Member Handbook. Regina Civic Employees Long Term Disability Plan

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1 Member Handbook Regina Civic Employees Long Term Disability Plan

2 Table of Contents About the Plan.. Eligibility and Enrollment.... Contributions Definition of Disability.. Applying for Benefits... Qualifying Period. LTD Benefits..... Rehabilitation Employment.... Decision Appeal... Other Information The purpose of this handbook is to provide general information with regard to the provisions of the Regina Civic Employees Long Term Disability Plan, and is intended for a broad audience. For legislative certainty, please refer to Schedule A of Bylaw No If information you receive from this handbook or any other source differs from the Bylaw, the terms and provisions of the Bylaw shall prevail. Contact Us: Pensions & Disability Administration B Albert Street P.O. Box 3030 Regina, SK S4P 3G8 Call: (306) Fax: (306) Page 1

3 About the Plan The Regina Civic Employees Long Term Disability (LTD) Plan provides eligible members with protection against the potential loss of income in the event they become ill or accidentally injured. The Plan has been designed to compliment the members sick leave plan and to integrate with government disability programs. Some of the benefits of belonging to the Plan include: monthly disability payments equal to 65% of your pre-disability salary; coverage for recurrent disabilities; early access to diagnostics and surgeries; access to therapy programs, conditioning, and rehabilitation programs; and access to return to work programs such as cross jurisdictional placement, split shifts, and work from home programs. Participation The Plan represents employees from the following five employers: the City of Regina; the Regina Qu Appelle Regional Health Authority; the Board of Education of Regina (Division No. 4 of Regina non-teaching staff); the Regina Public Library Board; and the Buffalo Pound Water Administration Board. Investment Holdings Assets of the Plan are actively managed in accordance with the Statement of Investment Policies and Procedures. Governance The Plan is governed by a Board of Trustees made up of 12 voting members; two employer representatives appointed by the City Manager, four employer representatives appointed by City of Regina City Council, and six employee representatives elected annually by the membership. The Plan is reviewed by a qualified actuary at least every three years and is subject to the requirements of The Income Tax Act. Page 2

4 Eligibility and Enrollment Eligibility Permanent employees are eligible for membership in the Plan when they meet the requirements of their employer to become plan members and start contributing to the Plan. Casual or non-permanent employees are not eligible to participate in the Plan. If you are uncertain about your eligibility, your Human Resources or Personnel Department can advise if and when you are eligible to join the Plan. Enrollment All employees eligible for membership in the Plan will be enrolled automatically. Page 3

5 Contributions You and your employer make contributions to the Plan. The remainder of the cost to your long term disability benefits is paid for by the investment earnings of the Plan. Contribution rates are based on recommendations by the Plan actuary and are subject to change. Member Contributions In accordance with Schedule A of Bylaw No your contribution rate is 0.92% of salary. Example Calculation: 2013 Annual Salary: $47, % x $47,500 = $ Member Contributions for 2013 = $ While on disability, neither you nor your employer shall contribute to the Plan. Member contributions are automatically deducted from each pay you receive throughout the year. Your contributions to the Plan are tax deductible. Employer Contributions Your employer matches your contributions to the Plan on a monthly basis (at the same rate outlined above). Leave of Absence You may elect to continue long term disability coverage by contributing to the Plan during periods of: suspension; leave of absence without pay; or lay-off (up to 90 days). If you elect to continue coverage, contributions from your employer will only be required during: the first six months of your suspension or leave of absence without pay; or the lay-off period (up to 90 days). Please contact your employer regarding the leave of absence form and the terms and conditions of the extended coverage. The leave of absence form must be completed and signed before you leave in order to ensure your continuing coverage. Page 4

6 Civic Pension Plan While on long term disability, you are required to continue to contribute to the Regina Civic Employees Superannuation & Benefit Plan at a rate of 75% of that plan s normal contribution rate. You may waive the required contributions (and related service credits) only if you are receiving partial disability benefits which are 50% or less of the total disability benefit. Page 5

7 Definition of a Disability Total disability or totally disabled means any physical or mental condition which, based on medical evidence, is so severe that you are prevented from performing the duties of your own occupation during the 120 calendar day qualifying period and the first 12 months immediately following the qualifying period. Thereafter, total disability or totally disabled means a condition where you are unable to engage in any gainful occupation or employment for remuneration or profit, for which you are reasonably well qualified by education, training, or employment. Members who are no longer totally disabled are considered partially disabled and may be eligible for partial disability benefits under the Plan. Recurrent Disability If you have been receiving disability benefits from the Plan and have returned to work and subsequently become disabled within 12 months from the same or a directly-related cause which created the original disability, your benefits can be reinstated without completing another 120 day qualifying period. Limitations and Exclusions You will not receive long term disability benefits in the following situations: during your 120 day qualifying period; while you are receiving sick leave or ongoing vacation leave payments from your employer; or while you are receiving payments from the Workers Compensation Board (WCB) at the maximum compensable benefit level for a related injury or injuries. Date of Disability Your date of disability, as determined by the Administrative Board, shall be the later of: the day on which you stopped working as a result of the disability or the disablement date reported by the attending medical practitioner. Page 6

