1 Long Term Disability Income Plan THIS BOOKLET SUMMARIZES THE PLAN; ARIZONA LAW GOVERNS This booklet is a summary description of the Long Term Disability Income Plan. Changes to or interpretation of Arizona law may supersede it. The law will govern in all cases no matter what the specific language in this booklet might state. Amended and Restated August 1, 2012
2 LONG TERM DISABILITY INCOME PLAN - WHAT IS IT? This plan provides you with a monthly benefit designed to partially replace income that might otherwise be lost during periods of total disability resulting from a covered injury, sickness or pregnancy. It is provided as a benefit with your membership in the Arizona State Retirement System (ASRS). The ASRS has contracted with Sedgwick Claims Management Services, Inc. (Sedgwick) for administration of this Long Term Disability (LTD) Income Plan. Sedgwick makes all initial decisions regarding claims submitted under the LTD Plan. Please contact Sedgwick if you have questions about the plan and its administration. The phone number and address are on the last page of this booklet. Contact your Human Resources, Benefits, or Payroll Department to obtain the application packet for LTD benefits. WHO IS ELIGIBLE? All public officers and employees who are participants in the ASRS and whom a participating employer employs in the system are eligible. There are exceptions: Active plan members from the Public Safety Personnel Retirement System, the Elected Officials Retirement Plan, the University Optional Retirement Plan, or the Corrections Officer Retirement Plan are not eligible for benefits. A participant who is initially hired on or after 7/20/11 by an agency, department, board, or commission of the state, a university under the jurisdiction of the Arizona Board of Regents, judicial branch, the Arizona Corporation Commission, or the legislature is not eligible to be a member of the State Retirement System including the Long-Term Disability Income Plan before the 27 th week of employment if ASRS membership criteria is met. A participant who is receiving retirement benefits from ASRS is not eligible for LTD benefits. A participant who withdraws employee contributions with interest and ceases to be a member of the plan is not eligible for LTD benefits. A participant who files an initial claim for disability benefits more than twelve months after the date of disability is not eligible unless the participant shows ASRS good cause for filing late. WHAT IS TOTAL DISABILITY? During the first 30 months of a disability, including a six-month waiting period, you are considered Totally Disabled if you are under the care of a licensed physician and are unable to perform all of the duties of the job you held when you became disabled. 2
3 After you have received benefits for 24 months within a five-year period, you are considered Totally Disabled if you are under the care of a licensed physician and are unable to perform any work for compensation or gain (greater than or equal to two thirds of compensation at the time of disability) for which you are reasonably qualified by education, training or experience. Total Disability is determined by objective medical evidence which is defined as evidence that establishes facts and conditions, as perceived without distortion by personal feelings, prejudices or interpretations, and includes x-rays, quantitative tests, laboratory findings, data, records, reports from the attending and consulting physician. WHAT DISABILITIES ARE NOT COVERED? Monthly LTD income benefits are not payable to a participant whose disability is due to, or a result of, any of the following: An intentionally self-inflicted injury; War, whether declared or not; An injury incurred while engaged in a felonious criminal act or enterprise; For employees hired on or after July 1, 1988, any injury, sickness, or pregnancy for which you received medical treatment within three months prior to the effective date coverage began under the LTD Income Plan. Except for any employee who becomes an active contributing member on or after July 1, 2008 and receives medical treatment within six months prior to the effective date coverage began under the LTD Income Plan. This exclusion does not apply to a disability commencing after a person has been an active contributing member of a participating employer for twelve continuous months from their most recent membership date. "Received medical treatment, means that you have consulted with or received the advice of a licensed medical or dental practitioner, including advice given during a routine examination. It also includes situations in which you have received medical or dental care, treatment or services, including taking drugs, medication, insulin, or similar substances. WHEN DO BENEFITS BEGIN? Benefits will commence on the day following a waiting period during which you have been totally disabled for six consecutive months. Benefits are paid monthly. The waiting period will not be interrupted by limited duty. Limited duty means, as advised by a licensed physician, work in a capacity where the member is unable to perform all the duties and or work less than a full-time schedule of the position held at the time that the member became totally disabled. 3
4 Also, if you are totally disabled and return to full-time work in your regular occupation with a participating employer for up to ten (10) full-time working days during any one waiting period and again become totally disabled for the same cause, then your waiting period will be extended by the number of days that you returned to full-time work in your regular occupation plus any days off in between. However, if you return to work for more than ten (10) full-time days in the first six month waiting period in your regular occupation for a participating employer and again become disabled, you will be required to satisfy a new six month waiting period in its entirety. WHAT IF I AM WORKING OR RECEIVING WORKERS COMPENSATION BENEFITS? If you are receiving workers compensation benefits or working limited duty due to an illness or injury you may be eligible to receive LTD income benefits. Limited duty means, as advised by a licensed physician, work in a