LONG TERM DISABILITY BENEFITS

Transcription

1 LONG TERM DISABILITY BENEFITS I. PURPOSE PPM: Issued: NOV 1990 Revised: NOV 1997 A. The ability to work and earn an income is one of our most valuable resources, but one which is too often overlooked by most employees. In order to protect you and your families against severe financial hardship, the College insures your income against loss by covering you under a Long Term Disability (LTD) Policy. The Plan is designed to replace a portion of earnings lost if you become disabled because a non-occupational illness or injury renders you unable to work. B. The benefits described in this policy are intended only to convey a summary of the most important coverage provisions. In situations where a question or dispute arises, the plan document will be the official and ruling instrument concerning this plan. II. EFFECTIVE DATE This revised procedure is effective immediately upon receipt and supersedes all previously issued procedures. III. ELIGIBILITY All full-time faculty and regularly scheduled staff members who work a minimum of 1462 hours yearly are eligible to participate in the LTD program after a 30 waiting period. IV. COST A. The cost of the LTD plan is paid in full by the College without any contribution by the employee. B. College members who are on an Unpaid Leave of Absence can continue the long term disability coverage at full cost to the employee. V. BENEFITS A. After a staff member has been out of work for 5 continuous working s, the immediate supervisor should notify the Human Resource Department. Department Heads should notify the Human Resource Department immediately when Faculty are on medical leave. B. Salary will be continued in the following manner: 1st-5th 6th-90th 91st-180th 181st Exempt/ Non-Exempt Sick Time Salary Continuation at 66-2/3% of Base Salary Begin collection of 66-2/3% of Base Salary from insurance carrier Faculty Salary Continuation at 66-2/3% of Base Salary Begin collection of 66-2/3% of Base Salary from insurance carrier (Refer to Policy ; "Salary Continuation", for additional information.)

2 C. Inasmuch as the College is self-insuring and is administering the first six months of each faculty and staff member's disability by providing a salary continuation program, the College will apply the same policies and principles which would be in effect if the plan were insured by a commercial insurance carrier. Therefore, the College reserves the right to request second opinions regarding your condition from an independent physician of its choice. In the event that there is not a concurrence on the part of the second opinion physician, the College may request a third opinion. Should this option be exercised, the cost of any examination incurred will be borne by the College. D. Once the disability has commenced and the elimination period* begun, the salary for calculation of benefits will be based on the base salary in effect at the time the faculty/staff member became disabled. During the elimination period, the position held by the staff member will be held for him/her. Once the staff member becomes eligible for benefits paid by the insurance carrier, his/her position will no longer be guaranteed. If during the elimination period the faculty/staff member attempts to return to employment, on either a full- time or on a part-time trial basis, the benefit which will be paid by the insurance carrier will be based on the salary in effect at the time disability began, regardless of whether the annual increase provided by the College has been implemented. *Elimination period in this context means the 180 period before the benefits of the insurance company begin. E. In order for a faculty or staff member to ensure the timely receipt of benefits from the insurance carrier, documentation must be filed approximately 45 s prior to the scheduled commencement of the insurance benefit. The Human Resource Department will work with the faculty/staff member to ensure that all required paperwork is filed on a timely basis. 1. Individuals disabled for five months or more are eligible to apply for Social Security disability. 2. Awards from the Social Security Disability Administration are directly offset by your insurance disability income. It is the College member's responsibility to inform the Human Resource Department and the insurance carrier of any award/denial by the Social Security Disability Administration. 3. Individuals awarded Social Security disability income will be eligible under current law to enroll in the Medicare program 29 months after the onset of the disability. F. At the time that an employee becomes eligible to collect benefits from the insurance carrier, the Human Resource Department will make arrangements in conjunction with the Payroll Office to begin paying the Retirement Income Replacement Protection into the employee's Retirement Account. This amount will be equal to 5% of the disability benefit. EXAMPLE: Employee earns $18,000 year ($1,500/mo) Disability % = 66 2/3% Employee receives $12,000/yr ($1,000/mo) from disability. Retirement Income Replacement is calculated as follows: $1,000/mo X 5% $ 50.00/mo X 12 months = $600.00/yr G. The Retirement Income Replacement Protection will continue for the faculty/staff member until the earliest of the following occurs: a. returns to full-time employment

