Voluntary Benefits

a.   Short-term Disability

Short-Term Disability Insurance
Should I consider purchasing the coverage?

If you were to become sick or disabled tomorrow and were unable to work for two or three months, would you have enough savings to cover your living expenses during that time? If you don't, short-term disability insurance (STD) would be an invaluable resource as you recover.

According to the American Council of Life Insurers, nearly one-third of all Americans will suffer a serious disability between the ages of 35 and 65. Statistics like that should make short-term disability insurance a vital piece of your overall financial plan.

What is STD?

Short term disability (STD) pays a percentage of your salary if you become temporarily disabled, meaning that you are not able to work for a short period of time due to sickness or injury (excluding on-the-job injuries, which are covered by workers compensation insurance). A typical STD policy provides you with a portion of your weekly salary for a specified number of weeks. You receive a maximum benefit amount per month.

During this initial annual enrollment offering, the short-term disability policy is "guaranteed issue," meaning you do not have to take a medical exam to prove insurability. Regardless of your health, you are guaranteed coverage. However, pre-existing conditions will not be covered for a 12-month period from the effective date of coverage. You must be actively at work on August 1, 2003 and continuously covered for that 12-month period. For example, if you are now pregnant and you become disabled on or after August 1, 2003 due to that pregnancy, this would be considered a pre-existing condition. However, if you become pregnant after August 1, 2003, and you meet the disability definition, benefits would be payable.

Causes of STD claims

Pregnancy (normal):
20 percent

Pregnancy (complications):
9 percent

Injuries (excluding back):
9 percent

Back injuries:
8 percent

Digestive/Intestinal:
8 percent

Source: UnumProvident

If you apply for disability coverage during future annual enrollment periods, you must provide medical proof to the insurance company that you are insurable. In other words, the insurance company will review your health history and decide if they will issue a policy. If you currently have a pre-existing condition, we encourage you to explore the short-term disability coverage at this time when coverage is guaranteed without looking at your medical history.

There are two plans offered. One plan begins payment on the 8th day of disability. The second plan begins payment on the 15th day of disability. Benefits are payable for up to 180 days for accidental injury or sickness. Costs for the short-term disability plans are payable by the employee.

Who should buy short-term disability?

All eligible employees are currently covered (after a one-year waiting period) under the Prudential Long-Term Disability program (LTD). However, you must be disabled for a six-month period before benefits are payable under the LTD. Do you have enough vacation, sick time or savings to cover the six-month period you will not be drawing a salary?

If you have enough in savings to last until you return to work again, you probably don't need to buy STD. However, if you do not have much in savings or any other income to fall back on if you were to become disabled, an individual STD policy may not be a bad option.

The American Fidelity Assurance Company STD brochure you received includes a table, which lists the monthly disability benefit amount you are eligible to purchase, based on your monthly salary. This is the maximum amount you can purchase. However, you can buy a lesser amount of coverage if this is more affordable. For instance, if your monthly salary is $1500.00, the table reflects that you can purchase a $1000 monthly disability benefit. You can purchase less than the $1000 monthly disability benefit. Ask the benefit enroller at BBI for the amounts you are eligible to purchase below the maximums stated in your brochure.

We encourage you to consider enrolling in this new benefit offering. Contact Better Benefits, Inc. at 800-933-5024 to further discuss benefit options and the associated costs. You do not need to complete an application for coverage. The Better Benefits enrollers will take your application over the telephone and advise us of the coverages you have elected and the cost. We will then contact your bookkeeper with this information to arrange for payroll deduction to begin in August.

The following are terms that can be found in most short term disability (STD) policies. While many of these terms apply only to group insurance, some are also applicable to individual disability insurance policies.

Active, Full-time Employee. An individual must work for the employer on a regular basis in the usual course of the employer's business to be considered an active, full-time employee and eligible for coverage. Usually, a minimum number of hours of regular work is specified. As this applies to the Diocese of Palm Beach, you must be a W-2 employee (taxes and social security deducted) and work 30 or more hours per week to be eligible for coverage.

Benefit Percentage. The benefit payable amount was selected by you when you applied for your policy.

Definition of Total Disability. Probably the most important provision in a disability contract is the definition of disability that will be used to determine an employee's eligibility for benefits.