capacity where the member is unable to perform all the duties and/or work less than a full-time schedule of the position held at the time that the member became totally disabled. WHAT IS THE AMOUNT OF MY BENEFIT? The basic monthly benefit is 66 2/3 percent (66 2/3%) of your Monthly Compensation as of the date you become disabled. In determining Monthly Compensation, Sedgwick will use the definition of "Compensation" outlined in Arizona Revised Statutes Section , subsection 7. If you are employed by a school district or other participating employer which pays you on a less than twelve month schedule, your Monthly Compensation will be one twelfth (1/12) of your annualized Compensation on the date disability begins. If you are employed under multiple contracts, for which contributions have been paid in the plan, your Monthly Compensation will be one twelfth (1/12) of your annualized compensation from all contracts. If benefits are payable for a period that is less than a full month, one thirtieth (1/30) of the monthly benefit amount is payable for each day that you are entitled to benefits. The basic monthly benefit may be reduced by an Offset Amount in determining the benefit actually due. If the Offset Amount under this plan is found to be different than that actually considered in calculating your benefits, Sedgwick will advise you of the effect on your benefit and adjust your benefit accordingly. If an overpayment of benefits occurs, Sedgwick will require a full refund from you for the amount of the overpayment. The monthly benefit, which would otherwise be payable to you, may be applied to reduce the overpayment until it is repaid in full. If the balance of the overpayment is not satisfied upon termination of your disability claim, the balance of the overpayment will be recovered from any benefit proceeds you may be entitled to receive from ASRS. 4
5 If an underpayment of benefits occurs, Sedgwick will promptly pay you the amount necessary to adjust the total payments to the amount that should have been paid under the plan. MINIMUM BENEFIT If you are eligible for a monthly benefit under the plan, a minimum monthly benefit of $50 will be due you, no matter how much income you receive from other sources. If an overpayment exists in your claim, this minimum benefit will not be paid to you, but will instead be applied to reduce the overpayment until it is reduced to zero. DEDUCTIONS FROM YOUR MONTHLY BENEFIT - THE OFFSET AMOUNT If you receive benefits from any of the following sources they will be directly subtracted from your basic monthly benefit in determining the amount actually payable to you. Sixty-four percent (64%) of the initial benefits you and your family receive from Social Security Disability or the United States Railroad Retirement Act, when paid because of your disability. Except for a member who becomes disabled on or after July 1, 2008, eighty-five percent (85%) of the initial benefits you and your family receive from Social Security Disability or the United States Railroad Retirement Act, when paid because of your disability. This amount does not include: The amount of attorney fees approved by Social Security rules and reasonable documented costs paid to an attorney to secure the Social Security disability benefit. Any cost of living adjustments that are granted after benefits commence under this section. Eighty-three percent (83%) of the retirement benefits you receive from Social Security or the United States Railroad Retirement Act, except for a member who becomes disabled on or after July 1, 2008, eighty-five percent (85%) of the retirement benefits you receive from Social Security or the United States Railroad Retirement Act. All benefits, including sick pay, retirement benefits, unemployment compensation benefits or disability provided by any other group insurance contract or benefit arrangement which are financed in whole or in part by your participating employer. This does not include any retirement benefit that is received by the member pursuant to a state retirement system or plan other than ASRS. Vacation pay and annual leave are also not considered deductions from your basic monthly benefit. All benefits for disability under any Workers' Compensation Act, non-occupational disability benefit law, the maritime doctrine of maintenance, wages, and cure, or similar legislation. Payments for a veteran s disability to the participant, if the payment is for the same condition or a condition related to the condition currently causing the total disability and is due to, or a result of, service in the Armed Forces of the United States. 5
6 Half of any salary, wages or commissions or other employment related pay that a participant receives or is entitled to receive from any gainful employment. Any money paid from employment during the LTD benefit period will be an offset for that period and will not be allocated over multiple benefit periods. For a member whose disability commences on or after August 2, 2012, a member s monthly income from the monthly LTD program benefits and income sources listed in this section shall not exceed one hundred percent (100%) of the member s monthly compensation at the time disability commences. The monthly LTD program benefits shall be offset by the amount necessary to reduce the member s total monthly income to meet the limit described in this paragraph. LTD recipients are eligible to receive the benefits and payments described above and the reductions provided above apply, even though the benefits are not actually paid, as follows: For primary and dependent Social Security benefits, LTD recipients are considered eligible for Social Security benefits until the benefits are appealed before a social security administrative law judge. For benefits and payments from any other source provided above, LTD recipients are eligible for the benefits if it is reasonable to believe that the benefits will be paid on proper completion of the claim or would have been paid except for the failure of the recipient to pursue the claim in time. If the Claims Administrator feels that you could be eligible for Social Security benefits as described above you may prevent your claim from being