Introduction

Why Supplemental LTD?

Plan Highlights

Commonly Asked Questions

Enrollment Information

Sample Policy University of Pennsylvania Human Resources



Commonly Asked Questions


When does my insurance coverage become effective?

Your coverage will become effective when it is put in force by The Standard, approximately 90 days after you receive your enrollment package, assuming you complete your enrollment application as instructed. Your specific effective date is noted in your personalized enrollment package.

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How will I pay for this coverage?

If your policy is approved and issued, premiums for the coverage will be deducted from your Penn paycheck on an after-tax basis. Deductions will begin in the month preceeding your effective date of coverage.

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Will my policy cover all pre-existing conditions?

This policy includes a PreExisting Conditions Amendment Endorsement. A disability due to a pre-existing condition will be excluded for the first 12 months that the policy is in force. After 12 months, a disability due to a pre-existing condition will be covered unless that condition is specifically excluded in the policy or a policy endorsement. A pre-existing condition is any mental or physical condition for which:

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Will I have to provide information regarding my medical history?

Only limited information about your medical history is required as part of the application process. This includes information about your use of tobacco or nicotine in any form in the last 12 months and your active work status for the last six months.

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What does it mean to be disabled under the terms of the policy?

The contract provides benefits for total and partial disabilities

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When The Total Disability Benefit Applies

This contract provides benefits for total and partial disabilities. Under the Protector Platinum Guarantee Issue policy, you are considered totally disabled if you suffer an injury or illness, you are unable to perform the primary duties of your regular occupation, and you are under the regular care of a physician appropriate for your injury or sickness. The physician's care requirement is waived when The Standard receives written proof that further care would not benefit you.

Regular occupation means the occupation(s) in which you are regularly engaged at the time your disability begins. If you have limited your practice to a professionally recognized specialty in medicine or law, then that specialty will be deemed your regular occupation.

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When The Presumptive Disability Benefit Applies

You are presumed to be totally disabled if you have an injury or illness, while the policy is in force, that results in total and permanent loss of speech, hearing, sight or the use two limbs.

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When The Partial Disability Benefit Applies

You are partially disabled under Protector Platinum when you are not totally disabled and you meet the definition of partial disability. There are two periods of partial disability, each with a distinct benefit and definition of partial disability:

  1. The Initial Period of partial disability refers to the waiting period and the first six months during which disability benefits are payable for your partial disability. During this period you are partially disabled if:

During the Initial Period, while benefits are payable, you are eligible for 100 percent of the policy's basic monthly benefit.

  1. After the Initial Period, during the Extended Period of partial disability, you are partially disabled if:

During the Extended Period, the amount of disability benefit payable each month will be a portion of the policy's basic monthly benefit, depending on the amount of earnings you have lost in that month due to your disability.

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How is the monthly benefit amount calculated?

During a total disability and the initial period of partial disability, the benefit amount equals the policy's maximum monthly benefit.

Total Disability - the disability benefit amount is equal to the basic monthly benefit purchased

Initial Period Of Partial Disability - the disability benefit amount is equal to the basic benefit amount purchased

Extended Period Of Partial Disability - the benefit amount is proportionate to your income loss. To calculate this benefit, The Standard will determine your loss of earnings ratio and multiply it by the basic monthly benefit purchase. The example below illustrates how a benefit might be calculated for an Extended Period of Partial Disability:

Indexed pre-disability earnings $10,000
   Less monthly earnings -$4,000
Loss of earnings $6,000
   Divided by indexed pre-disability earnings / $10,000
Loss of earnings ratio .60 (60%)
   
Maximum monthly benefit $1,000
   Times loss of earnings ratio x.60
Monthly benefit $600

If your monthly earnings are less than 20% of your individual predisability earnings, the disability benefit amount is equal to your monthly benefit.

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What are your your indexed pre-disability earnings?

Indexed pre-disability earnings are pre-disability earnings adjusted by the rate of increase in the Consumer Price Index for Urban Consumers.

Adjustments are made annually on the anniversary of the date of disability.

Pre-disability earnings are the sum of the highest annual earnings for any two full tax years within the three full tax years preceding the date disability began, divided by 24.

Annual earnings include income from any vocational activity including:

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What are your monthly earnings?

Monthly earnings include all earned income (less business expenses) received in the month for which you are claiming a disability benefit.

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When do monthly benefits begin?

The benefit waiting period is the period of time you must be continuously disabled before your monthly benefits become payable. Benefits are not payable during the benefit waiting period.

The benefit waiting period under this policy requires a total of 180 days of disability within a continuous 360 day period following the start of disability.

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When do monthly benefits end?

Monthly benefits end automatically on the earliest of:

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When does my supplemental LTD coverage end?

Your supplemental LTD coverage ends automatically on the earliest of:

You may also terminate the policy by giving The Standard written notice. In this case, the effective date of the termination will be the later of the date stated in the notice and the end of the policy month in which The Standard receives the notice.

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Will I be eligible for disability benefits if I return to work?

You may be eligible for disability benefits even while working and earning income. If you are partially disabled, The Standard will pay 100 percent of the disability benefit for the first six months of partial disability regardless of the income earned while you return to work. After the six months, The Standard will pay a portion of the monthly benefit based on the amount of income you lost that month.

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How do I apply?

See the enrollment instructions.

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Who Do I Contact If I Have Questions?

Please contact Income & Benefits Solutions, the plan administrator, at UPenn@IncomeBenefit.com or call 877.321.4427.