Long Term Disability Plan

 

Eligibility

 

All members of the Public Employees Federation working at least 18-3/4 hours per week on a regularly scheduled basis are eligible for the LTD plan.

 

Plan Options

 

Your PEF LTD plan offers two levels of coverage from which you can choose: 50% or 60% of your salary as of January 1st of the year you become disabled, up to $5,000 a month, after a six-month elimination period.  Elimination period means the period of time you must be disabled before benefits become payable. Once the elimination period ends, you’re guaranteed monthly income for as long as you’re disabled up to age 65.   (Disabilities that start between the ages of 62 and 69 are covered from one to three-and-a-half years.  Consult your insurance certificate for details.)  Please refer to the Plan Costs chart on pages 6 and 7.

 

LTD Benefits

 

Your LTD benefit percentage will be based on your salary, and will not take into account earnings from investments or savings plans. The plan will offset your benefit payments by other sources of income for which you may be eligible, such as:

  • Workers’ Compensation
  • Sick pay
  • Social Security (Primary and Family Source)
  • Disability pension or any New York State retirement payments
  • Any other group or association benefits for disability,  retirement or unemployment
  • Benefits from your PEF sponsored Short Term Disability (STD) program will offset benefits payable under this LTD program only when the STD benefits combined with PEF LTD benefits exceed 85% of your income.

However, your LTD benefit payments will not be reduced if Social Security benefits increase for general cost-of-living adjustments.

 

Furthermore, your LTD benefit payments will be offset by no more than 40% of employment or retirement income from sources other than New York State which you were receiving prior to disability.

 

Regardless of how much in other benefits you may be eligible for, your LTD benefit will never be less than $100 a month. Our disability claim specialists are available to help make sure you receive all the benefits you’re entitled to receive.

 


 

Definition of Disability

 

The definition of disability is the inability to engage in the material and substantial duties of your occupation during the first 2 1/2 years that benefits are payable. Thereafter, disability is the inability to perform any occupation for which you are or can become qualified by training, education or experience.

 

In addition to having more of your income replaced, your chances of qualifying for benefits are much better with this LTD plan than with Social Security or your pension. Your pension plan states you must be permanently disabled in your own occupation; Social Security states you must be permanently unable to perform any job in order to qualify for benefits.

 

This LTD plan does not require you to be permanently disabled to qualify for benefits.  For 2-1/2 years following the six-month elimination period, you’ll receive benefits if you’re unable to perform the duties of your own occupation. Then, after 2-1/2 years of receiving benefits, LTD payments will continue if you can’t perform the duties of any occupation for which you are or can become qualified by training, education or experience.

 

Financial experts agree that having coverage in your own occupation is one of the features to look for in a good disability income plan.

 


 

Important Advantages

  • Premiums paid through convenient payroll deduction.
  • Acceptance is guaranteed for new employees enrolled within 120 days of the date they were first eligible to become a member of PEF.
  • No premiums due while receiving benefits.
  • Prompt claim service from a leader in the business.
  • Rates that are one-third to one-fifth the cost of a comparable individual plan.

 

Survivor Income Benefit

 

If you elect the 60% level, your plan will also include a three-month Survivor Benefit which pays your survivor a lump sum equal to three times your monthly benefit if you die while collecting disability income.

 


 

Enhancements to LTD Plan

 

Residual Disability

 

You no longer have to be totally and permanently disabled during the elimination period. You can be partially disabled during the elimination period and still working, earning up to 80% of your pre-disability earnings. Benefits still will not be paid until after the elimination period.

 

Rehabilitation Benefit

 

To encourage your return to a productive lifestyle, the plan pays a Rehabilitation Benefit if you return to work on a part-time basis and earn at least 20% but no more than 80% of your monthly indexed pre-disability earnings. In fact, your part-time earnings and residual benefit combined may equal up to 100% of your indexed pre-disability earnings.

 

To receive the Rehabilitation Benefit, a disability must prevent you from performing some, but not all, of the essential duties of your or any occupation.

 

Vocational Rehabilitation Family Care Credit

 

This benefit encourages your participation in a rehabilitative employment program by deducting the cost of family care from those employment earnings. There is a maximum monthly deduction of $250 during the first six months of rehabilitative employment and $125 thereafter, not to exceed the amount of your monthly earnings, and a $2,500 calendar year maximum.

 

Your net earnings after deducting the family care credit will be used to determine your net monthly benefit, which results in a greater monthly benefit. The sum of your net monthly benefit and gross income from rehabilitative employment, before deducting your family care credit, may equal up to 100% of your pre-disability earnings. If it exceeds 100%, your net monthly benefit will be reduced by the amount of the excess.

 

Accidental Dismemberment And Loss Of Sight

 

If you have an accidental injury that directly causes certain dismemberments or loss of sight within 90 days of the accident, the LTD monthly benefit will be paid for a minimum number of months even if you return to work sooner. The benefit is paid for at least: 46 months if you lose both eyes, both hands or both feet, or any combination of one hand, foot or eye; 23 months if you lose one hand or one foot; 15 months if you lose one eye; or 12 months if you lose a thumb and index finger of either hand.

 

For example, if you qualify for at least 23 months of benefits and you return to work after 20 months, you’ll receive three additional months of disability benefits.

 

If you suffer more than one loss in an accident, your number of monthly benefit payments is limited to the loss for which the greatest number of monthly payments apply.

