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Long Term Disability Income Protection Insurance Highlights

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Fax: 407.708.2425


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Long-term Disability

2007 Long Term Disability Income Protection Insurance Highlights: Policy # 335732

Unim ProvidentPlease read carefully the following description of your UnumProvident Long Term Disability Income Protection insurance plan.

 


Eligibility

You are eligible for LTD coverage if you are an active employee in the United States working a minimum of 20 hours per week.

Guarantee Issue

You may apply for coverage without answering any medical questions or providing evidence of insurability if you apply for coverage within 60 days after your eligibility date. If you apply more than 60 days after your eligibility date, your coverage will be medically underwritten, and you will be required to qualify based on information you provide regarding your health history.

Please see your Plan Administrator for your eligibility date.

Benefit Amount

Monthly LTD Benefit:

  • 66 2/3 percent of your monthly earnings
  • To a maximum of $6000

Your LTD benefit may be reduced by the amount of other income replacement benefits you receive for the same disability, such as benefits from Social Security, Workers' Compensation, etc.

Annuity Protection

If an employee is receiving disability payments and has been a participant in the pension plan for at least three months prior to his or her disability, we will pay your company an extra monthly benefit to be deposited in the plan on the employee's behalf. This benefit will be up to 11 percent of the employee's monthly earnings, not to exceed $1,000 per month.

Definition of Disability

You are considered disabled when UnumProvident determines that:

  • you are limited from performing the material and substantial duties of your regular occupation; and
  • you have a 20 percent or more loss in indexed monthly earnings due to the same sickness or injury.
  • After benefits have been paid for 36 months, you are disabled when UnumProvident determines that due to the same sickness or injury, you are unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training or experience.

You must be under the regular care of a physician in order to be considered disabled.

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 consecutive days of disability, if you are disabled, as described in the definition above or at the end of your accumulated sick leave whichever is greater.

Benefit Duration

Your duration of benefits is based on your age when the disability occurs. Your LTD benefits are payable for the period during which you continue to meet the definition of disability up to age 65, but not less than 5 years. If your disability occurs at or after age 61, benefits would be paid for a reduced period of time.

Gainful Occupation

Gainful occupation means an occupation that is or can be expected to provide you with an income within 12 months of your return to work that exceeds:

  • 80 percent of your indexed monthly earnings, if you are working
  • 60 percent of your indexed monthly earnings, if you are not working
Taxation

Because you pay your premiums with post-tax dollars, your benefits will not be taxed.

Additional Benefits
Rehabilitation and Return to Work Assistance

UnumProvident has a vocational Rehabilitation and Return to Work Assistance program available to assist you in returning to work. We will make the final determination of your eligibility for participation in the program, and will provide you with a written Rehabilitation and Return to Work Assistance plan developed specifically for you. This program may include, but is not limited to the following benefits:

  • coordination with your Employer to assist your return to work;
  • adaptive equipment or job accommodations to allow you to work;
  • vocational evaluation to determine how your disability may impact your employment options;
  • job placement services;
  • resume preparation;
  • job seeking skills training; or
  • education and retraining expenses for a new occupation.

If you are participating in a Rehabilitation and Return to Work Assistance program, we will also pay an additional disability benefit of 10 percent of your gross disability payment to a maximum of $1,000 per month. In addition, we will make monthly payments to you for three months following the date your disability ends, if we determine you are no longer disabled while:

  • You are participating in a Rehabilitation and Return to Work Assistance program; and
  • You are not able to find employment.
Dependent Care Expense Benefit

UnumProvident will pay a Dependent Care Expense Benefit when you are disabled and you:

  • are incurring expenses to provide care for a child under the age of 15;
  • and/or start incurring expenses to provide care for a child age 15 or older or a family member who needs personal care assistance.

The payment will be $350 per month per dependent, to a maximum of $1,000 per month for all dependent care expenses combined.

Waiver of Premium

You will not be required to pay LTD premiums as long as you are receiving LTD benefits.

Survivor Benefit

UnumProvident will pay your eligible survivor a lump sum benefit equal to 3 months of your gross disability payment.

This benefit will be paid if, on the date of your death, your disability had continued for 180 or more consecutive days, and you were receiving or were entitled to receive payments under the plan. If you have no eligible survivors, payment will be made to your estate, unless there is none. In this case, no payment will be made. However, we will first apply the survivor benefit to any overpayment which may exist on your claim.

You may receive your survivor benefit prior to your death if you have been diagnosed as terminally ill, your life expectancy has been reduced to less than 12 months, and you are receiving monthly payments. If you elect to receive this benefit, no survivor benefit will be payable to your eligible survivor upon your death.

Limitations/Exclusions/ Termination of Coverage
Pre-existing Condition Exclusion

You have a pre-existing condition if:

  • you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines in the three months just prior to your effective date of coverage; and
  • the disability begins in the first 12 months after your effective date of coverage.
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;
  • loss of professional license, occupational license or certification;
  • pre-existing conditions (see definition).

UnumProvident will not pay a benefit for any period of disability during which you are incarcerated.

Mental and Nervous

The lifetime cumulative maximum benefit period for all disabilities due to mental illness and disabilities based primarily on self-reported symptoms is 24 months. Only 24 months of benefits will be paid for any combination of such disabilities even if the disabilities are not continuous and/or are not related. Payments would continue beyond 24 months only if you are confined to a hospital or institution as a result of the disability.

Termination of Coverage

Your coverage under the policy ends on the earliest of the following:

  • The date the policy or plan is cancelled;
  • The date you no longer are in an eligible group;
  • The date your eligible group is no longer covered;
  • The last day of the period for which you made any required contributions;
  • The last day you are in active employment except as provided under the covered layoff or leave of absence provision.

UnumProvident will provide coverage for a payable claim which occurs while you are covered under the policy or plan.

Next Steps
How to Apply
    To apply for coverage, complete your enrollment form within 60 days of your eligibility date. After that date you will be required to provide evidence of insurability in order to qualify for coverage.
Effective Date of Coverage

Pease see your Plan Administrator for your effective date.

Delayed Effective Date of Coverage

Insurance will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.

Questions

If you should have any questions about your coverage or how to enroll, please contact your Plan Administrator.

This plan highlight is a summary provided to help you understand your insurance coverage from UnumProvident. Details may differ from state to state. Please refer to your certificate booklet for your complete plan description. If the terms of this plan highlight summary or your certificate differ from your policy, the policy will govern.

Underwritten by: Unum Life Insurance Company of America 2211 Congress Street, Portland, Maine 04122, www.unumprovident.com UnumProvident is the marketing brand of UnumProvident Corporation's insuring subsidiaries. ©2001 UnumProvident Corporation. The name and logo combination is a servicemark of UnumProvident Corporation. All rights reserved.

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