suspended or terminated by providing the following to Sedgwick: Signed right of reimbursement form Authorization for Social Security Administration to release information to Sedgwick Copy of application receipt from Social Security Copies of all denials from Social Security Copies of all denial appeals to Social Security When your Social Security benefit has been awarded, or if you are denied Social Security benefits, you should notify Sedgwick as soon as possible. Social Security benefits will be deducted from your monthly LTD benefit for any months in which you were entitled to both Social Security and LTD benefits. Monthly LTD payments to you will not be affected by statutory or cost of living increases in Social Security benefits that take effect after monthly benefits under this plan commence. This also applies to statutory or cost of living increases in retirement plans, Veteran s disability payments and the maritime doctrine of maintenance, wages, and cure. Offset amounts for one-sum payments or lump-sum payments will be as determined by Sedgwick on a reasonable basis consistent with other similar determinations. 6
7 WHAT ABOUT TAXES? Your LTD income benefit is considered taxable income and is subject to applicable tax laws. If your disability commenced on or after 7/1/96, fifty percent (50%) of the benefit is taxable. The portion of your benefits that comes from employer contributions is taxable. Therefore, Sedgwick will withhold legally required federal taxes from the appropriate percentage of your adjusted gross monthly benefit. A Form W-4 will need to be completed indicating your withholding allowances. Your LTD income benefit is also subject to state income tax and a Form A-4 will need to be completed. A Form W-2 will be sent at the end of each year reflecting federal and state taxes withheld for that year. HOW LONG WILL BENEFITS BE PAYABLE? Benefits are payable following the waiting period, for the remainder of your period of total disability, except that benefits will not be payable beyond: The date you are no longer totally disabled; The date you are no longer under the direct care of a licensed physician. The date you refuse to undergo a medical examination or refuse to participate in any work rehabilitation program for which you are reasonably qualified by education, training or experience that is requested by Sedgwick. The date you fail to provide information, data, paperwork or other materials that are requested by ASRS or Sedgwick. If you provide the requested information, Sedgwick will retroactively reinstate the benefits or claim for which you are entitled. The later of the following: a. The later of your normal retirement date or the month following sixty months of payments if disability occurs before 65 years of age. b. The month following attainment of 70 years of age if disability occurs at 65 years of age but before 69 years of age. c. The month following twelve months of payments if disability occurs at or after 69 years of age. For a member with a membership date prior to 7/1/11, normal retirement is defined as the earliest of the following: a. A member s 62 nd birthday and completion of at least 10 years of credited service b. A member s 65 th birthday c. The date the member s age and years of total credited service equals 80 7
8 For a member with a membership date on or after 7/1/11, normal retirement is defined as the earliest of the following: a. A member s 62 nd birthday and completion of at least 10 years of credited service b. A member s 65 th birthday c. A member s 60 th birthday and completion of at least 25 years of credited service d. A member s 55 th birthday and completion of at least 30 years of credited service The date you begin to receive retirement benefits under the ASRS. The date you withdraw employee contributions with interest and cease to be a participant in the ASRS. If you are convicted of a criminal offense and sentenced to more than six months in a jail, prison or other penal institution, benefits will cease the month following thirty days of continuous confinement and will continue to be suspended for the remainder of the confinement. A participant who receives monthly benefits under the LTD Plan is entitled to receive service credits from the time disability commences until the participant's normal retirement date, except that for a participant who receives monthly benefits from the LTD Plan on or after June 30, 1999, the years of service credited to the participant s retirement account shall not exceed the greater of thirty (30) years or the total years of service credited to the participant s retirement account on the commencement of disability. WHAT HAPPENS IF MY DISABILITY STOPS AND THEN RECURS? If you have satisfied a waiting period, then return to work with a participating employer, and later become disabled again for the same or a related cause, you may not have to satisfy a new waiting period. If you become disabled for the same or a related cause, benefit payments will resume without a waiting period, as long as you have returned to work full-time with the participating employer for less than six consecutive months. A new period of disability for a different and entirely unrelated cause following at least one day of fulltime work with the participating employer will require a new waiting period before any additional benefits would be payable. WHAT IS THE AMERICANS WITH DISABILITIES ACT (ADA)? ADA prohibits discrimination in employment against people with disabilities. It requires employers to make reasonable accommodations to the known physical or mental limitations of a qualified applicant or employee, unless such accommodation would impose an undue hardship on the employer. 8
