Short Term Disability Summary
Summary of Benefits
Disability insurance pays a portion of your salary if you're unable to work due to a covered disability. When reviewing this coverage, consider how long you can personally go without receiving a paycheck.
Who Can Elect Coverage?
You: All active, full-time regular employees of AU, regularly working a minimum of 30 hours per week in the US, who are citizens or permanent resident aliens of the US. Coverage is effective immediately.
|Gross Weekly Benefit||Maximum Gross Weekly Benefit||Benefit Waiting Period||Maximum Benefit Period|
|50% of your weekly covered earnings||$1,500||7 days for accident
7 days for sickness
|25 weeks for accident
25 weeks for sickness
|Age||Monthly Rate Per $10 of Weekly Benefit|
Actual pay period premiums may differ slightly due to rounding. Rates vary by age and may be subject to change in the future.
How to Calculate Your Monthly Cost
Step 1: Divide your annual salary by 52 to calculate your weekly earnings.
Step 2: Multiply this amount by the benefit percentage defined above in the Available Coverage section. For example, 60% would be .60. Now you have your gross weekly benefit.
Step 3: Use the chart above to find your Monthly rate based on age. Multiply this rate by your gross weekly benefit, or the maximum gross weekly benefit, whichever is less.
Step 4: Divide the total by 10. The result is your Monthly cost.
Important Definitions and Policy Provisions
Disability- “Disability” or “Disabled” means if solely because of a covered injury or sickness, you are unable to perform the material duties of your regular job and you are unable to earn 80% or more of your covered earnings from working in your regular job. We will require proof of earnings and continued disability.
Covered Earnings- “Covered Earnings” means your wages or salary, not including overtime pay, bonuses, commissions, and other extra compensation.
When Benefits Begin- You must be continuously disabled for 7 Days for an accident and 7 Days for a sickness before benefits will be paid for a covered disability.
How Long Benefits Last- Once you qualify for benefits under this plan, the maximum number of weekly disability benefits is 25 weeks for an accident for 25 weeks for a sickness. Disability benefits will end sooner if you no longer qualify for benefits.
When Coverage Takes Effect- Your coverage takes effect on the plan or policy effective date, the date you become eligible, the date we receive your completed enrollment form, or the date you authorize any necessary payroll deductions, whichever is the latest date. If you’re not actively at work on the date your coverage would otherwise take effect, your coverage will take effect on the date you return to work.
Benefit Reductions, Conditions, Limitations and Exclusions
Effects of Other Income Benefits- This plan is structured to prevent your total benefits and post-disability earnings from equaling or exceeding pre-disability earnings. Therefore, we reduce this plan’s benefits by an amount equal to any Social Security retirement and/or disability benefits payable to you, your dependents, or a qualified third party on behalf of you or your dependents. Your disability benefits will not be reduced by any Social Security disability benefits you are not receiving as long as you cooperate fully in efforts to obtain them and agree to repay and overpayment when and if you do receive them. Disability benefits will be reduced by amounts received through other government programs, sick pay, employer funded retirement benefits, workers’ compensation, franchise/group insurance, auto no-fault, and damages for wage loss. For details, see your Certificate Insurance.
Termination of Disability Benefits- Your benefits will terminate when your disability ceases, when your benefit duration period is exceeded, you earn more than your allowable Covered Earnings, or the date you refuse to participate in rehabilitation services.
Exclusions- This plan does not pay benefits for a disability which results, directly or indirectly, from any of the following:
- Suicide, attempted suicide, or intentionally self-inflicted injury while sane or insane
- War or any act of war, whether or not declared
- Active participation in a riot
- Commission of a felony
- The revocation, restriction, or non-renewal of an Employee’s license, permit, or certification necessary to perform the duties of his or her occupation unless due solely to injury or sickness otherwise covered by the policy
- Any cosmetic surgery or surgical procedure that is not medically necessary
- An injury or sickness for which the employee is entitled to benefits from Workers’ Compensation or occupational disease law
- An injury or sickness that is work related
In addition, the plan does not pay disability benefits any period of Disability during which you are incarcerated in a penal or corrections institution.