Summary of Life Insurance and Disability Insurance Programs For Physicians/Faculty Members. Effective April 1, 2005

Transcription

1 & Summary of Life Insurance and Disability Insurance Programs For Physicians/Faculty Members Effective April 1, 2005 UMMMG/UMMS Provided Long Term Disability Coverage Optional Supplemental Long Term Disability Insurance Coverage UMMMG/UMMS Provided Life Insurance Coverage Optional Supplemental Life Insurance Coverage Optional Long Term Care Insurance Coverage

2 TABLE OF CONTENTS Overview of Insurance Programs 3 Long Term Disability Coverage 3 I. Overview 3 II. Group Long Term Disability Coverage 3 III. Housing Assistance Benefit 4 IV. Individual Coverage 4 Optional Disability Coverage Opportunities 5 I. Overview 5 II. Optional Group Long Term Disability Coverage 5 III. Optional Individual Coverage 6 Long Term Care Program 6 Group Life Insurance Coverage 7 I Group Life Insurance Coverage 7 II Optional Life Insurance Coverage 7 Obtaining Additional Information 7-2-

3 OVERVIEW OF INSURANCE PROGRAMS In our commitment to provide our physicians/faculty members with comprehensive and appropriate levels of coverage, UMass Memorial Medical Group and UMass Medical School (UMMMG/UMMS) are pleased to offer its members its group long term disability and group life insurance programs. In addition to the group long term disability and group life insurance programs that UMMMG/UMMS provides, we offer a voluntary disability insurance program that will allow most individuals to increase their coverage beyond the limits of the voluntary group disability insurance program and offer you and your family members the opportunity to obtain long term care coverage at reduced rates. Long Term Disability Coverage I: Overview UMMMG/UMMS provides all physicians/faculty members with long term disability coverage (LTD). The LTD provides for an income replacement of 55% of income up to a maximum benefit of $15,000 per month. This level of coverage is provided through a two tier approach that includes both group and individual contracts. The first tier is provided by a group insurance contract and then, when necessary, the second tier of individual contracts is provided. This plan design has the following parameters and advantages: Provides an additional level of protection for catastrophically disabled physicians/faculty that will equal 25% of your pre-disability income level (not to exceed $5,000/month). For those individuals that qualify, this plan will include a portable individual contract that locks in rates and terms of coverage. Offers physicians/faculty members the ability to increase coverage at a reduced premium. You will need to complete an election form to participate in the optional supplemental group LTD insurance program and a short application form for the UMMMG/UMMS provided individual contract. II: GROUP LONG TERM DISABILITY COVERAGE All UMMMG/UMMS physicians/faculty members are automatically covered under the group long term disability contract that provides 55% income replacement up to the monthly benefit limit of $10,000. This benefit will begin after 180 days of disability and will continue until the age of 65 (modified payout periods will apply to physicians age of 61 or over). -3-

4 This insurance contract is underwritten by Standard Insurance and provides you with protection in the event of both total and partial losses of income. Total disability is defined as your inability to perform you own specialty for the first two years of benefit payments. Thereafter, disability is defined as inability to perform your own occupation (performing the same type of general duties performed when the disability occurred). For physicians, the own occupation is as broad as the scope of your license. If you are disabled from your own occupation and you elect to work in another occupation, your earnings may offset your benefits. (This is a summary of the definition and is not meant to replace the language in the governing contract.) Through this group LTD program, all physicians/faculty members will receive a benefit equal to 55% of income until your monthly benefit reaches a maximum of $10,000/month. A physician/faculty member whose income is in excess of $218,182 per year will be eligible to apply for an individual policy without medical underwriting. The specifics of this individual policy are described in detail in the sections that follow. III: HOUSING ASSISTANCE BENEFIT The group insurance contract includes a feature that provides an additional benefit equal to 25% of your pre-disability income, up to $5,000/month, if you are catastrophically disabled. This benefit, called a housing assistance benefit, is provided to any physician/faculty member who is unable to perform two out of six activities of daily living or who is cognitively disabled. This additional level of coverage can greatly benefit any of our physicians/faculty members who suffer a catastrophic loss by substantially increasing the total benefit amount. IV: INDIVIDUAL COVERAGE UMMMG/UMMS provides those individuals with insurable annual incomes in excess of $218,182 per year with an additional level of protection through an individual policy underwritten by Standard Insurance The amount of benefit afforded through individual policies may be limited for applicants over the age of 61. The amount of coverage offered by this coverage will equal 55% of insurable income above the amount of income covered by your group coverage. The maximum amount of coverage offered through this contract cannot exceed $5,000/month. The individual insurance contract will provide benefits after the same 180 day waiting period as your group coverage and benefits continue up to age 66 or 67 (depending on your age at time of application.). Modified payout periods apply to physicians/faculty members age 61 or older. There are no medical underwriting requirements as long as the policy is applied for within 75 days after your hire date. There are financial underwriting requirements and other individual long term disability coverage you may maintain will be taken into consideration when determining eligibility. This individual policy will include protection in the event of total or proportionate losses of income. The policy will include a specialty specific definition of total disability. Total disability is defined as your inability to work in your own specialty while under the care of a doctor. This aggressive own occupation definition of disability will allow you to pursue alternative -4-