9 Reasonable accommodations may include: Making worksites accessible Modifying existing equipment Providing new devices Modifying work schedules Restructuring jobs WHAT ABOUT THE HEALTH INSURANCE PREMIUM BENEFIT PROGRAM? If you are a retired or disabled member of the ASRS, with at least five years of credited service, and receive your group health insurance coverage through your participating employer or through the ASRS Retiree Group Insurance Program, you are eligible to participate in the Health Insurance Premium Benefit Program. If you receive LTD income benefits and are covered by the ASRS Retiree Group Health Insurance Program and, later, become ineligible for the LTD benefits, you may continue health insurance for yourself and your covered dependents for up to twelve months from the date you become ineligible for additional LTD benefits. If you were receiving the Health Insurance Premium Benefit, this benefit will cease the date you become ineligible for additional LTD benefits. You will be financially responsible for the full amount of the premiums. You should contact your participating employer or the ASRS Member Services Division for information regarding the Health Insurance Premium Benefit Program and other insurance programs available to you. HOW TO FILE A CLAIM FOR BENEFITS You should file your claim as soon as it appears that you will be disabled for six consecutive months. If you are not certain how long your disability will last, you should file your claim when you have been off work or working limited duty for two months. Contact your Human Resources, Benefits, or Payroll Department to obtain the application packet necessary to file a LTD claim. The forms included in the packet are: Claim Statement, Release of Information form, W-4 form, A-4 form, Direct Deposit form, and the Attending Physician's Statement. Complete, in full, the Employee Claim Statement. The information requested here relates to the date and cause of your disability, other sources of income available to you, and an authorization, which allows Sedgwick to obtain medical records, if necessary. Please provide as much pertinent information as possible, e.g., any return to work period, light duty status, etc., which would help Sedgwick in the determination process. You may attach a separate sheet, if necessary. Complete, in full, Claim Statement Part 2. The information requested here is used for the possible exploration of rehabilitation services. Please provide as much information as possible, which will help Sedgwick in determining possible assistance in rehabilitation. 9
10 Complete the W-4 and A-4 tax withholding forms. If Sedgwick does not receive these completed forms from you, Sedgwick will withhold federal taxes based on an S1 (single with one exemption) rate, and Arizona State taxes at a rate of 5.1%. Complete the Direct Deposit form. This will allow Sedgwick to electronically deposit the LTD benefit payments into your bank account. Ask your doctor to complete the Attending Physician's Statement. This form provides details of your condition, current treatment, and prognosis. The information requested here should date from the onset of disability to the current date. If different doctors are involved, it may be necessary to submit more than one physician's statement. Return the disability packet to your Human Resources, Benefits or Payroll Department. They will submit the claim directly to Sedgwick. Once Sedgwick has received the claim, it will be processed and you will be sent written notice of the status of your claim. The earlier you file your claim, the more likely it is that Sedgwick can complete all of the processing necessary, including gathering additional information, to provide you with a decision regarding your claim on or before the date that benefits would be payable. NOTIFICATION OF DECISION BY PROGRAM ADMINISTRATOR (SEDGWICK) A decision regarding your claim will be made promptly after Sedgwick receives complete proof of loss. Complete proof of loss means the forms specified in the preceding section, any additional forms that Sedgwick requires, and any investigation by Sedgwick which is necessary to determine benefits that may be payable under the plan. Sedgwick may ask that you be examined by a physician of its choice at no cost to you and may also make any other investigation deemed necessary to determine benefits that may be payable under the plan. Once you have been approved for LTD benefits, you are required by Arizona law to be under the direct care of a licensed physician in order for monthly LTD benefits to continue. In order to verify that you are under the direct care of a physician and to establish proof of loss, a physician s supplemental statement form completed by your attending physician will be required as deemed necessary by Sedgwick. This form will be provided to you at no cost, however, the cost of having this form completed will be your responsibility. Sedgwick will inform you as to the frequency that such proof of loss will be required. Sedgwick will advise you when additional medical or other evidence is necessary to determine if additional benefit payments can be paid. If the claim is denied in whole or in part, Sedgwick will provide written notice of such denial. The notice will contain: The specific reason or reasons for the denial. A description of the additional material or information, if any, necessary to complete the information to make a decision on an appeal of the claim and an explanation of why such material or information is necessary. 10
11 An explanation of the plan s claim appeal procedure. IF I DISAGREE WITH THE DECISION ON MY CLAIM, WHAT CAN I DO ABOUT IT? If you disagree with the determination made on your claim, you have the right to request a thorough review of the decision. The procedure is as follows: Within sixty (60) days after you receive written notice of the initial determination on your claim, you must file a written request for a review. The review request should include any additional facts and documentation that will support your claim. For your assistance, you may: o Request a copy of the LTD Statutes; o Ask for further explanation of the pertinent plan provisions and the reason for the initial determination; Your written request for a review must be mailed to the address below: Sedgwick Attn: ASRS Claims Manager P.O. Box 9830 Calabasas, CA If you should have any questions regarding the LTD Income Plan, the toll-free telephone number is
LONG-TERM DISABILITY BENEFITS Revised September 1, 2004 No. 6 (*) 7000CI-U-EZ E O BENEFIT INFORMATION WHY LONG-TERM DISABILITY COVERAGE People tend to take their good health and ability to work for granted.