8 Applying for Benefits To apply for long term disability benefits, claim forms must be completed by: your employer (Employer Statement); yourself (Employee Statement); and your physician (Attending Physician s Statement of Disability). Your physician s form must be completed by a legally qualified practitioner who is involved in the care and treatment of your disabling condition. If any specialist has been seen you should ensure that copies of the consultation reports and test results are included with the Attending Physician s Statement of Disability. All forms are available from your employer or from the Pensions & Disability Administration Department. If you are applying for a disability benefit which has been claimed through the Worker s Compensation Board, ensure that all applicable correspondence is also included with your initial claim forms. You must mail or deliver all application forms and supporting documents to the Pensions & Disability Administration Department. Your claim is then forwarded to an adjudication specialist for processing. Page 7

9 Qualifying Period There is a 120 day qualifying period which must elapse before you begin to receive disability benefit payments. During this waiting period you are required to apply for sick leave, which may be payable through your employer s benefit plan. If you have not earned enough sick leave credits to cover the 120 day qualifying period, it is your responsibility to apply for a disability benefit from the Government of Canada s Employment Insurance. You cannot receive long term disability benefits while you are receiving sick leave benefits from your employer or the Government of Canada s Employment Insurance plan. Partially completed qualification periods, from the same or another disability, within any 12 month period may be combined to a maximum of 120 days. If you are engaged in a rehabilitative program and cease working again within a 12 month period as a result of disability, or if there is no work available, your long term disability benefits can be reinstated without completing another 120 day qualifying period. If you have completed 12 consecutive months of employment after returning from a disability and again become disabled, you will be required to complete another 120 day qualifying period. Recurrent Disability If you have been receiving disability benefits from the Plan and have returned to work and subsequently become disabled within 12 months from the same or a directly-related cause which created the original disability, your benefits can be reinstated without serving another 120 day qualifying period. Page 8

10 LTD Benefits Once you have completed the 120 day qualifying period, long term disability benefits are payable for the duration of your disability, to age 65, or voluntary early retirement. Benefits are payable at the end of each month. If the payment is for less than a full calendar month, your payment will be pro-rated based on the number of calendar days that the benefit is payable. Benefit payments are subject to the provision of medical evidence supporting your disability. Annually, and at such other times as the Administrative Board deems appropriate, medical updates will be required from a legally qualified medical practitioner. You will be notified in advance of the requirement to provide updated medical evidence. If you refuse to obtain a medical update, or are unable to provide satisfactory medical evidence of your continuing disability, your long term disability benefits will cease. The Administrative Board may submit any medical evidence received to a qualified medical practitioner of its choice for a second opinion or interpretation. Benefit Payments The total disability benefit payment is based on 65% of your pre-disability salary. Your gross benefit will be reduced by the contributions you are required to make to the Civic Pension Plan and any disability benefits you are receiving from the Canada Pension Plan. Permanent Full Time Employees If you are a permanent full time employee, the benefit amount will be based on the regular basic salary rate for the position you occupied at your date of disability or the date your disability payments become payable, whichever is greater. Example Calculation: Date of Disability: June 15, Annual Salary: $47,500 Monthly Pre-disability Salary: $3,958 Disability Benefit from the Canada Pension Plan (if applicable): $800 Gross Benefit: $3,958 x 65% = $2,573 Less: Civic Pension Contribution: $3,958 x (9.42% x 75%) = $ 280 CPP Disability Income: $ 800 $1,080 Monthly LTD Payment = $1,493 Permanent Part Time Employees If you are a permanent part time employee, the benefit amount will be based on the regular basic salary rate, and the number of part time hours worked, in the year prior to your date of disability. Page 9

