Archdiocese of Chicago
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1 Protect the most important people in your life. Archdiocese of Chicago Group Basic and Supplemental Life and Disability Insurance RELIANCE STANDARD LIFE INSURANCE COMPANY
2 Plan Highlights Group Basic and Supplemental Life Insurance Eligibility Lay Employees: All Archdiocesan Staff scheduled to work at least 26 hours per week for 8 or more months of the year in active employment except any person employed on a temporary or seasonal basis. Benefit Amount Basic Life: One (1) times annual salary to a maximum of $750,000 Supplemental Life: One (1) to four (4) times annual salary to a combined maximum of $750,000 Contribution Requirements Basic Life: Coverage is 100% employer paid Supplemental Life: Coverage is 100% employee paid Guarantee Issue New Hires/New Enrollees: Basic and Supplemental Life (combined): $500,000 or over 3x earnings. If you are a new enrollee and electing 1 times or increasing from 1 to 2 times your salary coverage, EOI is not required as long as the total coverage (basic and supplemental combined) is not above $500,000. Changes in Current Supplemental Coverage: increase no more than the lesser of 1 unit of coverage or the New Hire Guarantee Issue without submitting Evidence of Insurability. No Current Supplemental Coverage: Evidence of Insurability is required for your election. Benefit Reductions Due to Age Age Original Benefit Reduced by: 70 35% 75 50% Exclusions and Limitations For a comprehensive list of exclusions and limitations, please refer to the Certificate of Insurance. The Certificate also provides all requirements necessary to receive a benefit. Supplemental Life Rates per $1,000 Age of EE Rate/$1000 Age of EE Rate/$1000 <30 $ $ $ $ $ $ $ $ $ $1.56 Provisions Conversion Privilege Waiver of Premium (Supplemental Life) Portability Living Benefit Rider* * In some states this is expressed as Accelerated Benefits, in others it is labeled Imminent Death Benefit. Bereavement Counseling and WorldNet Travel Assistance (Basic Life) are included with this policy. This Plan Highlights is a brief description of the important features of the RSL insurance plan. It is not a certificate of insurance or evidence of coverage. Insurance is provided under group policy form LRS- 6422, et al. Terminates at Retirement 2
3 Plan Highlights Voluntary Group Short Term Disability Eligibility Lay Employees: All Archdiocesan Staff scheduled to work at least 26 hours per week for 8 or more months of the year in active employment and earning at least $15,000 annually, except any person employed on a temporary or seasonal basis. Coverage Disability income protection insurance pays a benefit for disability resulting from a covered injury or sickness. Benefits begin at the end of the elimination period and continue while you are disabled up to the maximum benefit duration. Benefit Amount You may elect a weekly benefit starting from $100/week up to a maximum of $1,250/week in increments of $25, not to exceed 60% of your covered earnings. This benefit will not be offset with any accumulated sick leave. Elimination Period Accident and Sickness benefits begin on the 30th consecutive day of disability Maximum Benefit Duration Benefits for one period of disability, will be paid up to a maximum of 22 weeks. Contribution Requirements Coverage is 100% Employee paid. Plan Highlights Maternity covered as any other illness Employee Rates (per $10 of Weekly Benefit) Age Rate $ $ $ $ $ $ $ $ $ $ and over $ 0.65 Rates change as an insured moves from one age band to the next Exclusions and Limitations No benefits are paid for any disability caused by an intentionally self-inflicted injury; an act of war (declared or undeclared); commission of a felony; sickness covered by workers compensation or other workers disability law; or injury which occurs out of or in the course of work for wage or profit. For a comprehensive list of exclusions and limitations, please refer to the Certificate of Insurance. The Certificate also provides all requirements necessary to receive a benefit. This Plan Highlights is a brief description of the important features of the RSL insurance plan. It is not a certificate of insurance or evidence of coverage. Partial Disability Benefit included Pre-existing condition- 3/12 Non-occupational coverage 3
4 So important. So easy to enroll. Voluntary Short Term Disability I don t need it. Many people make the mistake of thinking that if they are healthy, they don t need disability insurance. However, just like medical insurance acts as a safety net for you in the event that you become ill or injured, disability insurance is another level of protection: it will help provide for you financially in the event that you cannot work due to injury or illness. Great news! Your employer is offering you the opportunity to purchase disability income protection insurance at group rates from Reliance Standard, a trusted group benefits carrier for over a century. Even though no one likes to think about getting sick or sustaining an injury, almost everyone makes sure to get medical insurance just in case. But medical insurance is only designed to cover all or most of the healthcare costs an illness or injury brings what happens to your paycheck if you can t work for a period of time and you ve exhausted your paid time off? If your paycheck were to stop for a period of time, how would that affect you and your family? If you ve never thought about the possibility, now is a good time. And if you have thought about it, but have questions, read on you may be surprised! That will never happen to me. Disability is more common than most people realize. In the last ten minutes alone, 498 Americans became disabled. 1 An illness or accident will keep one in five workers out of work for at least a year before the age of 65, 2 and one in seven employees can expect to be disabled for five years or more before retirement. 