Plan Year Disability Benefits for Employees of. The University of Texas System

Transcription

1 Plan Year Disability Benefits for Employees of The University of Texas System

2 Fort Dearborn Life Insurance Company Wholly owned subsidiary of Health Care Service Corporation, a Mutual Legal Reserve Company. Ranked 13th nationally based on in-force group life volume* Rated A+ (Superior) by A.M. Best Company** and A+ (Strong) by Standard & Poor s*** * Based on results shown in the National Underwriter Life/Fitch Ratings Life & Health Statistical Report, August 18/25, **Affirmed December 22, A.M. Best Company rates the overall financial condition of a company using a scale of A++ (Superior) to F (In Liquidation). *** For financial strength in its most recent report.

3 What s New and Exciting for 2009? FDL is the new provider of disability benefits for UT System employees. Decreased premiums for both STD and LTD. No EOI is required if you enroll in STD and/or LTD during the July 2009 annual enrollment. STD elimination period has changed from 30 days to 14 days.

4 2009 Annual Enrollment Eligibility for STD and LTD You may enroll for Short-Term Disability and/or Long-Term Disability without providing satisfactory evidence of insurability using My UT Benefits (formerly UT Touch) If you are not actively at work on September 1, 2009 due to a disability, you may enroll in the disability plans within 31 days of your return to active work without evidence of insurability.

5 Eligibility after 2009 Annual Enrollment You may enroll for benefits within 31 days of the date of hire. Previously eligible employees may enroll for new benefits or increased benefit amounts: during annual enrollment with satisfactory evidence of insurability; or within 31 days of a qualified change in status event without evidence of insurability.

6 New Products for 2009 You may elect to participate in the following benefits: Blue CareLink SM Integrated Medical and Disability Case Management (available at no cost and if you are enrolled in Short-Term Disability) Short-Term Disability Long-Term Disability

7 Summary of Benefits Blue CareLink SM The Blue CareLink SM (BCL) program is available to you at no cost and compliments the disability management program provided through Fort Dearborn Life Insurance Company. If you are enrolled in Short-Term Disability and are losing time from work, you may participate in the program. Participation is voluntary. Access to prior medical and claims history allows our case managers to identify if you are at increased risk to develop a potentially disabling condition and to intervene prior to a short-term disability. Once you have been identified as having a potentially disabling condition, our case managers will call you to discuss the program. If you have not spoken with one of our case managers prior to filing a Short-Term disability claim, our claims department will refer your information to the BCL team. Referrals after the disability occurs enable us to assist with care coordination needs, discuss treatment options, and support your individualized treatment plan. BCL does not apply to pregnancy, terminal illnesses, or Workman s Compensation. You do not have to wait for our case managers to contact you. You may enroll in the program by calling us toll-free at

8 Who is eligible for Blue CareLink SM? Employees only, not your dependents or spouses Must be enrolled in Short-Term Disability Must be losing time from work

9 Telephonic Claim Submission for Short-Term Disability Telephonic claim intake focuses on saving you time. It is an easy and accurate submission that allows for faster claim processing. How it works: You call us toll free at or for the hearing impaired. Our claims specialists will: assign a claim number; secure your authorization to obtain any necessary medical information; contact your physician for information needed to review the claim. Once the claim is approved, benefits are sent to you.

10 Summary of Benefits Short-Term Disability Elimination Period Benefit Amount Maximum Period Payable 14 days 60% of weekly earnings to a maximum of $693 per week Maximum period payable is 22 weeks for disabilities not caused by pre-existing conditions. The maximum period payable for disabilities caused by pre-existing conditions is 4 weeks. Note: Sick leave must be exhausted before STD benefits can begin.

