Reading your LTD Schedule of Benefits
Your Schedule of Benefits outlines key details about your coverage, including benefit amounts and plan highlights.
Terms to know
Here are a few important terms to understand:
- Disability Definition – You must meet specific criteria to qualify:
- Own Occupation: Unable to perform your regular job or primary income-generating activity during the elimination period and the number of months listed.
- Any Occupation: Unable to perform any job for which you’re reasonably qualified by training, education, or experience thereafter for the number of months listed.
- Monthly benefit percentage – The portion of your salary paid monthly.
- Maximum/Minimum Monthly Benefit – The highest and lowest amounts payable, regardless of salary.
- Elimination period – The number of consecutive days you must be disabled before benefits begin. No LTD benefits are paid during the elimination period.
- Maximum benefit period – The longest duration benefits will be paid.
- Pre-Existing Condition Exclusion – Your disability must meet the following conditions:
- Lookback: No diagnosis or treatment for the disability within the specified months.
- Treatment-Free: No treatment received for the disability during the specified period.
- Continuous Coverage: You must have been actively working and had LTD coverage for the duration listed.
- Offsets – Other income benefits that may reduce your disability benefit.
- Mental Illness / Addiction Coverage – Covered for the time period listed.
- Waiver of Premium (optional) – If included, you won’t pay premiums while receiving LTD benefits.
- Survivor Benefits (optional) – If you pass away while on disability, a benefit is paid to your beneficiary.
- Recurrent Disability – If the same disability recurs within the listed timeframe, the elimination period is waived.
- Rehabilitation Incentive – Your benefit may increase if you participate in approved programs (e.g., job training, GED completion).
Please note, your plan includes options tailored to your employer. For full definitions and details, refer to your Schedule of Benefits or Certificate of Insurance. To obtain your specific Schedule of Benefits or Certificate, contact your employer or our Customer Service team.
Sample Long Term Disability Schedule of Benefits
| Benefit | Benefit amounts and highlights | ||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Disability Definition | 24-Month own occupation, any occupation thereafter / Residual | ||||||||||||||||||||||||||
| Monthly Benefit Percentage | 40% | ||||||||||||||||||||||||||
| Maximum Monthly Benefit | $6,000 | ||||||||||||||||||||||||||
| Minimum Monthly Benefit | None | ||||||||||||||||||||||||||
| Elimination Period | 90 days | ||||||||||||||||||||||||||
| Maximum Benefit Period | The later of:
|
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| Pre-Existing Exclusion | 3 lookback / 12 continuous coverage | ||||||||||||||||||||||||||
| Offsets | Primary & Family Government Social Plans and other offsets | ||||||||||||||||||||||||||
| Mental Illness / Drug Addiction / Alcoholism | 24-month limitation | ||||||||||||||||||||||||||
| Waiver of Premium | Included | ||||||||||||||||||||||||||
| Survivor Benefits | 3-month lump | ||||||||||||||||||||||||||
| Recurrent Disability | 6 months | ||||||||||||||||||||||||||
| Rehabilitation Incentives | Included | ||||||||||||||||||||||||||
| Additional Benefits | |||||||||||||||||||||||||||
| Single Sum Payment in the Event of Your Death | Yes | ||||||||||||||||||||||||||
Enhanced LTD options
There are additional benefit options that can be added to your plan by your employer, which are explained below. If you have any of these options, you will see them in your Long Term Disability Schedule of Benefits. Please check your Schedule of Benefits to see the options available on your plan.
- Survivor Benefit – Pays a monthly or lump sum benefit in the event of a disabled employee’s death. A three-month lump sum is standard.
- Limited Disability Benefits – Help getting back to work for mental or nervous disorders; neuromuscular, musculoskeletal or soft tissue disorders; chronic fatigue; and drug and alcohol disabilities. Coverage for up to 24 months is standard.
- Recurrent Disability – If, within a specified time, you become disabled again with the same disability, the elimination period is waived. Six months is the standard specified time. Offsets. Our plan coordinates with primary and family government social plans and other offsets to help reduce claims. Flexible benefits provide coverage when (and where) you need it most.
- Offsets – Our plan coordinates with primary and family government social plans and other offsets to help reduce claims.