Short-Term Disability Pay Policy for Hourly & Commissioned Associates POLICY DESCRIPTION Effective March 1, 2014 Effective March 1, 2014, Updated November 26, 2013 1 of 15 Table of Contents Table of Contents...
Date January 1, 2016 Marsh & McLennan Companies This Plan provides you with income in case you can t work for an extended period of time because of an injury or illness. Benefits under Marsh & McLennan
Short-Term Disability Pay Policy for Hourly & Commissioned Associates POLICY DESCRIPTION Effective March 1, 2016 Effective March 1, 2016, Updated March 2, 2016 1 of 14 Table of Contents Table of Contents...
El Paso County Self-Funded Short Term Disability Plan Effective January 1, 2003 Restated January 1, 2011 Index INTRODUCTION... 2 ELIGIBILITY... 2 Eligible Classes... 2 Eligibility Date... 2 POLICY EFFECTIVE
LONG TERM DISABILITY INSURANCE CERTIFICATE BOOKLET GROUP INSURANCE FOR MONROE CO COMMUNITY COLLEGE SCHOOL NUMBER 704 TEACHERS The benefits for which you are insured are set forth in the pages of this booklet.
Section D Long Term Disability (LTD) Insurance Section Page When Coverage Begins...D. 1 When Coverage Terminates...D. 1 What are the Benefits...D. 1 Duration of Benefits...D. 2 What is Total Disability...D.
Long Term Disability Insurance Group Insurance for School Employees FERRIS STATE UNIVERSITY INSTRUCTOR,FACULTY,LIBRARIAN Underwritten by Connecticut General Life Insurance Company 1475 Kendale Boulevard
Short Term Disability Insurance This subsection summarizes the group Short Term Disability Insurance plan available through PEBB. It is a summary only. For full details, see the Certificate of Insurance
Short Term Disability Plan The Short Term Disability Plan provides eligible Full-Time Employees with short term income protection for absences due to nonworking related disability. Coverage is automatic
St. Thomas University Group Policy Number: G0050234 Plan B: Support Staff Employee Name: Certificate Number: Welcome to Your Group Benefit Program Group Policy Effective Date: September 1, 2010 This Benefit
For this plan year, the plan includes the following provisions, subject to change or discontinuation with or without notice at any time. This Summary Plan Description presents an overview of your Benefits.
LONG TERM DISABILITY INSURANCE CERTIFICATE BOOKLET GROUP INSURANCE FOR SOUTH LYON COMMUNITY SCHOOL NUMBER 143 TEACHERS The benefits for which you are insured are set forth in the pages of this booklet.
LONG TERM DISABILITY INSURANCE CERTIFICATE BOOKLET GROUP INSURANCE FOR WAYNE WESTLAND COMMUNITY SCHOOLS SCHOOL NUMBER 944 TEACHERS The benefits for which you are insured are set forth in the pages of this
Campbell Long-Term Disability (LTD) Plan The Campbell Soup Company Long-Term Disability (LTD) Plan is designed to provide you with income protection if you re unable to work for an extended period of time
SUMMARY PLAN DESCRIPTION LONG-TERM DISABILITY (LTD) BENEFIT PLAN University of Southern California (FOR DISABILITIES COMMENCING ON OR AFTER JANUARY 1, 2007) I. WHAT IS THE PURPOSE OF THE PLAN? The principal
L o n g Te r m D i s a b i l i t y I n s u r a n c e O p t i o n s Long Term Disability Insurance Group Insurance for School Employees INTRODUCTION This booklet will help you understand MESSA's Optional
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK Long Term Disability Insurance Benefits Guide For The Employees of The State University of New York Answers to your questions about coverage from The Standard
Benefits through the stages of your life. DISABILITY BENEFITS Table of Contents 1. Disability Benefits Death and Disability Plan...1 Overview.... 1 Eligibility and Enrollment... 3 Disability Benefits....
