EMPLOYEE BENEFITS. A product of Southern National Life Insurance Company, Inc.

Transcription

1 Dsabi i lity EMPLOYEE BENEFITS A product of Southern National Life Insurance Company, Inc. 31SN /11 Southern National Life is an independent licensee of the Blue Cross and Blue Shield Association.

2 PROTECTION F R O M T H E UNEXPECTED Southern National Life provides Louisiana employers of all sizes a full suite of employee benefits that are among the best in the market today. We work with employers to develop complete and competitive benefit packages that provide employees protection for many unexpected events. LIFE Dsabi i lity DENTAL MEDICAL WELLNESS HSA/FSA Bundle up & save We know how important the right benefit package can be to recruiting and retaining quality employees. That s why we offer the Blue Bundle. Employers have the option to bundle employee benefits with affordable, high-quality health and wellness benefits. With one team to administer all their benefits, employers save time, and time is money. COMPANY. SOURCE. ONE BILL.

3 Impact of Disability on the Workforce Dsabi i lity Almost 3 in 10 workers entering the workforce will become disabled before age 67. National Safety Council, Injury Facts, 2010 Ed. In the last 10 minutes, 490 Americans became disabled. US Social Security Administration, Social Security Basic Facts, Aug Approximately 90% of disabling accidents and illnesses are not work related; therefore, not covered by workers compensation. Council for Disability Awareness, CDA 2010 Long Term Disability Claims Review These are alarming statistics. It just goes to show how important protection against lost income can be to a workforce. Unfortunately, many people have not planned for the financial burden they will face if they should become disabled and unable to work for an extended period of time. Helping employees stay at work. Our disability coverage encourages employees to continue working as long as they are safely able protecting their eligibility for benefits and without penalty. Employees are able to satisfy the elimination period with only a loss of duties. We can extend the elimination period up to a year for disabled employees who do not meet the earnings loss amount. An employee doesn t have to be totally disabled to receive benefits. Our disability coverage allows disabled employees to return to work for up to one-half of the elimination period without restarting it if they are unable to endure their return to work. Protecting employers and employees. Our disability coverage helps protect employees, which in turn protects the employer s company. Here are a few highlights see this booklet for more specific details. Our disability coverage does not have limitations for symptoms that are self-reported or subjective. We manage all employees claims carefully and effectively. There is a treatment-free period within the pre-existing condition limitation. During this period, if the employee does not receive treatment for the pre-existing condition, he or she may qualify for benefits before completing the continuous days of coverage period. WHO PAYS THE PREMIUM? PREMIUM TAXABLE? BENEFIT TAXABLE? how are benefits taxed? Non-Contributory Employer pays 100% Contributory Employer pays 50% Employee pays 50%... No... Yes... 50%... 50% Voluntary Employee pays 100%... Yes... No The above illustration assumes disability insurance premiums are not deducted on a pre-tax basis in an employer-sponsored cafeteria plan. Blue Cross and Blue Shield of Louisiana is not engaged in rendering tax, legal or investment advice. We recommend you seek the guidance of a tax professional or financial advisor.

4 Short-Term Disability Products Group Employers with 2-9 Eligible Employees Group + voluntary Employers with 10 or More Eligible Employees Contributions/ Participation Benefit Percentages Non-Contributory: 100% employer paid 100% participation 60% Non-Contributory: 100% employer paid 100% participation Contributory: Minimum employer contribution of 25% 75% participation Voluntary: Employee paid Greater of 25% or 10 eligible employees enrolled Group: 50%, 60% or 66 2/3% Voluntary: employees: 60% 36+ employees: 50%, 60% or 66 2/3% Day Benefit Begins 1st, 8th or 15th day accident 8th or 15th day sickness 1st, 8th or 15th day accident 8th, 15th or 30th day sickness Benefit Duration 13 or 26 weeks 9, 11, 13 or 26 weeks Guaranteed Issue and Maximum Benefit Up to $400 per week employees: Up to $1,000 per week 36+ employees: Up to $2,500 per week Disability Definition Totally disabled or disabled and working Loss of duties and income Totally disabled or disabled and working Loss of duties and income Features Maternity No pre-existing limitation Maternity Group: No pre-existing limitation Voluntary: Pre-existing limitation 3/6/12 (look back period/treatment free/continuously insured period) Product Eligibility Must be in business for minimum of two years. Must not insure more than 50% immediate family members. Group STD can only be written with group term life; stand-alone STD is not available. Must be in business for minimum of two years. Must not insure more than 50% immediate family members. Group STD can only be written with group term life; stand-alone STD is not available.

