| How
do I qualify for disability benefits?
You must become totally disabled (see Definitions
of Terms), and apply for disability benefits before
retirement, termination of employment, Workers' Compensation
redemption, reduction in force, educational or military
leave of absence without pay, or termination of coverage
for nonpayment while you are on a leave of absence.
If
you are on a leave of absence during which you continue
to be eligible for disability, you are responsible for paying
your share of the cost, if any, for continuing disability
coverage on that portion of your salary.
Are
there any pre-existing condition exclusions or limitations?
No.
The Expanded Long-Term Disability Plan pays benefits regardless
of any pre-existing conditions.
Are
there any exclusions?
Yes.
The Plan will not pay benefits if your disability occurs:
- due
to an intentionally self-inflicted injury or illness;
- due
to war or acts of war, declared or undeclared;
- while
you are committing or attempting to commit a crime;
- while
participating in a riot;
- while
you are in jail or in prison.
See
the Plan Limitations and Interpretations
section for more information.
Who
determines if I am disabled?
The Claims Administratoreither ManageAbility or UNUMProvidentdetermines
whether you meet the definition of disability. If your benefit
payment under the Plan (before any offsets) will be less
than or equal to $16,250 per month, ManageAbility makes the determination.
If your benefit payment will exceed $16,250 per month, UNUMProvident
makes the determination.
What
is the basis for determining disability?
The Claims Administrators make disability determinations
at their sole discretion based on medical information, which
includes objective clinical findings. You must provide medical
information that the Claims Administrator, at its sole discretion,
accepts as evidence of your total disability as defined
in Definition of Terms.
The
Claims Administrator bases its determination of disabilityand
the effective date of the disabilityon the information
you provide when you apply for benefits and additional information
the University may require. The University reserves the
right to reject any information provided after the determination
is made.
All medical information must document your health condition during the period of time that your LTD coverage is in force. In no case will the University accept medical information that documents your health condition during a time when you are not covered by this LTD plan.
Length
of Time of Disability
If it is determined that your total disability is not expected
to last more than 12 months, your application will be denied.
If
it is uncertain whether your disability will last a year
or more, determination of disability may be delayed until
you have shown that you were totally disabled for 12 consecutive
months.
Note:
Being out of work for 12 continuous months does not necessarily
qualify you as being totally disabled.
When
will disability benefits begin?
If your claim is approved, your disability benefits will
begin on the latest of the following dates:
- the
day after you have used up all your sick (including extended
sick), vacation pay, and/or PTO; or
- after
the waiting period, or
- after
your leave has ended (see Coverage
During Leaves of Absence).
What
disability benefits will I receive?
If your claim is approved, the Expanded Long-Term Disability
Plan replaces up to 65% of your base salary minus any disability
income you receive from other public sources, such as Workers'
Compensation, Social Security disability and/or retirement
benefits, or Veterans Administration benefits. (See "Other
disability income" in the Definition
of Terms section.) If you receive other disability incomeor
if the Claims Administrator determines that you are eligible
to receive other disability incomethe Plan will pay
you the difference between that income and 65%
of your base salary (or the maximum benefit, if that is
less). If your other disability income exceeds 65% of your
base salary, the Expanded Long-Term Disability Plan makes
no payments.
If
you receive no other disability income, the Plan will pay
you the full 65% of your base salary up to the maximum benefit.
Disability
benefits are paid monthly on the last working day of each
month. The maximum annual base salary covered is $424,615.
The Plan's maximum benefit is $23,000 per month.
Reduced
AppointmentIf your appointment is reducedvoluntarily
or involuntarilywhile you are covered by this Plan,
your disability benefits will be calculated using the base
salary for your reduced appointment. There is one exception,
however. Your disability benefits will be calculated using
your base salary prior to the reduction
in appointment, if:
- There
is satisfactory evidence that your appointment and/or
base salary were reduced because of your disability,
and
- You
are approved for benefits within two years of such reduction.
The approval date for benefits under the Plan is the date
the Claims Administrator (ManageAbility or UNUMProvident) provides written
approval.
Less
than Four Years of ServiceIf you have less
than four years of service and did not earn at least 75%
of your total base salary during the full period of employment,
the Plan will not pay disability benefits based on your
full salary. This means that you must earn at least 75%
of your annual salary as of your last day of work.
For
example, if your annual salary is $100,000, 75% of this
amount is $75,000. In order to receive disability benefits
based on your full salary, you must earn at least $75,000
as of your last day of work. If you do not earn at least
75% of your annual base salary as of your last day of work,
benefits will be based on the salary that was earned.
Extended
Sick PayIf you are on extended sick pay,
the Plan will not consider a salary increase of more than
your average increase over your last three years of work
(or, if it is greater, the average increase in your department
during the current year). Retroactive salary adjustments
will be considered only if the salary was proposed in writing
to Human Resources before your last day of work.
Retirement,
Retirement Furlough, and SabbaticalExpanded
Long-Term Disability benefits will not be paid if you apply
for disability benefits after you are scheduled
to retire or take retirement furlough, or during
scheduled retirement furlough or sabbatical.
What
other benefits will I receive?
If you are approved for disability benefits under this Plan,
you will continue any University benefits in which you were
participating as of your last day of pay, or the date disability
payments begin.
