| Disability Income Insurance |  |
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| Build A Plan Suited To Your Individual Needs! | | You can create a plan design specific to your individual needs by first selecting monthly benefit amounts from $200, to as much as $3,000 (in $100 units). When combined with all other disability coverage which you may have in force, the benefit you are eligible to apply for may not exceed 50% of your average earnings per month at the time of application (see Plan Definitions section). If you become totally disabled while covered under the plan, benefits will become payable after the waiting period that you select. While you are totally disabled, benefits will continue to be payable until you reach the maximum benefit period that you select or age 65, whichever occurs first. Disabilities beginning on or after age 64 are payable for a maximum of 12 months. |
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| Highlights of Coverage | How The Plan Works | - Coverage for up to $3,000 in Monthly Benefits
- Convenient Payroll Deduction
- No Reduction For Sick Leave
- Choice of Benefit & Waiting Periods
- Affordable Group Rates
- Renewable Coverage To Age 65
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| plan design |
| Plan Design |
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| Select from one of the following plans: |
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| | Benefits Begin After A Total Disability Of | And Continue
For * | | Plan A** | 30 Days | 1 Year | | Plan B | 60 Days | 2 Years | | Plan C | 90, 180 or 365 Days (as selected) | To Age 65 |
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| * A Total Disability which occurs when you are age 64 is payable for a maximum of 12 months regardless of the Plan selected. No benefits are payable for a Total Disability which begins on or after age 65. | | | ** NOTE: Plan A will be available only to those applicants who can certify they have 60 days of less of sick leave. Recertification will be requested every 24 months in order to maintain coverage. If recertification cannot be made, coverage will revert to Plan B. |
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| premiums |
| Premiums |
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Monthly Premiums
Per $100 Unit | Plan A
1 Year Benefit and a 30 Day Waiting Period | Under 40
40 to 49
50 to 59
60 to 64* | $1.08
$1.46
$2.28
$3.53 |
| Plan B
2 Year Benefit and a 60 Day Waiting Period | Under 40
40 to 49
50 to 59
60 to 64* | $0.88
$1.30
$2.20
$3.70 |
| Plan C
To Age 65 Benefits and a
Choice of 3 Waiting Periods | | (in days) | 90 | 180 | 365 | Under 40
40 to 49
50 to 59
60 to 64* | $1.35
$2.43
$4.30
$5.25 | $1.15
$2.05
$3.65
$4.45 | $1.01
$1.82
$3.23
$3.94 |
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| | *Renewal only. Coverage terminates at age 65. Rates change as you enter a new age bracket as shown above. All rates are subject to change. |
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Tenthly Premiums
Per $100 Unit | Plan A
1 Year Benefit and a 30 Day Waiting Period | Under 40
40 to 49
50 to 59
60 to 64* | $1.30
$1.75
$2.74
$4.24 |
| Plan B
2 Year Benefit and a 60 Day Waiting Period | Under 40
40 to 49
50 to 59
60 to 64* | $1.06
$1.56
$2.64
$4.44 |
| Plan C
To Age 65 Benefits and a
Choice of 3 Waiting Periods | | (in days) | 90 | 180 | 365 | Under 40
40 to 49
50 to 59
60 to 64* | $1.62
$2.92
$5.16
$6.30 | $1.38
$2.46
$4.38
$5.34 | $1.21
$2.18
$3.88
$4.73 |
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| | *Renewal only. Coverage terminates at age 65. Rates change as you enter a new age bracket as shown above. All rates are subject to change. |
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| definitions |
| Definitions |
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| Average Monthly Earned Income means your monthly earned income averaged over the 24 months preceding application. It includes salary, wages, fees or other forms of remuneration, after deduction of normal and customary business expenses but before deduction of income taxes. It does not include dividends, rents, royalties, annuities or other forms of unearned income. |
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| Total Disability means that, because of sickness or injury and during the first 24 consecutive months following the waiting period, the insured is unable to perform the substantial and material duties of his/her job or profession. After 24 months of benefits have been paid, total disability will mean the inability of the insured to engage in any occupation or employment for which he or she is qualified by reason of education, training or experience. The insured at all times must be under the regular care of a physician other than the insured. We will not pay benefits for sickness for any period that a person may claim benefits for an accident. |
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| Half-Time means that you are regularly working at least one-half of the number of hours necessary to fulfill your contractual requirements with an eligible employer as defined by FACCC's by-laws. |
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| limits |
| Limitations |
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Pre-existing Condition means any injury or sickness for which the insured incurred medical expenses, received medical treatment, care or services during the 12 month period immediately preceding the insured's effective date of coverage. The pre-existing condition limitation will not apply to any period of total disability that begins after: - no such treatment, care or services have been received for the condition for 12 consecutive months after the effective date; or
- coverage has been in effect for for more than 24 months; whichever comes first.
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| Successive Periods of Disability |
| Two periods of total disability that are the result of the same or related causes, which are separated by less than 180 days, will be considered one period of disability. Two periods of total disability that are the result of unrelated causes will be considered one period of disability unless separated by one full day of work performing your job or profession on your usual basis. |
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| Mental Illness, Alcoholism & Drug Addiction |
| Benefits will be provided for the first 24 months for a total disability resulting from mental or nervous disorders, alcoholism, drug addiction or the use of any mind-altering drug provided pyschiatric care is received at least twice a month for this disability. |
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| Underwritten By |
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| Life Insurance Company of America (LINA) The Life Insurance Company of North America (LINA) is the underwriting company for this disability insurance. LINA, a CIGNA Company, has earned high marks from a respected insurance rating service (A.M. Best: A Excellent). CIGNA companies have been providing affordable insurance programs that offer quality and value to millions of members of affinity groups. |
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This information is a brief description of the important features of the plan. It is not a contract. Terms and conditions of coverage are set forth in group policy
#AGL-1089, issued in Delaware to the Universal Protection Trust. The group policy is subject to the laws of the jurisdiction in which it is issued. The availability of this offer may change. Please keep this material as a reference and refer to the Certificate of Insurance for additional state specific details. |
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