3 Accidental injuries are a major cause of disabilities, but common chronic health conditions can also limit your ability to work. In fact, the majority of long-term absences aren t due to accidents, but to back injuries and illnesses like cancer and heart disease. 4 Your chances of becoming disabled increase with age, doubling from 11% for those ages to 23% for those ages 45 64, and again at 51% for those 65 and above. 5 I have enough insurance already. Very few people hesitate to insure assets like their home or car, but many fail to protect their most valuable asset of all: themselves. Disability income protection insurance will help protect your financial security in the event that you cannot work. The chance of poverty jumps from 9% for people without a disability to 27% for those with a severe disability. 6 Unexpected illnesses and injuries cause 350,000 personal bankruptcies each year, 7 and nearly 50% of all mortgage foreclosures. 8 4
5 There s always workers compensation. Disability insurance covers you when workers compensation doesn t. Workers compensation only applies to injuries sustained while an employee is at work. Statistics show that there are almost twice as many off-the-job injuries as on-the-job injuries and twice as many work days lost due to off-the-job injuries as on-thejob injuries. 9 Partial disabilities may also be covered. I can t pay another bill every month. Your employer has made it possible for you to purchase this coverage at group rates. You pay for your coverage through convenient payroll deduction. Why Reliance Standard? Reliance Standard Life Insurance Company has been a trusted national insurer for over a century. Purchasing short or long-term disability insurance will help to protect you and your family s financial well-being. What do I do now? If you agree that you and your loved ones can benefit from this important coverage, it s easy to get started. Simply review the accompanying materials and complete the Reliance Standard enrollment form supplied by your employer. If you have questions or require an enrollment form, please contact your Benefits Administrator. Additional information to aid you in your disability income protection insurance purchase decision can be found online at 1 National Safety Council, Injury Facts 2008 Edition. 2 Life and Health Insurance Foundation for Education, Health Insurance Association of America, Commissions Disability Table, Council for Disability Awareness, Long-Term Disability Claims Review, U.S Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, U.S. Census Bureau, Illness and Injury as Contributors to Bankruptcy, Health Affairs, February Health Affairs, The Policy Journal of the Health Sphere, February National Safety Council, Injury Facts 2008 Edition. This information is not an insurance policy and does not describe the whole plan. For more detailed information, you must ask your employer or Human Resources benefits manager. There is a detailed description of the plan s provisions, limitations and exclusions in the Certificate of Insurance or Policy, which is issued to you after your application is processed. Reliance Standard Life Insurance Company provides insurance products in all states (except New York), the District of Columbia, Puerto Rico and the U.S.Virgin Islands. Benefits are provided under group policy form series LRS-6564, LRS-9228, LRS-6451, LRS-9334, et al. 5
6 Reliance Standard Voluntary Plans Voluntary Short Term Disability Premium Worksheet Plan Holder: Archdiocese of Chicago Voluntary Short Term Disability VPS Scheduled Benefit: Each eligible employee may elect 60% of their weekly earnings, up to $1,250 per week benefit maximum. To calculate your monthly payroll deduction, use the formula indicated below: (Round all numbers to the nearest whole number). 1. Enter your Weekly Earnings, not to exceed $2, $ 2. Multiply your weekly earnings (Line 1) by $ 3. Find your rate from the age table displayed. 3. $ 4. Multiply the amount on Line 2 by the appropriate rate for your age entered on Line Divide the amount on Line 4 by 10 and enter the amount on Line 5 to get your monthly payroll deduction. *The amount shown on Line 5 is your estimated monthly payroll deduction. 4. $ 5. $ Example Calculation: Jane Smith is Age Enter your Weekly Earnings, not to exceed $2, $ 600 (weekly earnings) 2. Multiply your weekly earnings (Line 1) by $ 360 (maximum weekly benefit) 3. Find your rate from the age table displayed. 3. $.35 (rate for age 35-39) 4. Multiply the amount on Line 2 by the appropriaterate for your age entered on Line Divide the amount on Line 4 by 10 and enter the amount on Line 5 to get your monthly payroll deduction $ Age Rate $ $ $ $ $ $ $ $ $ $ and over $ $ (monthly payroll deduction) 6
7
8 Please read this important information This brochure does not describe the whole plan. It is not an insurance policy.this brochure provides an overview and answers some of the most common questions.there is a detailed description of the plan s provisions, limitations, and exclusions in the Certificate of Insurance, which is issued to you after your application is processed. Applications may be subject to medical underwriting.there is also a detailed description of all provisions of the Group plan in the master Group policy, which is the legal contract. If there are discrepancies between this brochure and the master Group policy, the Group policy takes precedence. Reliance Standard Life Insurance Company is licensed in all states (except New York), the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Guam. In New York, insurance products and services are provided through First Reliance Standard Life Insurance Company, Home Office: New York, NY Market Street Suite 1500 Philadelphia, PA
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