Note:
If you do not elect to continue these benefits when you
go on disabilityor if you elect these benefits and
then opt out of them at a later dateyou will not be
eligible to re-enroll in them at a later date.
| Other
Benefits |
| Benefit |
What
to Consider |
Medical
Insurance
Dental Plan Option I
Group Term Life Insurance
Prescription Drug |
Your
coverage will continue at no cost to you. You may continue
dependent coverage only for those named dependents who
are enrolled as of your last day of pay. Note:
You cannot add dependents to your coverage while you
are on disability unless dependents qualify under the
provisions of the University's commercial transfer policy.
If you remove dependents from your coverage, you will
not be eligible to re-enroll them at a later date. |
| University
Basic Retirement Plan |
If
you are enrolled in the Basic Retirement Plan or if
you are a compulsory Basic Retirement Plan participant,
the Plan will contribute 15% of your annual base salary
at the time of your disability, to the extent it is
legally permitted. Additional contributions cannot
be made under the provisions of this Plan. |
Dental
Option II and III
Group Legal
Long-Term Care
Vision |
You
are eligible to continue these benefits and must pay
the full cost for them yourself; however, if you withdraw
from these benefits, you cannot re-enroll. |
Taxes
and premiums
If a new federal or state law requires the University to
pay taxes or premiums to the federal or state government
(or another entity) for hospital or medical benefits, the
University may make any necessary adjustments to avoid duplicating
benefits and may adjust taxable income as needed to comply
with such laws.
Medical
Leave of Absence
If your Expanded Long-Term Disability benefits are not approved
before your last day of pay, you must ask your supervisor
and your Campus Employment Office to place you on a medical
leave of absence. (For further information, see Standard
Practice Guide 201.30, "Leaves of Absence.")
If
your disability benefits are approved later, any benefits
plans you discontinued will be restored retroactive to your
last date of payor the date your disability payments
beginwhichever occurs later. You will be reimbursed
for any benefits covered under the plan that you continued
at your own expense (except for coverage during the Plan's
waiting period).
How
will the University know if I am eligible for other disability
income?
It is your responsibility to inform the University that
you and/or your dependents are eligible for other disability
income such as Social Security disability or retirement
benefits, Workers' Compensation, or Veterans Administration
benefits. If you qualify for disability income under this
Plan, you must pursue the possibility of receiving disability
income from all other sources. See "Other disability
income" in the Definition of Terms
section. You must notify the University's Long-Term Disability
Coordinator in writing promptly whenever you are awardedor
denieddisability income from any other source.
In
addition, you are responsible for notifying the Long-Term
Disability Coordinator immediately when your spouse and/or
children are no longer eligible for Social Security, Veterans
Administration, or other benefits. Your Expanded Long-Term
Disability Plan benefits will be adjusted accordingly.
If
you fail to apply for other disability income, or fail to
inform the Benefits Office of all awards and denials, the
University has the right to:
- withhold
or discontinue all payments and benefits under the Expanded
Long-Term Disability Plan, or
- reduce
your Plan benefits by the amount of other disability income
that you and your dependents are eligible to receive.
When
must I apply for Social Security disability benefits?
You must apply for Social Security disability benefits at
the same time you apply for disability benefits under this
Plan. You can apply by calling Social Security's toll-free
number 1-800-772-1213. TTY for hearing- or speech-impaired
callers: 1-800-325-0778, Monday through Friday, 7:00 a.m.
to 7:00 p.m., Eastern Time.
If
your claim for Social Security disability benefits is denied,
you must request an immediate reconsideration of that decision.
If your claim is denied again, within 60 days you must file
for a hearing with a Social Security Administration law
judge.
If
you do not apply for Social Security disability benefits,
do not follow the full appeal process, or are denied Social
Security disability benefits because you refuse to accept
rehabilitation, the University has the right to:
- withhold
or discontinue all benefits under the Expanded Long-Term
Disability Plan, or
- reduce
your Plan benefits by the amount of other disability income
you and your dependents are eligible to receive.
If
you retain an attorney for assistance with Social Security
disability claims, the Long-Term Disability program will
reimburse your attorney fees up to the legal limit, which
is currently 25% of the retroactive benefit but not more
than $4,000.
When
do Plan benefits end?
Your Expanded Long-Term Disability Plan benefits end on
the earliest of the following dates:
- the
day you are no longer totally disabled as determined by
the Claims Administrator at its sole discretion and are
able to return to work at least half time;
- the
end of the month in which you retire (in most cases, age
65; refer to the chart below) ;
- the
end of the month in which your University employment is
terminated;
- your
scheduled retirement date;
- the
date you go to jail or prison;
- the
end of the month in which you die.
LTD Benefit Duration After Age 60 |
Age |
LTD Benefits Schedule |
61 or Younger |
To age 65 |
62 |
3.5 yrs/42 mos. |
63 |
3 yrs/36 mos. |
64 |
2.5 yrs/30 mos. |
65 |
2 yrs/24 mos. |
66 |
1.75 yrs/21 mos. |
67 |
1.5 yrs/18 mos. |
68 |
1.25 yrs/15 mos. |
69 |
1 yr/12 mos. |
Over 69 |
1 yr/12 mos. |
However:
- If
you are disabled and meet the requirements for age and
years of continuous service under the Retirement Plan,
you may retire at any time.
- Your
participation in the Expanded Long-Term Disability Plan
will end at the time of retirement.
Your
Plan benefits may end if:
- You
fail to provide documents or medical information requested
by the Plan;
- You
fail to follow reasonable medical advice;
- You
fail to cooperate in obtaining rehabilitation or employment;
- You
otherwise fail to abide by the terms of the Plan.
In
each of the above cases, your employment with the University
will terminate on the same date your Expanded Long-Term
Disability benefits end. |