HCA Short-Term Disability Plan As part of the HCA Health and Welfare Benefits Plan, short-term disability insurance coverage through The Prudential Life Insurance Company of America (Prudential or insurance
THE UNIVERSITY OF IOWA Life Insurance Long Term Disability Insurance and Retirement Annuity Protection Insurance 1 2 TABLE OF CONTENTS Page(s) GENERAL INFORMATION... 4-5 Participation in Insurance Programs...
Disability Plans Honda offers both Short-Term and Long-Term Disability benefits that provide you with continuing income if you become disabled from a non-occupational illness or injury or in some circumstances
Member Handbook Regina Civic Employees Long Term Disability Plan Table of Contents About the Plan.. Eligibility and Enrollment.... Contributions Definition of Disability.. Applying for Benefits... Qualifying
HEALTHCARE BENEFIT TRUST TO THE EMPLOYEE: QUESTIONS AND ANSWERS ABOUT YOUR LONG TERM DISABILITY COVERAGE For Claimants disabled on or after April 1, 2004 under the: Aboriginal Services Collective Agreement
1 STIIP (Short Term Illness and Injury Plan) 1.1 Eligibility (a) Regular employees shall be covered by the Short Term Illness and Injury Plan upon completion of six months active service with the Employer.
Chicago Public Schools Short Term Disability Plan Plan Effective Date: January 1, 2012 CPS Short-term Disability Plan rev. 02-25-2013 Page 1 TABLE OF CONTENTS PAGE Introduction...3 General Definitions...4
LIFE INSURANCE COMPANY OF NORTH AMERICA 1601 CHESTNUT STREET GROUP POLICY PHILADELPHIA, PA 19192-2235 (800) 732-1603 TDD (800) 552-5744 A STOCK INSURANCE COMPANY POLICYHOLDER: POLICY NUMBER: The Hospital
The Ohio State University Disability Program Specific Plan Details Program Provisions for: Long-Term Disability (LTD) Short-Term Disability (STD) Plan Year 204 (January December 3, 204) Office of Human
Long Term Disability Insurance Conversion Plan The Prudential Insurance Company of America INST-A002112-A Long Term Disability Insurance Conversion Plan If you have any questions regarding the conversion
Long Term Disability (LTD) TABLE OF CONTENTS (Click on any item below to go to that section) Overview LTD Coverage Benefit Payment of LTD Benefit Other Income Benefits Defining Disabled Recurrent disability
1 LTD (Long Term Disability Plan) 2.1 Eligibility (a) (1) Regular full-time employees shall be covered by the Long Term Disability Plan upon completion of six months active employment with the Employer.
County of Los Angeles MegaFlex Short-Term Disability Plan County of Los Angeles Board of Supervisors Gloria Molina First District Mark Ridley-Thomas Second District Zev Yaroslavsky Third District Don Knabe
SUPPLEMENT to the WESTERN PENNSYLVANIA ELECTRICAL EMPLOYEES INSURANCE TRUST FUND SICKNESS AND DISABILITY BENEFITS PROGRAM April 2013 BUS_EST:349238-1 TABLE OF CONTENTS Page Introduction... 1 1-1 Eligibility
Massachusetts Institute of Technology Summary Plan Description for the Massachusetts Institute of Technology Long-Term Disability Plan July 1, 2009 Table of Contents Introduction 3 For Assistance or More
Nova Scotia College of Art & Design Plan Document Number: G0080847 Group Policy Number: G0050232 Plan - All Employees Employee Name: Certificate Number: Welcome to Your Group Benefit Program Plan Document
S h o r t Te r m D i s a b i l i t y I n s u r a n c e O p t i o n s Short Term Disability Insurance Group Insurance for School Employees INTRODUCTION This booklet will help you understand Messa's Optional
Your plan provides you with disability coverage that gives you and your family protection against some of the financial hardships that can occur if you become disabled or injured. The benefits include:
Group Disability Income Plan SECTION EIGHT AT-A-GLANCE General Information...pg. 69 Eligibility and Participation...pg. 69 Short Term Disability Income (STD)...pg. 71 Step-by-Step Instructions for Filing
Table of Contents Section 4: Disability YOUR CALTECH DISABILITY BENEFITS... 4.1 Short Term Disability... 4.1 Paid Family Leave... 4.1 Long Term Disability... 4.1 YOUR BASIC AND SUPPLEMENTAL LONG TERM DISABILITY