11 Example Calculation: Partial Disability Date of Disability: June 15, Annual Salary: $23,400 (1,200 hours at $19.50 per hour) Monthly Pre-disability Salary: $1,950 Disability Benefit from the Canada Pension Plan (if applicable): $400 Gross Benefit: $1,950 x 65% = $1,268 Less: Civic Pension Contribution: $1,950 x (9.42% x 75%) = $138 CPP Disability Income: $400 $538 Monthly LTD Payment = $730 After you have received total disability benefits for a period of 12 months, partial benefits may be payable if the medical evidence indicates that you are not totally disabled from employment, but a permanent medical impairment does exist. The amount of disability benefits payable during periods of partial disability shall be calculated in the same manner as for total disability but reduced by a percentage determined by the Administrative Board based on the opinion of one or more qualified medical practitioners with regards to the severity of the disability. Benefit Offsets and Reductions Your disability benefits will be reduced if you receive payments from: employer paid leaves; the Workers Compensation Board for the same injury and/or illness; the Canada Pension Plan (disability benefits); the Government of Canada s Employment Insurance plan; the Saskatchewan Government Insurance Personal Injury Protection Plan; and/or; any salary or wage loss awarded as the result of action against any third party for the same disability except for benefits received from a member s private disability plan. There is no reduction in your disability benefits as a result of: lump-sum vacation payouts; increases in payments from third parties as a result of increases in the Consumer Price Index (after the initial reduction of said payments); and/or payments received from the Workers Compensation Board for an unrelated injury and/ or illness. Page 10

12 Cost of Living Adjustment Your long term disability benefit payment is protected against inflation through an annual cost of living adjustment (COLA). Your benefit payments will be increased by 1/2 of the increase in the Consumer Prince Index each year to a maximum of 4.25% in any one year. Please note that if there is a reduction in the Consumer Price Index there will be no change to your benefit payments (you will not receive an increase, however your payments will not be reduced). The anniversary date for cost of living adjustments is one year from the date on which your benefit payments started. When Benefits Stop Disability benefit payments will cease upon the earliest of the following dates: you recover from your disability; you elect voluntary early retirement; you reach age 65; you are no longer considered totally or partially disabled under the provisions of the Plan; in the event you pass away; or if you waive your right to further disability benefit entitlements. Disability benefit payments are not terminated if you resign from service with an employer participating in the Plan. Disability or Pension? If partial disability benefits are approved by the Administrative Board and the amount of the disability benefit payments you would receive are less than the amount you could receive immediately as a pension from the Regina Civic Employees Superannuation & Benefit Plan, you may elect to retire and receive an immediate pension rather than collect disability benefits provided that : you qualify for an immediate reduced or unreduced pension and you notify the Administration Board of your intention to retire as required by the Civic Pension Plan. Page 11

13 Rehabilitation Employment While you are disabled, it may be determined that some form of rehabilitation and/or retraining program would be beneficial to your recovery and return to the workforce. Rehabilitation and retraining programs are programs approved by the Administrative Board that are designed to advance recovery from a disability. A rehabilitation or retraining program may include, but is not limited to: resuming work in your regular occupation on a part-time basis, or with modified duties; resuming work in an alternative position; a formal training or upgrading program; a vocational assessment or a period of on-the-job training; medical or psychological therapy; or combinations of the above. Refusal to participate in a rehabilitation program approved by the Administrative Board will result in a 50% reduction of your disability benefits. Wage top-up benefits may be provided if you are engaged in approved rehabilitative employment up to 90% of your pre-disability or deemed salary. You will not have to serve an additional 120 day qualifying period if you are engaged in rehabilitative employment and cease work again within a 12 month period as a result of disability. Page 12

14 Decision Appeal If you do not understand the decision regarding your claim, or if you disagree with the decision to deny your long term disability claim, please contact the Claims Adjudicator who reviewed your claim. You may have some additional information which could result in the adjudicator reconsidering the original decision. If you still do not understand the decision, or disagree with the decision, you can appeal to the Administrative Board and request a review of your case. Please contact the Pensions & Disability Administration Department for further information about the appeal process and procedures. You must service notice of your request for appeal to the Chairperson of the Administrative Board within 30 days of being notified of the decision you wish to appeal. The review will be done at the discretion of the Administrative Board and the Board s decision shall be final and conclusive. Page 13

15 Other Information Other Benefits During LTD Please contact your employer to determine if you can continue receiving coverage for the following benefits while you are on long term disability: group life insurance; dental plan coverage; and medical plan coverage. Power of Attorney A power of attorney is a legal document that allows you to appoint someone else to look after your affairs should you become unable to look after them on your own. If you currently have assigned a power of attorney to look after your affairs, which included your long term disability benefits, a copy must be on file with the Pensions & Disability Administration Department so that we may act in a timely manner on any requests received by your attorney. If you have not already provided a copy of your power of attorney, please do so as soon as possible. Taxes There are different types of power of attorney. For information specific to your own personal circumstances, you should consult a lawyer. Disability benefits are considered taxable income. Tax will be withheld from each payment you receive and remitted to the government on your behalf. Each year you will be issued a T4A form which lists the total taxable benefit you received for the year and the amount of tax withheld. The government permits you to deduct contributions made to the Plan since January 1, 1992, from any benefit received, provided you did not claim the contribution on a previous year s tax return. Therefore, you should include the T4A form you receive when calculating and filing your income tax return. Page 14

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