3 b. reaches age 65 c. begins collecting Pension income either in the form of an annuity or as a total cash withdrawal d. dies e. or the cessation of disability payments from the providing company, regardless of the reason. H. The faculty/staff member may also continue to make after-tax contributions directly to the Pension account. I. If the employee is on salary continuation due to an accident or injury for which the employee will receive a settlement, the employee is responsible for reimbursing the College for the amount of the salary paid for lost time. J. Should a faculty/staff member die while collecting disability payments, the insurance carrier will pay to the named beneficiary a survivor benefit equal to the sum of three monthly payments. VI. BENEFICIARY For the purposes of the Long Term Disability Plan, the beneficiary of any LTD proceeds shall be the same as the named individual(s) on the faculty/staff member's Basic Group Life Insurance Policy. Should the faculty/staff member wish to designate another named beneficiary, it shall be his/her responsibility to provide the Human Resource Department at any time with a signed and dated letter naming the designated beneficiary for the purposes of this LTD policy. VII. STATUS OF BENEFITS WHILE ON DISABILITY A. Medical At the time the faculty/staff member begins collecting his/her disability income from the insurance carrier, it will be necessary to make arrangements with the Human Resource Department to provide for continuance of the medical premium. The premium charged to the disabled faculty/staff member will be the same as if he/she were an active member of the College. Employees will be billed on a monthly basis. Failure to remit the required premium contribution on a timely basis or the cessation of disability payments from the providing company, regardless of the reason, will result in the cancellation of the health coverage. B. Life Insurance Provided that the proper documentation has been approved by the insurance carrier, life insurance coverage will be continued under the waiver of premium clause by the carrier under which the disability commenced. The amount of life insurance benefit will be the same amount that was provided by the College prior to the commencement of the disability. It will be necessary for the employee and the employee's attending physician to provide a certification of Evidence of Disability to the insurance carrier initially to establish the waiver of premium claim and then periodically (normally every year) for continued support of the disability. The Human Resource Department will work with the faculty/staff member in processing the necessary paperwork. However, the responsibility of responding to the insurance carrier's inquiries for either the initial claim or its continued follow-up must rest with the individual College member. C. Pension Plan See Section V. D. for details related to the continuation of contributions. D. Tuition Programs Refer to Policy , Tuition Remission for Faculty and Staff.

4 E. Travel Accident Coverage under the Travel Accident Plan will cease effective with the the disability commenced. Upon return to full-time active employment, coverage under this Plan will reconvene. F. Flexible Spending Accounts Should a faculty/staff member be enrolled in either of the College's Flexible Spending Account Programs, the following procedures will apply: 1. During the 180 elimination period, deductions will continue to be made from the faculty/staff member's paycheck on a pre-tax basis. If the elimination period overlaps into a new calendar year, the College member will be given the opportunity to make a new election (or discontinue participation) in the Flexible Spending Accounts. 2. At the 181st, upon receipt of disability benefits from the insurance carrier, the faculty/staff member may elect one of the following options: a. discontinue payments into the Flexible Spending Account. However, claims for services incurred will only be honored up to the date of disability benefit commencement or b. continue to participate in the Flexible Spending Account until the end of the calendar year by making after-tax contributions. If this option is chosen, it will be necessary to make arrangements with the Human Resource Department to continue contributions. G. Employee Assistance Program (EAP) - Realizing that College member's (and frequently their immediate families) are often thrust into a stressful situation as a result of a faculty/staff member's disability, the College will continue to provide EAP counseling opportunities to affected individuals or their immediate families for one year from the date the disability began. H. Dental Care/Voluntary Life Insurance/Cancer Insurance - Faculty/staff members enrolled in the dental plan, voluntary life insurance plan and/or cancer insurance at the time their disability commenced will continue to have the applicable premiums deducted from their pay through the 180 elimination period. Once disability benefits commence from the insurance carrier, arrangements will need to be made by the faculty/staff member through the Human Resource Department to continue remitting the premiums on an individual basis. Failure to remit the required premium contribution on a timely basis or the cessation of disability payments from the providing company, regardless of the reason, will result in the cancellation of the dental, voluntary life and/or cancer insurance. I. Paid Time Off (PTO)- Once disability benefits commence from the insurance carrier, the College will pay the faculty/staff member their remaining PTO accrural balance. VIII. STATUS CHANGES A. At the time the faculty/staff member discontinues his/her relationship with the College due to retirement, voluntary or involuntary termination or lay-off, coverage under the LTD Plan will cease that. The insurance carrier has a conversion provision in the policy. Coverage under the group plan may be continued on an individual basis if the faculty/staff member meets the eligibility requirements. B. Reduction in Hours - If a faculty/staff member's regularly scheduled hours change and fail to meet the eligibility plateau established in Section III, coverage under the LTD Plan will cease beginning on the the new schedule takes effect. The insurance carrier has a conversion provision in the policy. Coverage under the group plan may be continued on an individual basis if the faculty/staff member meets the eligibility

5 requirements. C. Increase in Hours - If a faculty/staff member's regularly scheduled hours increase to a level which would make him/her eligible as established in Section III, the effective date of coverage would begin the the hours increased provided the faculty/staff member had worked a minimum of 30 s for the College. IX. MISCELLANEOUS Future Modifications - While it is the intention of the College to provide Long Term Disability coverage for all eligible individuals, the College reserves the right to make any material modification to the plan that it deems necessary, to change the insurance carrier or, if necessary, to cancel the coverage should it be deemed necessary. X. FORMS Contact the Human Resource Department for the appropriate enrollment form and descriptive brochure. Return to Policy Index Return to Human Resource Home Page