 

Your monthly benefits may continue after the minimum number of payments have been made if you are then totally disabled.

 

Plan Costs  (Bi-weekly costs based on age and annual salary)

 

                                     Under Age 40                      Age 40-49                           Age 50+

Annual Salary      50% Level      60% Level  50% Level      60% Level   50% Level      60% Level

Less than 20,999     $2.21             $3.15            $3.36             $4.76            $4.63             $6.60

21,000 - 24,999         2.64               3.75              3.83               5.37             5.15               7.32

25,000 - 28,999         3.06               4.38              4.47               6.34             6.04               8.59

29,000 - 32,999         3.49               4.98              5.11               7.28             6.94               9.87

33,000 - 36,999         3.96               5.61              5.74               8.17             7.83             11.10

37,000 - 40,999         4.38               6.25              6.38               9.07             8.77             12.47

41,000 - 44,999         4.81               6.85              7.02             10.00             9.70             13.78

45,000 - 48,999         5.27               7.49              7.66             10.90           10.55             14.98

49,000 - 52,999         5.70               8.08              8.30             11.78           11.44             16.25

53,000 - 56,999         6.12               8.72              8.94             12.68           12.39             17.58

57,000 - 60,999         6.60               9.36              9.57             13.62           13.36             18.98

61,000 - 64,999         7.02             10.00             10.42             14.81           14.38             20.42

65,000 - 69,999         7.66             10.90             11.28             16.00           15.45             21.96

70,000 +                   8.30             11.78             12.13             17.23           16.55             23.53

Rates are based on 26 paychecks per year.  If you are not on a 26 bi-weekly pay period, call Corporate Benefit Planning for rates.

 

Questions and Answers

 

Q. Do I have to provide evidence of insurability when I enroll?

A.  If you enroll within 120 days of the date you were first ELIGIBLE to become a member of PEF, your application will automatically be approved. After 120 days, you will have to complete an Evidence of Insurability form that will need to be approved by Hartford before coverage can begin.

 

Q. If I become disabled, how long will I have to wait before receiving benefits?

A. Payments start after you have been disabled for 6 months.

Q. What if I go back to work after being disabled, and then get sick again?

A.  If during the elimination period, you return to work for less than 15 days and become disabled from the same cause, there will be no interruption in calculating the elimination period. You can be partially disabled during the elimination period and still working, earning up to 80% of your pre-disability earnings. However, benefits still will not be paid until after the elimination period.  If after receiving benefits, you return to work for 90 days only to become disabled again from the same cause, you will not have to go through another elimination period to resume benefit payments.

 

Q. Does this plan cover illnesses that occur before the insurance goes into effect?

A. Benefits are not payable for medical problems which existed prior to your effective date of insurance unless total disability commences on or after:  1) the last day of a 12-month period during which you did not receive treatment for that condition, or 2) the last day of a 24-month period during which you’ve been insured.

 

Q. Does this plan cover mental and nervous illnesses?

A. Yes, but those benefits are limited to a total of 24 months for all disability periods during your lifetime.  This limitation does not apply to periods of confinement in a hospital, or another qualified institution, for treating mental and nervous disorders, alcoholism and drug addiction.

 

Q. What happens if I leave my present job and am no longer a PEF member?

A. If you had the LTD Plan for 12 months, you may be eligible to convert your PEF sponsored LTD plan to a similar group plan at rates much lower than individual plan rates. Ask Corporate Benefit Planning for details.

 


General Information

 

Effective Dates

 

Your policy will become effective the first day of the month following the month your enrollment card is received by the Membership Benefits Program, provided you meet all the eligibility requirements and are not absent from work due to a disability on the date your insurance becomes effective. If you are absent from work due to a disability on that date, your insurance will become effective on the date you actually return to work on a full-time basis.

 

Coverage will continue for as long as the group contract is in effect, your premiums are paid, and you remain an active, eligible employee. However, if the contract terminates while you’re receiving LTD benefits, your payments will continue for as long as you’re disabled or until age 65.

 

How To Enroll

 

Send your completed enrollment form to PEF Membership Benefits Program. When your application is approved, your premiums will be automatically deducted from your paycheck.

 

Exclusions

 

Benefits are not payable for disabilities resulting from: the commission of, or attempt to commit an assault, battery or felony; war or act of war, insurrection, rebellion or participation in a riot or civil disorder.

 

Pre-existing medical conditions are subject to certain limitations.

 

For More Information

 

Corporate Benefit Planning can answer any questions about this program. Just call (800) 233-3394 or (518) 785-0115.

 

When your insurance goes into effect, you’ll receive a certificate of insurance and a booklet on how to file a claim.

This plan has been made available through the trustees of the PEF Membership Benefits Program, 1168-70 Troy-Schenectady Road, P.O. Box 12414, Albany, NY  12212.

 

Agent of record:

Corporate Benefit Planning

40 British American Blvd.

Latham, NY  12110

(518) 785-0115

(800) 233-3394

 

This policy provides disability income insurance only. It does not provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. The expected ratio for this policy is 80%. This ratio is the portion of future premiums which the company expects to return as benefits, when averaged over all people with this policy.

 

This brochure explains the general purposes of the insurance described, but in no way changes or affects the policy as actually issued. In the event of any discrepancy between this brochure and the policy, the terms of the policy apply. Complete details are in the certificate of insurance issued to each insured individual.

 

Underwritten by:

Hartford Life Insurance Company

Hartford Plaza

Hartford, CT 06115