SECTION III DISABILITY A. Short-Term Disability 6 Months B. Long-Term Disability Benefits 18 Months 39 DISABILITY BENEFITS RESOURCE GUIDE Where To Call For Short-Term Disability Benefits (646) 473-9200
Release 9.1.0 YOUR GROUP VOLUNTARY LONG-TERM DISABILITY BENEFITS FOR EMPLOYEES OF: State of Nebraska CLASS(ES): All Eligible Employees EFFECTIVE DATE: July 1, 2013 PUBLICATION DATE: May 15, 2013 NOTICE(S)
STATE INCOME CONTINUATION INSURANCE Wisconsin Retirement System ET-2106 (10/2014) Department of Employee Trust Funds (ETF) P.O. Box 7931 Madison, WI 53707-7931 etf.wi.gov Cover photo courtesy of the Wisconsin
Act Now! You must apply within 60 days of termination GIVE YOUR FAMILY PEAK PROTECTION Group Long Term Disability Insurance Conversion Plan Enrollment Kit Customer Service Center 888-262-6873 Monday through
LONG TERM DISABILITY INSURANCE CERTIFICATE BOOKLET GROUP INSURANCE FOR CLINTON COMMUNTIY SCHOOLS SCHOOL NUMBER 411 ADMINISTRATION/TEACHER/SUPPORT STAFF The benefits for which you are insured are set forth
Section 4: Optional Benefits State of Oregon PEBB offers eligible employees the opportunity to select optional benefits. This section summarizes the following plans. Optional Employee and Spouse or Domestic
Group Short Term Disability Insurance Protect Your Employees from Loss of Income Standard Insurance Company Short Term Disability Insurance Your proposed Group Insurance Plan Standard Insurance Company
BENEFIT PLAN Prepared Exclusively for Hampton City Schools What Your Plan Covers and How Benefits are Paid Long Term Disability Table of Contents Schedule of Benefits... Issued with Your Booklet Preface...1
Effective: 10-1-2012 American Fidelity Assurance Company s Long-Term Disability Income Insurance Plan Designed Specifically For: Non-Clerical Education Support Personnel Why Do You Need Disability Income
Buy-up Long Term Disability Insurance For the employees of Montana University System Answers To Your Questions About Coverage From Standard Insurance Company About This Booklet This booklet is designed
For this plan year, the plan includes the following provisions, subject to change or discontinuation with or without notice at anytime. This Summary Plan Description presents an overview of your Benefits.
The University of Tennessee Group Long Term Disability Plan For Academic and Exempt Employees Effective December 1, 2003 Contents What If Your Paycheck Stops?.........................1 About TIAA and The
UNIVERSITY OF ROCHESTER LONG-TERM DISABILITY PLAN The Long-Term Disability (LTD) Plan provides a monthly income benefit when an individual is totally disabled for more than six months. The benefit provided
University of British Columbia (the University) CUPE Local 2278 English Language Instructors Contract Number 23218 Part G Effective January 1, 2008 Table of Contents Table of Contents General Information...1
Group Short Term Disability Insurance Protect Your Employees From Loss Of Income Standard Insurance Company Short Term Disability Insurance Your Proposed Group Insurance Plan Standard Insurance Company
Table of Contents SHORT TERM DISABILITY BENEFITS 5.2 Eligibility... 2 5.3 Enrollment... 2 5.4 Plan Cost... 2 5.5 How the Plan Works... 3 Schedule of Benefits... 3 5.6 Recurring Disability... 4 5.7 Duration
Balancing Life Advocate Health Care Network Disability Income Protection Summary of Benefits (Amended and Restated as of January 1, 2016) inspiring possibilities What s Inside Introduction...3 Disability
INTRODUCTION This information booklet has been prepared to give you an informal summary of the main features of your group insurance program. This booklet is not an insurance policy, and does not grant
Long-Term Disability (LTD) Plan This document is a Summary Plan Description (SPD), as defined by the Employee Retirement Income Security Act of 1974 (ERISA), of the Toys R Us, Inc. Long-Term Disability
American Fidelity Assurance Company s Short-Term Disability Income Insurance Plan Designed Specifically For: New Mexico Schools Plan Highlights s are paid directly to you, not to a doctor or your employer.
