Fortis/Assurant Long Term Disability Plan

CALCULATE YOUR COST FOR THE BUY UP OPTION PLAN.

General Information
• A Dual Definition of Disability allows insured participants to qualify for benefits under an own occupation or an earnings test.
• If the earnings test is met, zero day residual stipulates that full-time work, in which the disabled employee is performing all of the material duties of his/her regular or some other occupation, will not interrupt the elimination period or the period of disability.
• Under unlimited partial disability, if a disabled employee meets the occupation test only, works less than on a full- time basis, or works but does not perform all of the material duties of his/her regular occupation, the elimination period and the period of disability will not be interrupted.
• Under the earnings test, a disabled employee can earn, or be capable of earning, up to 80% of pre-disability pay. The amount an employee can earn and still meet the earnings test is increased by the indexing amount listed in the Schedule.
• In the earnings test, earnings are defined as basic pay for a 40-hour work week, plus the monthly average of prior calendar year commissions where applicable; monthly average of prior calendar year draw or salary for proprietors; or ordinary income on Schedule K-1 for partners.
• FICA PLUS services are included.
• No offsets apply for Individual, Franchise or Wholesale Disability Plans, Profit-Sharing Plans, Thrift Plans, 401 (k) Plans, IRAs, Tax-Sheltered Annuities, and Stock Ownership Plans.
• Offsets may include retirement or government plans, other group disability plans, settlements or payments received, no-fault benefits, and return-to-work earnings.
• For employees who become disabled after age 68, additional benefit duration restrictions apply, however, the maximum benefit duration will be at least 12 months.
• A Conversion Privilege up to $1,000 is included.
• Includes a Survivor Benefit, which is equal to 3 months of benefit payments if the insured dies while receiving LTD benefits. The Survivor Benefit is payable to the insured’s spouse, if living, otherwise to any eligible dependent children.
• Pre-existing condition limitation at issue is the same as for new hires. Pre-existing condition limitation for new hires is 3/3/12. A pre-existing condition is one for which an individual has seen a medical practitioner or taken medication in the 3 months prior to her or his coverage effective date. Fortis Benefits will not pay benefits for any pre-existing condition until the earlier of 3 consecutive months ending on or after the effective date of coverage during which the individual has not seen a medical practitioner or taken medication for a condition; OR the individual remains insured under this plan for 12 consecutive months.

Employee Eligibility
• Eligible employees, as described in the Schedule, must be full-time employees of the employer or an associated company, at active work and working in the United States of America*. Temporary or seasonal workers are not eligible. Insured employees are covered for incidental business and personal travel outside of the United States. If a more expansive eligibility is required, please contact your sales representative. Non-standard options are available, subject to Home Office approval.
• The rates in this proposal reflect coverage only for employees who are actively at work on the effective date.
• Fortis Benefits will require proof of good health from all individuals wanting to enroll in this plan who were declined for long-term disability coverage under the prior carrier’s plan, as well as individuals who were eligible for coverage under the prior carrier’s plan but chose not to participate.
• A 10% increase in the benefit percentage, to a maximum of $1,000, will be provided to disabled employees who are actively participating in a qualifying rehabilitation program.
• A maximum of 100% of an employee’s first month’s wages may be paid to an employer as an incentive to assist employees in their return to limited work following a period of disability.
• A 100% Return-to-Work Incentive applies for the first 12 months of trial employment; thereafter, a 70% indirect offset of return-to-work earnings applies.
• A Family Care Expense Credit to a maximum of $350 per dependent per month is included.
• Fortis Benefits may pay a maximum of $3,000 under the Americans with Disabilities Act (ADA) to cover expenses incurred by an employer or claimant making workplace modifications to enable a disabled employee’s return to work.
• A Spousal Rehabilitation Benefit is included that may provide vocational services for spouses of disabled employees.

Privacy Policy
Fortis Benefits Insurance Company does not disclose any personal information, financial or health, unless otherwise permitted by law. If you would like more information, you may obtain a copy of our Privacy Notice by contacting us at:

Assurant/Fortis Benefits Insurance Company
Attention: Privacy Officer
P.O. Box 419052
Kansas City, MO 64141-6052
For Disability Claims call: 800- 283-3636
www.assurantemployeebenefits.com

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