The definition of disability under the American Fidelity Assurance Company policy offered to Diocesan employees is:

Disability or Disabled means you are unable to perform the material and substantial duties of your Regular Occupation.

Under this definition, an insured will be considered disabled only if he or she is unable to perform the duties of his or her occupation.

To assist you in comparing the American Fidelity policy and other policies, please be aware that some short-term disability policies follow a stricter disability definition. An example of said definition is:

  • Any Occupation (Any Occ): Under this definition, an insured will be considered disabled only if he/she is unable to work in any occupation for which he/she is qualified by education, training, or experience. This is closely related to the definition that the Social Security Administration uses in determining disability.

Elimination Period. This is the period of time between the date the disability commences and the beginning of the benefit payment period. It is the period during which an employee must be disabled before payment of benefits begins. There are two plans offered to Diocesan employees. One plan begins payment on the 8th day of disability. The second plan begins payment on the 15th day of disability.

Evidence of Insurability. Group disability coverage is generally sold as "guaranteed issue" which means that evidence of insurability is not required. After this initial enrollment period, if you apply for disability coverage during future annual enrollment periods, you must provide medical proof to the insurance company that you are insurable. In other words, the insurance company will review your health history and decide if they will issue a policy. If you currently have a pre-existing condition, we encourage you to explore the short-term disability coverage at this time when coverage is guaranteed without looking at your medical history.

Exclusions. There are specific provisions included in group disability plans which exclude coverage in certain situations. Typically, a plan will not pay benefits for disabilities arising from war, participation in a riot, commission of a felony, or self-inflicted injury. Contact Better Benefits at (800)933-5024 for specific exclusions information on the American Fidelity policy.

Limitations. There may be specific provisions included in group disability plans that limit coverage in certain situations. Often only limited benefits are payable for specific conditions or under specific circumstances. For example, the American Fidelity policy offered to you limits benefits if you are disabled due to alcoholism and drug addiction. Always check your policys list of exclusions and limitations.

Maximum Benefit Period (Benefit Duration). This is the maximum length of time for which benefits are payable under the plan as long as the employee remains continuously disabled. The American Fidelity policy offered to you will pay benefits for up to 180 days as long as you are continuously disabled.

Maximum Monthly Benefit. This is the highest dollar amount a disabled employee can receive on a monthly basis under the STD plan.

Mental Illness and Substance Abuse Limitations. When a disability is caused by a psychological/behavioral/emotional disorder, or by alcoholism or the non-medical use of narcotics, sedatives, and so on, benefits are usually limited.

Pre-Existing Condition Limitations. When an insured has a physical or mental condition that existed prior to the effective date of his or her insurance coverage, it is considered a pre-existing condition. Your American Fidelity policy states as follows:

Pre-Existing Condition means a disease, accidental injury, sickness, physical condition, or mental illness for which you have experienced any of the following: (a) treatment; (b) incurred expense; (c) took medication; (d) received care or services including diagnostic testing or related measures; or (e) received a diagnosis or advice from a Physician, during the 12-month period immediately before your effective date of coverage. The term Pre-Existing Condition will also include conditions which are related to such disease, accidental injury, sickness, physical condition or mental illness.

Waiver of Premium. When an individual becomes disabled and eligible for benefits, no further disability premium payments are required as long as benefits are being paid out. Waiver of Premium will begin the first of the month following your satisfaction of the Elimination Period, provided premium has been paid from the beginning of Disability to the date Waiver of Premium begins. This will continue until the end of your disability, the end of the maximum benefit period, the date you are no longer eligible to receive disability payment, the date your policy terminates, or the date your employment with the Diocese of Palm Beach ends, whichever first occurs. The insurance company will require proof that you remain disabled during that period.


 

b.   Optional Term Life (Prudential)

Prudential Optional Life Insurance Benefit

Life is full of pleasant surprises and, at the same time life holds many uncertainties It's easier to plan for events you know will occur, such as buying a home, planning for a wedding or saving for college tuition costs. It’s more difficult to plan for the unexpected. For these times, it’s important that you have enough life insurance coverage. Your current life insurance plans may not offer enough insurance protection. Together with your employer, Prudential offers you the opportunity to purchase term life insurance which can help further safeguard your earnings and helps cover your financial obligations in the event of your death.