5 employment opportunities outside your specialty without impacting the policy s benefit amount (see contract for specific requirements). For physicians/faculty members at the age of 61 and older, total disability is defined as your inability to work in your own specialty and not working. This individual policy will be paid for by your employer as long as you are actively at work at UMMMG/UMMS. The individual coverage can be maintained at the same permanently discounted rate if you should leave UMMMG/UMMS without any regard to your current health status or any level of coverage provided by a future employer. The individual program has been designed to include future benefit increases should your current income not initially qualify for the entire $5,000/month amount. Annually UMMMG/UMMS will provide the insurance carrier with your current level of insurable income. Any increase in coverage will automatically be covered without the completion of any additional paperwork. This individual contract will require the completion of a short form application. OPTIONAL DISABILITY COVERAGE OPPORTUNITIES I: OVERVIEW The UMMMG/UMMS program includes supplemental opportunities to enhance your level of income protection. The UMMMG/UMMS program offers this additional coverage through a group and/or individual contract. The type of coverage you will be able to obtain will depend on your income and current participation in the optional supplemental program. II: OPTIONAL GROUP LONG TERM DISABILITY COVERAGE The group LTD insurance coverage offers two voluntary options to increase your income replacement percentage from 55% to 65%: Option A 65% without cost of living protection and Option B 65% with cost of living protection. Once the cost of living protection through this new contract has been activated, it will offer increases each year until you recover or reach the age of 65. The opportunity to participate in this program without having to satisfy any medical questions is only available for 60 days from the date you become benefit eligible. After this enrollment period, any physician/faculty members who wish to participate will be required to submit evidence of insurability and participation is not guaranteed. The maximum amount of coverage that you can obtain through this optional group policy is $10,000/month. This maximum monthly benefit will be available to all physicians earning up to $184,615/year. Physicians/faculty members with incomes in excess of this amount will be eligible to obtain coverage through individual policies. The premiums for this coverage will be billed to you via payroll deduction. -5-

6 III: OPTIONAL INDIVIDUAL COVERAGE Physicians/faculty members earning in excess of $184,615 will be able to apply for individual coverage without medical underwriting. The maximum amount of coverage that can be obtained through this individual contract offer will be up to 65% of income up to a maximum benefit of $5,000/month. Physicians/faculty members over the age of 61 may be eligible for a policy with a maximum less than $5,000 per month. The individual coverage that will be made available without any medical underwriting requirements will be provided with permanently discounted guaranteed rates and can be maintained if employment with UMMMG/UMMS ends. The rates for these contracts will be based on your age, specialty and whether or not you use tobacco products. The premiums for this coverage will be billed to you via payroll deduction. The ability to obtain this coverage without medical underwriting will only be available during the open enrollment period. New employees will have a window of 75 days from date of hire to enroll without evidence of insurability. Any request for coverage after this period will require the applicant to satisfy the carrier s medical underwriting requirements. LONG TERM CARE PROGRAM UMMMG/UMMS has elected to sponsor an individual long term care insurance program. Discounted rates are available to you, your spouse and family members. If you or a family member obtains a long term care policy under this program, the premiums will be billed directly to you. This program underwritten by the MetLife Insurance Company, offers you the opportunity to obtain the provisions and benefit amounts that best meet your needs. Choose an elimination period to receive benefits after 20, 45 or 100 days of a qualifying event. Choose a benefit period to receive benefits for 2, 3, 4, 5, 7 years or lifetime. Choose the type of coverage that will provide benefits in the event of a stay in a long term care facility and/or a professional home community care center. Choose a cost of living increase that can be tied to the CPI or offer compound or simple interest growth. Since the selection of the level of coverage is an individual decision, representatives of the plan administrators are available to support you in the process and to select the plan provisions that suit your needs and budget. Individuals interested in obtaining personalized proposals for this valuable protection may request additional information by contacting InsMed Insurance Agency, Inc. at or via at [email protected]. -6-

7 GROUP LIFE INSURANCE COVERAGE I: GROUP LIFE INSURANCE COVERAGE UMMMG/UMMS has elected the Standard Insurance Company to underwrite its group life coverage. All physicians/faculty members will be provided with $50,000 of life insurance paid by the employer and will have the opportunity to obtain an additional amount of coverage without having to medically qualify during the enrollment period. II: OPTIONAL GROUP LIFE INSURANCE COVERAGE The optional group life insurance program will provide our physicians/faculty and their family members with the opportunity to maintain a substantial amount of supplemental life insurance coverage. Through this plan our physicians/faculty members will be able to obtain up to $1,500,000 of insurance coverage. Spouses will be able to obtain up to $300,000 and children will be able to qualify for $10,000. For employees, any amount of additional life insurance in excess of $700,000 will require medical underwriting. Spousal coverage in excess of $50,000 will require medical underwriting. The premiums for this coverage will be billed to you via payroll deduction. OBTAINING ADDITIONAL INFORMATION OR ASSISTANCE Representatives of the program administrators will be available to meet with any individual that needs assistance in the completion of this paperwork or wishes to discuss the costs and benefits of this program. Representatives will be able to meet with you at a time and location that is most convenient for you. If you wish to arrange a meeting with a service representative please call the plan administrators, The InsMed Insurance Agency, Inc. Please call their toll free customer service number or them at [email protected]. -7-

8 Reminder: This program summary is a general description of UMMMG/UMMS s disability and life insurance programs. Full details of each option are provided in plan documents and other publications available from the InsMed Insurance Agency, Inc. and the Human Resources department. Should there be any discrepancy in any of the materials, the information in the plan documents will govern. UMMMG/UMMS reserves the right to amend, modify, suspend or terminate any plan at any time. This booklet is an overview only and not an ERISA summary plan description (SPD). -8-