Long-Term Disability Insurance Developed for the Employees of City of Colorado Springs (Employees with less than 5 years of PERA Service) (City Council Members) How This Program Protects You If you suffer
Short Term Disability Income Protection Plan Effective Date: January, 1, 2015 Contact Information Plan Administrator: Address and Telephone #: Prime Therapeutics, LLC 1305 Corporate Center Drive Eagan,
Public Employees Benefits Agency Public Employees Disability Income Plan Table of Contents INTRODUCTION...4 Overview Administration Employee Booklet ELIGIBILITY...5 Employer Responsibility Enrolment BENEFITS...7
! " #$%&' ( First, an important note from our lawyers. This booklet is intended only as a guide and does not establish any legal rights. It is intended as a summary of the benefits provided at the time
Voluntary Short Term Disability Insurance For Government of the District of Columbia Employees Answers To Your Questions About Coverage From Standard Insurance Company About This Booklet This booklet is
For Use With Form AA-1d EMPLOYEE DISABILITY BENEFITS United States of America Railroad Retirement Board Visit our Web site at http://www.rrb.gov Form RB-1d (03-09) Table of Contents Part I - General Information
American Fidelity Assurance Company s Long-Term Disability Income Insurance Plan Designed Specifically For: Oklahoma State University Why Do You Need Disability Income Protection? No One Plans To Be Disabled.
Disability Coverage Your Disability benefits are designed to provide continuing income if you become ill, injured, pregnant and are unable to wk. F me infmation on See Page Sht-Term Disability Plan 6 3
Frequently Asked Questions About Disability Benefits The following information is a brief synopsis of frequently asked questions regarding Prince Willam County School Board Long Term Disability (LTD) benefit
MUNICIPAL EMPLOYEES ANNUITY AND BENEFIT FUND OF CHICAGO A Pension Trust Fund of the City of Chicago DISABILITY HANDBOOK OFFICE OF THE FUND 321 North Clark Street, Suite 700, Chicago, Illinois 60654 (312)
GROUP DISABILITY INSURANCE GROUP DISABILITY INSURANCE GROUP DISABILITY INSURANCE for New Employees of for New Employees of FLORIDA ATLANTIC UNIVERSITY FLORIDA ATLANTIC UNIVERSITY Underwritten by: Standard
LifeMap Assurance Company 100 SW Market Street P.O. Box 1271, MS E-3A Portland, OR 97207-1271 (503) 721-7161 (800) 794-5390 Short Term Disability Income Plan Benefit Booklet OREGON PUBLIC EMPLOYEES UNION
SPD covers NO codes 7/30/04 9:58 AM Page 3 US Airways, Inc. Flight Attendant Long Term Disability Benefit Plan Summary Plan Description As of January 1, 2004 September 2004 Dear US Airways Benefit Plan
Certificate of Insurance Creditor Insurance for CIBC Personal Lines of Credit 13002-2016/03 Page 1 of 9 Table of Contents Note: This is an important document. Please keep it in a safe place. Introduction...2
COUNTY OF SANTA CLARA BASIC AND SUPPLEMENTAL LONG-TERM DISABILITY PLAN BENEFIT BOOKLET Revised Effective December 26, 2011 TABLE OF CONTENTS PAGE Long-Term Disability Plan Part One... 1-10 Article I Benefits
VI. Long-Term Disability Program Table of Contents About This Section...1 An Overview of the Long-Term Disability Program...2 Definition of Disability...2 Long-Term Disability Benefit Options...2 Basic
PLANS PERS 2 & 3 Disability Benefits for Plan 2 and 3 members of the Public Employees Retirement System (PERS) and the School Employees Retirement System () If you are a member of PERS Plan 2 or Plan 3
Department of State Treasurer Disability Training - Updated January 2015 1 This presentation is based on current legislation and is subject to change without notice. This material is to be used for training
Electrical Pension Trustees Pension Plan No. 2 ABOUT THIS BOOKLET To understand your benefits from the Electrical Contractors Association and Local Union 134, I.B.E.W. Joint Pension Trust of Chicago Pension
Voluntary Short Term Disability (STD) Insurance Short Term Disability insurance pays a weekly benefit in the event you cannot work because of a covered illness or injury. An STD benefit replaces a portion
Voluntary Long Term Disability (LTD) Insurance Long Term Disability insurance is designed to pay a monthly benefit to you in the event you cannot work because of a covered illness or injury. This benefit
Employee Group Benefits UNDERWRITTEN BY SUN LIFE ASSURANCE COMPANY OF CANADA Simpson College Your Group Long Term Disability Insurance Plan GROUP POLICY NUMBER - 64067 POLICY EFFECTIVE DATE - January 1,
Employment Insurance Guide for Employers EI Premium Reduction Program Service Canada Government of Canada Gouvernement du Canada IN-041-05-06 For further information on the Employment Insurance Premium
North Carolina State Government W O R K E R S C O M P E N S A T I O N E M P L O Y E E H A N D B O O K PURPOSE The contents in this handbook are designed to provide employees of the State of North Carolina