Group Disability Income Insurance

Transcription

1 Group Disability Income Insurance Underwritten by The United States Life Insurance Company in the City of New York Benefits Guide for CPhA Members Stand-alone OR As A Complement This group coverage can be your sole, stand-alone disability insurance coverage. Or, if you have some type of disability coverage through an employer, this plan can be used to complement it. That s an approach some of our members take because these benefits are NOT taxable,* unlike most employer plans and the coverage is 100 percent portable, provided you pay your premiums. Questions? CPhA CPhA.Insurance.service@mercer.com *Consult your personal tax advisor for specific details. Eligibility As a California Pharmacists Association member, you are eligible to request coverage under this group plan if you are: A member in good standing Under age 60 Actively Working Full-Time (at least 30 hours per week) (Not available in all states at this time. Contact the Administrator for current information.) Diagnostics: 3 Key Reasons You May Need Disability Coverage Your income is substantial and your lifestyle is based on the assumption of that income stream Your expenses are significant, including: mortgage(s) children s college education savings to fully fund retirement savings to fully fund monthly living expenses healthcare costs, insurance student loan debt office rent/maintenance Your livelihood demands full use of your mind and body Common Accidents & Medical Conditions That Could Result in Disability Motor Vehicle Accident Sports Injury Fall (ex: from ladder doing work around the home) Arthritis Neuropathic Damage Degenerative Disc Disease Post-Traumatic Stress Disorder Depression, Anxiety Disorder Visual or Auditory Impairment Stroke, Heart Attack, Aneurysm Multiple Sclerosis, Parkinson s Disease, ALS Cancer

2 Advantages How This Plan Works H Your own occupation protection for the first 60 months of disability As a pharmacist, your job is highly specialized. And if you are totally disabled due to an injury or sickness and can t perform the material duties of your regular job for the first 60 months, the plan will pay you monthly income benefits. H Your coverage is portable you can take this plan with you anywhere you go* Unlike other employer-paid or sponsored plans, you own your CPhA group coverage. It can go wherever you go, as long as you remain a CPhA member, you are under age 70, the group policy does not end, you continue to pay your premiums when due, you do not cease active work (except for reasons of total disability), and the CPhA remains a participating association. You don t have to worry about losing your disability insurance simply because you change employers or if you strike out on your own as part of a practice or as a sole pharmacist. H You pay group rates typically a savings over individual coverage This plan is only available to CPhA members and rates have been specifically negotiated on your behalf. *Subject to policy terms and U.S. government regulations on restricted countries. 2

3 Advantages How This Plan Works Group disability income insurance, underwritten by The United States Life Insurance Company in the City of New York, can help protect your income if you become totally disabled due to injury or sickness and unable to perform the material duties of your regular job. Our disability program recognizes your regular job for the first 60 months of a total disability. Choice of Plans You can choose either the: Two-Year Plan provides benefits for total disability due to an injury or sickness for up to 2 years. Long-Term Plan provides benefits for total disability due to an injury or sickness up to Normal Retirement Age if total disability begins prior to age 60, or to age 65 if total disability begins on or after age 60 but prior to age 64, or 12 months if total disability begins on or after age 64 but prior to age 70. Choice of Benefit Amounts If you are under age 50 on the effective date of coverage, you may apply for benefits up to $10,000 per month. If you are at least age 50, but under age 60 on the effective date of coverage, you may apply for up to $6,000 per month. The amount you choose cannot exceed 60% of your basic monthly pay. At age 65, the benefit amount is reduced by 50% of the amount in effect on the day before you attained age 65. Choice of Waiting Period You determine how long a waiting period you need between the date of disability and payment of benefits. Choose either a 90- or 180-day waiting period. If you elect the two-year plan, only the 90-day waiting period is available. Special Features Definition of Total Disability You will be considered totally disabled if you are completely unable to perform the material duties of your regular job during the waiting period and the next 60 months of a total disability. Your regular job is that which you were performing on the day before total disability began. After such 60 month period, you will be considered totally disabled if you are unable to perform the material duties of any gainful job for which you are reasonably fit by training, education or experience. The total disability must be a result of an injury or sickness. To be considered totally disabled, you must also be under the regular care of a physician, other than yourself and not performing the duties of any gainful job. Residual Disability Benefit If you return to your regular occupation and sustain a loss of at least 25% of your predisability earned income, you may receive a residual disability benefit proportionate to your percentage of continuing income loss. For example, if you return to your work part-time and you sustain a loss of 1/3 of your monthly income, you may receive 1/3 of the monthly disability benefit. Waiver of Premium If you become totally disabled as defined by the group policy and receive monthly benefits for 6 continuous months, future premiums will be waived for as long as you are entitled to receive benefits. When you stop receiving monthly benefits, premiums must again be paid when due. Monthly Benefits To Be Paid For Mental, Nervous Or Emotional Disorders, Alcoholism and Drug Addiction Disabilities due to nervous, mental or emotional disorders, alcoholism or drug addiction are covered for up to a maximum of 24 monthly benefits while such disability continues. After that, benefits will only be paid if you are an inpatient under a doctor s care in a hospital or institution as a result of the disability, but not beyond the maximum benefit period. Recurrent Disability Disability due to the same or related cause, when separated by a return to active work for 3 or more continuous months, will be treated as a new claim subject to a new waiting period and benefit period. If less than 3 months has passed, it will be treated as part of the original claim. Disability due to a different cause is automatically considered as a new claim. 3