5 Long-Term Disability Products Dsabi i lity Contributions/ Participation Benefit Percentages Day Benefit Begins Elimination Period Benefit Duration Guaranteed Issue and Maximum Benefit Disability Definition Pre-existing Limitation (in months) Features Product Eligibility Group Employers with 2-9 Eligible Employees Non-Contributory: 100% employer paid 100% participation 60% 2-3 employees: 180 days 4-9 employees: 90 or 180 days 2-3 employees: 180 days 4-9 employees: 90 or 180 days 2-3 employees: five year graded 4-9 employees: five year graded, or ADEAI with SSNRA 2-3 employees: Up to $3,000 per month 4-9 employees: Up to $6,000 per month 24 month own occupation and any occupation thereafter Loss of one essential duty during elimination period 12/24 (look back period/continuously insured period) Standard: - Waiver of premium - Survivor income benefit - Return to work incentive - Workplace modification - Disability Guidance (EAP) - LTD Continuity of coverage - Mental, nervous, substance abuse coverage Must be in business for minimum of two years. Must not insure more than 50% immediate family members. Can be written stand-alone or with any other life or disability product. Group + voluntary Employers with 10 or More Eligible Employees Non-Contributory: 100% employer paid 100% participation Contributory: Minimum employer contribution of 25% 75% participation Voluntary: Employee paid Greater of 25% or 10 eligible employees enrolled employees: 60% 36+ employees: 50%, 60% or 66 2/3% employees: 90 or 180 days 36+ employees: 60, 90, 120, 180 or 365 days employees: 90 or 180 days 36+ employees: 60, 90, 120, 180 or 365 days employees: five year graded, or ADEAI with SSNRA 36+ employees: ADEAI with RBD, or ADEAI with SSNRA Group:* employees: Up to $10,000 per month 36+ employees: Up to $15,000 per month Voluntary:* employees: Up to $6,000 per month 36+ employees: Up to $15,000 per month 24 month own occupation and any occupation thereafter Loss of one essential duty during elimination period 36+ employees: Other options available employees: 12/ employees: 3/12, 12/24, 3/6/12, 12/6/24, 12/12 Standard: - Waiver of premium - Survivor income benefit - Return to work incentive - Workplace modification - Disability Guidance (EAP) - LTD Continuity of coverage (group) - Mental, nervous, substance abuse coverage Optional (Group): - Cost of Living Adjustment - Activities of Daily Living - Accidental Dismemberment/Loss of Sight Benefit Must be in business for minimum of two years. Must not insure more than 50% immediate family members. Can be written stand-alone or with any other life or disability product. * Industry restrictions could lower guaranteed issue amounts.

6 Disability Claims Expertise STD CLAIM SEAMLESS DISABILITY CLAIM TRANSITION At the mid point of STD, the claim is given to an LTD Analyst who manages the end of the STD claim, gathers LTD information and develops a plan for ongoing claim management. LTD CLAIM short-term disability We offer provisions in our policy that help make it easier for disabled employees who are able to work to continue to do so while still qualifying for the benefits they need. Dedicated STD return-to-work coordination helps employees get back to work faster. Our contract does not require a period of total disability to qualify for benefits. Our STD and LTD contracts work together to allow disabled employees to return to work for up to one-half the LTD elimination period without restarting it; and, without having to start a new STD claim should they be unable to sustain their return to work. We offer telephonic claims intake for groups of all sizes. telephonic std intake Telephonic Intake Analyst Gathers information from employee. Contacts the employer. Short-Term Disability Analyst Reviews employee s claim based on automatic system prompt or referral from intake analyst. Utilizes specialized resources to make decisions and determines ongoing case management plan. Dedicated Rehabilitation Experts Reviews claims for return to work potential at specific intervals. Coordinates with employee, physician and employer to facilitate faster, smoother return to work.

7 Dsabi i lity long-term disability Our LTD plan supports employers so they can focus on helping their employees, while also encouraging employees to stay on the job as long as they can or return to work sooner. Our definition of disability allows employees to satisfy the elimination period with only a loss of duties. Return to work incentive: Allows employees to receive up to 100 percent of their pre-disability income for the first 12 consecutive months following the date they first returned to work. Workplace modifications: Helps with expenses for adaptations to the worksite that are necessary for a disabled employee to return to work. Family care credit: A disabled employee can use this credit to help with expenses needed to care for any dependent family member if the employee is participating in an approved rehabilitation program. Disability Guidance: Supporting a healthy return to work When an employee becomes disabled, coming back to work is often a long and bumpy road. Our disability coverage provides support to help smooth out the bumps and make a healthy return to work easier for employers and their employees. Our Disability Guidance service provides insured employees up to five counseling sessions per year that give confidential support for emotional, legal and financial issues. Telephonic assessments and counseling that include confidential sessions with a counselor, financial planner and/or an attorney. EMPLOYEE ASSISTANCE PROGRAM 24-hour access to counselors with master s or doctoral degrees in counseling via a dedicated toll-free phone number 365 days a year. Referrals to resources and services in callers communities are provided, such as community and governmental agencies serving the disabled, homemaker services, assistive equipment and day care for children and elderly parents. Employees are provided access to self-assessment tools, information and other resources through a password-protected interactive website.

8 General Conditions for All Disability Products For consistency and accuracy, when adding life or disability benefits to existing medical insurance with a first-of-the-month billing date, the new benefits will have a first-of-the-month effective date. The same applies for groups with a 15th-of-the-month billing date. Eligibility for actively at work, full-time employees requires a minimum of 30 hours per week for our medical, life, disability and other ancillary products. Waiting periods are allowed to vary by product within a single group. Employers have the option to tie their life and/or disability coverage to their medical coverage. how to get a quote 2-35 LIVES equoting (available in AccessBlue) Request for Proposal Form (available in AccessBlue) 36+ LIVES Send request to your Regional Office Request for Proposal Form online tools Administrative forms and guides eenrollment ebill Alexandria Coliseum Blvd., Suite A Alexandria, LA Baton Rouge Reitz Ave. Baton Rouge, LA Lafayette Johnston St., Suite 200 Lafayette, LA Lake Charles West Prien Lake Road Lake Charles, LA New Orleans North Causeway Blvd., Suite 600 Metairie, LA Shreveport Ashley Ridge Blvd. Shreveport, LA This brochure is presented for general information only. It is not a contract, nor intended to be a contract. If there is any discrepancy between this document and the appropriate policy(ies), the provisions of appropriate policy(ies) will govern: 31SN /12; 31SN /12.