You can receive many benefits by participating in Prudential’s voluntary Optional Term Life plan.

  • Choice of Coverage - Prudential’s Optional Term Life plan offers you the opportunity to obtain additional life insurance protection and to choose the level of coverage that’s right for you.
  • Group Rates - This plan is available to you at group rates, which are typically lower than individual insurance rates.
  • Convenient Payroll Deduction - Your insurance costs are deducted from your paycheck, so there’s no check writing or mail delay.
  • Conversion of Coverage - If your employment ends for any reason, your term life coverages may be converted within 31 days of termination (without having to furnish evidence of insurability) to one of a number of Prudential individual life insurance policies. The amount you convert may be limited if, within the conversion period, you become insured for group life insurance through a different employer. Please refer to your personalized enrollment form for details.

Employee Optional Term Life

Guaranteed Coverage Amounts
Certain coverage is available without providing evidence of good health. If you enroll within 31 days of your date of eligibility, you must provide evidence of good health satisfactory to Prudential for coverage amounts greater than $50,000. If you select a coverage amount greater than $50,000, you must complete a Health Statement Questionnaire. If you enroll after 31 days, you must complete a Health Statement Questionnaire for any coverage amount you select.

Living Benefit Option
If you provide satisfactory proof that you are terminally ill with a life expectancy of 6 months or less, you may elect to receive up to 50% of your Optional Term Life coverage while still living, up to a maximum of $50,000. This benefit is available only once and is payable in a lump sum or in 6 equal monthly installments. The death benefit payable to your beneficiary will be reduced by the amount you elect under this option.

Waiver of Premium
If you are totally disabled for a continuous 9 month period and are less than 60 years of age at the time disability begins, Prudential will continue your coverage with no premiums due, provided you report your disability within 12 months of its start and submit any required proof to Prudential.

Reduction/Termination of Coverage
At age 70, your amount of insurance will be reduced to 50% of your coverage amount before any reduction. This coverage will end on termination of your employment or retirement, however you may convert your coverage to a Prudential individual life insurance policy, if applicable. Upon retirement, your amount of insurance is limited to $5,000.

Enrolling is Easy

This is a general description of your benefits. Please carefully review all available information, so you can make an informed decision about participating in this program. Once you have elected your coverage, simply complete the personalized enrollment form available from your bookkeeper and/or the benefits office. Make sure to complete all white pages, sign and date the form, and return as instructed.

About Prudential

Prudential has been a trusted and reliable source of insurance and benefits products for much of the 20th century. As a provider of life insurance since 1916, Prudential is one of the most powerful brands in the insurance and financial services industry. In the new millennium, Prudential continues to be recognized for services and product features that help meet diverse employee needs.

Rate Sheet

Optional Term Life - Coverage Rates per $1,000

Age
(Initial rates are based on age as of effective date of your coverage. Rates will change based on the following schedule.)

Employee 
Monthly Cost 
of Insurance

0-29

$0.070

30-34

$0.080

35-39

$0.110

40-44

$0.170

45-49

$0.230

50-54

$0.410

55-59

$0.700

60-64

$1.-010

65-69

$1.540

70-100

$2.900

 

How to determine your cost
of insurance for Optional Life

For illustrative purposes only, consider a 42 year old employee selecting a coverage amount of $50,000 whose deductions are taken monthly.

Steps to follow

Example

In this example, the individual is choosing a coverage amount of $50,000

$50,000

The employee would then locate their age on their rate chart. We have used a sample rate of $0.170 per $1,000 for this employee.

42 years old
Sample - $0.17 rate per $1,000

Divide the selected amount of coverage by $1,000 and multiply the result by the rate for that age group. This results in the total monthly cost of insurance. (If the person were paid bi-weekly then the $8.50 would be multiplied by 12 [12 months in a year] then divided by 26 [52 weeks in a year divided by 2] for a total bi-weekiy deduction of $3.92.)

$50,000 / $1,000 = 50
50 x $0.17 = Total Monthly Cost: $8.50

 

 

c.   VSP Vision Plan



d.   LifeLock



For assistance or questions, contact Sandy Maulden