4 Advantages How This Plan Works Optional Benefits For an extra premium cost, you can add one or more of the following benefits: Cost-of-Living Adjustment (COLA) Recovery Benefit Cost-of-Living Adjustment (COLA) You may elect to have your monthly benefit amount adjusted on a compounded annual basis with changes in the cost of living. Adjustments will begin on the 25th month after your period of disability and the amount of adjustment will be one-half of the percentage change in the Consumer Price Index, or 6%, whichever is less. Annual increases will continue until the earliest of: 10 annual increases have been made; the end of your disability; or the end of the maximum benefit period. Eligibility All members in good standing under age 60 are eligible to apply as long as they are actively at work on a full-time basis (at least 30 hours per week). Effective Date The insurance will take effect on the date United States Life approves the request, provided the required premium is paid. You must be actively at work on the date your insurance is to take effect. If not, the insurance will take effect on the day you resume such work. Recovery Benefit This option pays you a lump sum equal to one-fourth of the monthly benefit amount received for each full month of total disability if you return to your regular occupation on a full-time basis after having received total disability benefits. Maximum payable is three months of the Monthly Benefit Amount. This benefit is not payable if residual disability benefits have been paid. 4

5 Current 2013/2014 Group Rates for Members Two-Year Plan Semiannual Premium Per $1,000 of Monthly Benefit Age 90-Day Waiting Period Under AGE 30 $23.00 AGE 30 but before AGE 35 $28.00 AGE 35 but before AGE 40 $30.00 AGE 40 but before AGE 45 $43.00 AGE 45 but before AGE 50 $56.50 AGE 50 but before AGE 55 $76.00 AGE 55 but before AGE 60* $ AGE 60 but before AGE 65* $ AGE 65 but before AGE 70* $ Long-Term Plan Semiannual Premium Per $1,000 of Monthly Benefit Age 90-Day Waiting Period 180-Day Waiting Period Under AGE 30 $92.58 $72.76 AGE 30 but before AGE 35 $ $88.24 AGE 35 but before AGE 40 $ $99.08 AGE 40 but before AGE 45 $ $ AGE 45 but before AGE 50 $ $ AGE 50 but before AGE 55 $ $ AGE 55 but before AGE 60* $ $ AGE 60 but before AGE 65* $ $ AGE 65 but before AGE 70* $ $ ACT NOW to request insurance protection before an accident, injury or illness makes it harder or impossible to get! * For renewal purposes only. At attained age 65, your benefit per month of total disability will be reduced by 50% of the amount in effect on the day before you attained age 65. Coverage terminates at age 70. Ways to Manage Your Premium Disability insurance to help replace lost income can be a critical part of any sound financial planning for pharmacists. The CPhA Group Disability Income Insurance Plan is flexible, giving you options so you can easily customize coverage that best meets your income replacement needs with the benefit/premium configuration that s tailored to your budget. Strategy A Start income benefit checks ASAP so you have an income stream quickly Choose the 90-day waiting period This approach is a good choice if your need for income is such that you do not want to use (or do not have) savings as a fallback at the start of your disability. Some pharmacists choose this option because they want to replace lost income starting as soon as possible. Strategy B Make your premium more economical by delaying the start of income checks Choose a longer waiting period as long as 6 months (180 days) This approach is a good choice if you can wait for your benefit payments to begin, perhaps using your own savings in the interim. You ll see that your premium is more economical because of the longer waiting period, so you can significantly reduce your cost of coverage if you select 180 days. SEND NO MONEY NOW 30-Day Free Look As a CPhA member in good standing, you are NOT required to send any premium payment with your application. All applications will be processed promptly and coverage issued for every eligible member whose evidence of insurability is found to be satisfactory. We want you to be 100% satisfied with your coverage before you pay. As soon as your application is approved, you ll be sent a Certificate of Insurance with more information about your group coverage benefits. Review it for a full 30 days. If you are not satisfied for any reason: Return your Certificate marked Cancel within those 30 days and your coverage will be invalidated, no questions asked, provided there have been no claims. You ll owe nothing. 5