11 Summary of Benefits Short-Term Disability Pre-existing conditions are excluded for 3 months prior to effective date, if less than 12 months of service. Premiums are fully paid by you; therefore benefit payments are not Federal Income taxable. No Evidence of Insurability required for July Benefits are payable for Partial Disability; for example, a person who can perform most of his regular duties but cannot lift more than 50 pounds. STD claims are filed over the phone by calling

12 Summary of Benefits Long-Term Disability Elimination Period Benefit Amount 90 days 60% of monthly earnings to a maximum of $12,025 per month Note: Sick leave must be exhausted before LTD benefits can begin. Age at Disability Less than age 60 Age 60 through age 64 Age 65 through 69 Age 70 and over Maximum Period Payable To age 65, but not less than 60 months 60 months To age 70, but not less than 12 months 12 months

13 Summary of Benefits Long-Term Disability Own Occupation Definition Any Occupation Definition Benefits limited to 24 months for mental illness or substance abuse. No Evidence of Insurability required for July During the first 24 months of disability, the definition for Total Disability is based on your own occupation. After the first 24 months of disability, the definition for Total Disability is based on any occupation in which you can work based on education, training, and experience. Pre-existing conditions are excluded for 3 months prior to effective date, if less than 12 months of service. Benefits payable for Partial Disability; for example, a doctor who can continue to see patients, but cannot perform surgery due to a disability that impedes his ability to stand for long periods of time.

14 Additional LTD Benefits Survivor Income Accidental Dismemberment Worksite Modifications Work Incentive Benefit Conversion Privilege Catastrophic Disability Caregiver Respite Caregiver Training Emergency Alert System

15 Why should you enroll for Disability Benefits? You insure your car. You insure your home. Why not insure your most valuable asset? YOUR PAYCHECK! For less than the cost of dinner at a fast-food restaurant, you can buy income protection for a full month. For example if you make $30,000 per year, your monthly premium would be $6.68 for STD and $9.93 for LTD.

16 Enrollment Information For those employees on a disability leave of absence prior to the September 1, 2009 Effective Date of the new Fort Dearborn Life plan

17 If Then Your date of disability is prior to September 1, You are already receiving benefits under a Hartford STD claim. You are receiving benefits under a Hartford LTD claim. You have been receiving STD benefits from Hartford and you return to work on or after September 1, Your disability claim must be filed with Hartford. You will continue to receive your STD benefit from Hartford, and benefits could transition to Hartford LTD if you are enrolled under the Hartford LTD plan. You will continue to receive your LTD benefit from Hartford. You will need to enroll for coverage in the new FDL disability plan within 31 days of your return to work, otherwise EOI will apply.

18 If Then You have been receiving STD benefits from Hartford and you return to work on or after September 1, 2009, then go out on disability again due to the same cause within 14 days of your return. You have been receiving STD benefits from Hartford and you return to work on or after September 1, 2009, then go out on disability again due to the same cause more than 14 days after your return. Your claim would be reopened by Hartford as it is considered recurrent under their STD plan. Your claim for disability would be submitted to FDL as a new claim, provided you have properly enrolled for the FDL coverage.

19 If Then You have been receiving LTD benefits from Hartford and you return to work on or after September 1, 2009, then go out on disability again due to the same cause within 6 months of their return. Your claim would be reopened by Hartford as it is considered recurrent under their LTD plan. Note: You would not be eligible to also file a new claim under the FDL STD plan. You have been receiving LTD benefits from Hartford and you return to work on or after September 1, 2009, then go out on disability again more than 6 months after your return due to the same cause or a different cause. Your claim for disability would be submitted to FDL as a new claim, provided you have properly enrolled for the FDL coverage.

20 Waiver of Premium If Then You are receiving either STD or LTD coverage as well as Voluntary Life coverage. You are receiving STD benefits and are enrolled in LTD. The Life waiver of premium will be initiated automatically once you have been continuously disabled for at least 6 months. (Filing of a separate waiver claim is not needed.) The LTD waiver of premium will be initiated automatically once the STD claim moves to LTD (filing of a separate waiver claim is not needed).

21 Questions? Call Fort Dearborn Life toll-free at or for the hearing impaired. Visit Fort Dearborn Life s University of Texas web site for additional information at Contact UT Institution HR/Benefits Office

22 Disclaimer This is a brief description of the important features of this STD and LTD insurance plan. This coverage contains limitations and exclusions and terms and conditions under which the policy may be cancelled. Refer to your benefit guide (certificate booklet) for details of coverage. Policy Numbers FDL2-510-UT-109 and 2-LTDP-705 UT 109. The group policies are subject to the laws of the state of Texas.

23 Thank You