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Definitions
Eligibility: You are eligible for LTD coverage if you are:
a full-time active employee working a minimum of 20 hours per week.
Effective Date: The date you are eligible for coverage is
the day after you complete your waiting period. See your Plan Administrator
for your waiting period.
Guaranteed Issue: You may apply for coverage without answering
any medical questions for 60 days following the date you become
eligible for coverage. Please see your Plan Administrator for your
eligibility date.
Elimination Period: The Elimination Period is the length
of time of continuous disability, which must be satisfied before
you are eligible to receive benefits. LTD benefits would begin after
90 or 365 consecutive days of disability, as described in the definition
below. The employee can choose the Elimination Period that they
wish.
Benefit Amount:
Monthly LTD Benefit:
- 60% of your basic monthly earnings
- To a maximum of $8,000
Benefit Duration: Your duration of benefits is based on
your age when the disability occurs. Your Long Term Disability benefits
are payable for the period during which you continue to meet the
definition of disability for 3 years. If your disability occurs
at or after age 68, benefits would be paid for a reduced period
of time.
Definition of Disability (LTD Definition): You would be
considered disabled and eligible for benefits if, due to injury
or sickness:
- you cannot perform each of the material duties of your regular
occupation, and
- after benefits have been paid for 36 months, you cannot perform
each of the material duties of any gainful occupation for which
you are reasonably fitted by education, training or experience.
"Partial disability" and "partially disabled" mean that because
of injury or sickness, you, while unable to perform all the material
duties of your regular occupation on a full-time basis, are:
- Performing at least one of the material duties of your regular
occupation or another occupation on a part-time or full-time basis;
and
- Earning at least 20% less per month than your indexed pre-disability
earnings due to the same injury or sickness
Partial Disability: If you have met this definition of disability
and have satisfied the elimination period, you can return to work
on a part-time basis and still receive a partial benefit, provided
your earnings are at least 20% less per month than your pre-disability
earnings due to that same injury or illness.
Taxation: If you pay your premiums with post-tax dollars,
your benefits will not be taxed. If you pay your premiums with pre-tax
dollars, your benefits will be taxed. Also, if you share payments
of premiums with your employer, a portion of your benefits will
be taxed.
Instances when benefits would not be paid:
Benefits would not be paid for disabilities caused by, contributed
to by, or resulting from:
- intentionally self-inflicted injuries;
- active participation in a riot;
- war, declared or undeclared, or any act of war;
- conviction of a crime under state or federal law;
- loss of professional license, occupational license or certification;
- pre-existing conditions (see definition).
UNUM will not pay a benefit for any period of disability during
which you are incarcerated.
Pre-existing Condition Exclusion: A pre-existing condition
is a sickness or injury for which you received medical treatment,
consultation, care or services including diagnostic measures, or
took prescribed drugs or medicines in the 3 months prior to your
effective date of coverage. If you suffer a disability caused by,
contributed to by, or resulting from a pre-existing condition and
it begins in the first 12 months after your effective date, that
disability would not be covered by this policy.
Mental and Nervous: LTD benefits would be paid for 24 months
per lifetime for disabilities caused by mental illness that meet
the definition of disability. Mental and nervous benefits would
continue beyond 24 months only if you are institutionalized or hospitalized
as a result of the disability.
Waiver of Premium: You will not be required to pay LTD premiums
as long as you are receiving LTD benefits.
This plan highlight summary is provided to help you understand
your insurance coverage from UNUM. If the terms of this plan highlight
summary and the policy differ, the policy will govern.
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