6 Duration Of Benefits Monthly benefits will be paid up to the maximum benefit period. The duration of this period is based on your attained age when you become disabled. The benefit will end on the date: you fail to give required proof of continuing total or residual disability; your total or residual disability ends; the maximum benefit period ends; or you die. When Coverage Ends Your coverage will terminate for any one of the following reasons: when you reach age 70; you cease to be a member of the Association; you are no longer working 30 hours per week for reasons other than total disability; you fail to pay premiums when due; the group policy ends; or the Association ceases to be a participating Association. Exclusions No monthly benefit will be paid for disability due to: intentionally self-inflicted injury; a war or an act of war; committing a crime or an attempt to do so; disability which commences during, or as a result of an injury or illness that occurs during full-time active duty in the armed forces of any country; or travel in, flight or getting in or out of: 1. an aircraft being used for testing or experimental purposes; or 2. an aircraft being piloted by the insured, or being flown for the purposes of pilot training; or 3. a military aircraft other than transport aircraft flown by the Military Airlift Command or similar transport service of another country. Pre-Existing Conditions Limitation Pre-Existing Condition means an injury or sickness for which the member: a) incurred charges; b) received medical treatment; c) consulted a physician; or d) took prescribed drugs within 12 months before becoming insured by this plan. If total disability is due to a pre-existing condition and it begins within 12 months of the date the member becomes insured by this plan, no benefits will be paid unless the member has not: a) incurred charges; b) received medical treatment; c) consulted a physician; or d) taken prescribed drugs for such condition, or any complication of it, for 12 continuous months, while insured. 6

7 Questions? Call Toll-Free CPhA 8:00 AM - 5:00 PM Monday-Friday If you have any questions about your eligibility, what the plan covers, rates, or how to complete the application, please do not hesitate to call. A Client Advisor will be able to immediately provide you with the information you need. Or you can us: CPhA.Insurance.service@mercer.com About Our Role and Compensation The California Pharmacists Association has selected The United State Life Insurance Company in the City of New York for this insurance program. Alternative insurance products may be available in the insurance marketplace. Mercer Health & Benefits Insurance Services LLC is providing this single insurer option on behalf of the California Pharmacists Association. In accordance with industry custom, we are compensated through commissions that are calculated as a percentage of the insurance premiums charged by insurers. We may also receive additional monetary and nonmonetary compensation from insurers, or from other insurance intermediaries, which may be contingent upon volume, profitability, or other factors. This compensation may include payment from insurers for marketing related expenses or investments in technology. Our compensation may vary depending on the type of insurance purchased and the insurer selected. We will provide you additional information about our compensation and information about alternative quotes, upon your request. You may obtain this information by referring to and entering the security code E or call us at for specific details. CA Ins. Lic. #0G39709 Mercer Health & Benefits Insurance Services LLC CPhA CPhA.Insurance.service@mercer.com Sponsored by: Underwritten by: The United States Life Insurance Company in the City of New York The underwriting risks, financial and contractual obligations and support functions associated with products issued by The United States Life Insurance Company in the City of New York (United States Life) are its responsibility. The most prominent independent ratings agencies continue to recognize The United States Life Insurance Company in the City of New York in terms of insurer financial strength. For current insurer financial strength ratings, please consult the website at The enclosed materials are a brief description of coverage provided under Group Policy No. G-216,173, Form No. G-19000, and are subject to the terms, conditions, limitations and exclusions of the policy. Please see the Certificate of Insurance for details. Plan may vary or may not be available in all states. AG S. Figueroa Street Los Angeles, CA #4-454 (1/14) Copyright 2014 Mercer LLC. All rights reserved. 7

8 Disclosure Notice (Retain For Your Records) MIB Disclosure Notice Information regarding your insurability will be treated as confidential. The United States Life Insurance Company in the City of New York or its reinsurers may, however, make a brief report thereon to the MIB, Inc., formerly known as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, MIB, upon request, will supply such company with the information about you in its file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at (TTY ). If you question the accuracy of the information in MIB s file, you may contact MIB and seek a correction in accordance with the procedures set forth in the federal Fair Credit Reporting Act. The address of MIB s information office is 50 Braintree Hill Park, Suite 400, Braintree, Massachusetts The United States Life Insurance Company in the City of New York, or its reinsurers, may also release information from its file to other insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Information for consumers about MIB may be obtained on its website at Note: Canadian Members should continue to use the following address: 330 University Avenue, Suite 501, Toronto, Ontario, Canada, M5G 1R7, tel. no Notice As Required Under The Fair Credit Reporting Act(s) This is to inform you that as part of our procedure for processing your insurance application, an investigative consumer report may be requested for the preparation of a report whereby information is obtained through personal interviews with your neighbors, friends, or others with whom you are acquainted or who may have knowledge of any such items of information. This inquiry includes information as to your character, general reputation, personal characteristics, and mode of living. You have the right to make a written request to be informed as to whether or not such consumer report was requested, and if such report was requested, the name and address of the consumer reporting agency to whom the request was made. You may receive a copy of this report by contacting such agency. 8