Feature The Standard (Protector Platinum) Ameritas Life (DInamic Foundation) MetLife (Income Guard) Principal's (HH750) Definition of Total Disability
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1 Feature The Standard (Protector Platinum) Ameritas Life (DInamic Foundation) MetLife (Income Guard) Principal's (HH750) Definition of Total Disability For all occupation classes, an insured is totally disabled if the insured is unable to perform the substantial and material duties of his or her own occupation. The own occupation definition of total disability is part of the base contract. If the insured's occupation is limited to a professionally recognized specialty in medicine or law, the specialty will be deemed to be the insured's own occupation. A choice of three definitions is offered: 1. own occupation for the length of the benefit period 2. own occupation and not working for the length of the benefit period, and 3. five year own occupation and then not working for the remainder of the benefit period. Medical and dental specialty coverage is part of the benefit period. The substantial and material duties of the regular occuptation are insured in the base policy. Medical and dental specialties are covered in the specialty your occupation definition in the base policy. With the Your Occupation rider the insured may be gainfully employed in another occupation and still meet the definition of disability. A transitional your occupation rider is offered that allows the insured to receive a disability benefit if totally disabled in their regular occupation but working in another occupation. The benefit is based on replacement of up to 100% of the insured's prior earnings. For the definition of total disability, the policy provides for an initial "own occupation" period. The "your occupation" period is the first 2 years of disability in the base contract, and can be extended to the maximum benefit period for white-collar occupation classes. During the "your occupation" period, total disability is defined as being unable to perform the substantial and material duties of the insured's regular occupation, and the insured is not working in any occupation. "Your occupation" is defined as the profession the insured was working in at the time of disability. Following the "your occupation" period, the insured is totally disabled if unable to work in any occupation" suited to him or her by education, training, and experience. Pure own occupation coverage is available with a regular occupation rider to select occupation classes. A two-year mental/nervous limitation is always attached for physicians who select the Regular Occupation Rider. A transitional occupation rider is available for white-collar occupation classes, including all physicians. A transitional your occupation rider is offered that allows the insured to recieve a disability benefit if totally disabled in their regular occupation but working in another occupation. The benefit is based on replacement of up to 100% of the insured's prior earnings. Specialty protection may be offered by letter. Definition of Partial/Residual Disability For the first six months partial disability benefits are payable, the benefit equals 100% of the basic monthly benefit regardless of earnings. Partial Disability means that an insured is not totally disabled, the insured is working his or her own occuptations or any other occupation but, due to an injury or sickness, the insured has a 20% loss of duties, or a 20% loss of time, or a 20% loss of income. After six months, the definition is changed to mean that the insured is working in his or her occupation or any other occupation but, due to his or her injury or sickness, the insured has a loss of income of at least 20%. A Basic Residual Disability Rider and an Enhanced Residual Disability Rider are offered. With the Basic Residual Disability Rider, the residual benefit will be the lesser of 50% of the base benefit or the base benefit multiplied by the ratio of the insured's loss of earnings during disability to earnings prior to disability. The insured is considered to be residually disabled if there is at least a 15% loss of earnings, and the loss is a result of an injury or sickness, and the insured is able to perform one or more, but not all, of the material and substantial duties of the occupation, or the insured is unable to work in their occupation for 80% or more of the time as was usually prior to the start of the disability. With the Enhanced Residual Disability Rider, the residual benefit will be paid based on the ratio of the insured's loss of earnings prior to disability. If the ratio exceeds 75%, the full benefit will be paid. For the first 6 months of residual disability, the amount paid will be at least 50% of the total base benefit. The definition of residual disability is identical to the definition under the Basic Residual Disability Rider. Recovery benefits are paid with this rider. (See Recovery Benefits) Four types of partial/residual disability riders are offered. The Partial Disability Rider offers 50% of the monthly benefit payable up to the first 12 months. The Basic Residual Rider has a 15% minimum loss of income requirement and a minimum of 50% of the monthly benefit is paid for the first 12 months. The Residual With Recovery Rider also pays a recovery benefit for the maximum benefit period, and the Enhanced Residual With Recovery Rider removes the time or loss requirement from the residual definition. Residual disability means the insured is not totally disabled; and solely due to injury or sickness the insured has a loss of earnings of 20% or more of prior earnings and the insured is able to perform some, but not all, of the substantial and material duties of, or is unable to work full time in his or her occupation; or the insured is working in another occupation. 100 percent of the maximum monthly benefit is paid if the loss of earnings percentage exceeds 75 percent. A minimum of 50 percent of the maximum monthly benefit will be paid for the first six months of a residual disability. If the insured is retired or unemployed, 50% of the maximum monthly benefit will be paid for residual disability.
2 Feature The Standard (Protector Platinum) Ameritas Life (DInamic Foundation) MetLife (Income Guard) Principal's (HH750) Recovery Benefits A recovery benefit is paid if the insured is no longer A Recovery Benefit is offered only under the Recovery benefits through the maximum benefit After recovering from a residual or total disability for which benefits were disabled but continues to experience a loss of income Enhanced Residual Disability Rider. If the insured has period are available with the Residual With paid and returning to work full-time, recovery benefits are payable as long as and this loss is solely the result of the previous injury returned to work in their occupation and is Recovery Rider and the Enhanced Residual With the insured continues to have a loss of earnings equal to or greater than 20 or sickness that caused the disability. The insured performing the substantial and material duties 80% or Recovery Rider. The Basic Residual and Partial percent and the loss is directly and solely due to the injury or sickness that must be able to demonstrate that the loss of income more of the time as was usual prior to the start of Disability Riders do not include recovery caused the prior residual or total disability. Recovery benefits end when the continues to be solely the result of the previous injury disability, a recovery benefit will be paid provided benefits. insured no longer has a loss of earnings of at least 20 percent for any two or sickness for the recovery benefit to be payable as long as the conditons are met, subject to the policy's maximum benefit period. The loss of income must be at least 20%. that the loss of earnings is at least 15% and a demonstrable relationship exists between the loss of earnings and the previous disability. consecutive months, or at the end of the policy's maximum benefit period. The insured does not need to have qualified for residual benefits in order to qualify for recovery benefits. If the insured was retired or unemployed prior to disability, no recovery benefits will be paid. Compassionate Care Benefit A Compassionate Care Benefit will be paid while the insured is working at least 20% fewer hours in order to care for a loved one who has a serious health condition, and the insured's monthly earnings are at least 20% less than predisability earnings due to that reduction in hours worked; and the insured is not disabled, and no other benefit is payable under this policy. The insured may claim the Compassionate Care Benefit up to two times while the policy is in force. The maximum amount of Companssionate Disability Benefit for all claims and all loved ones is a total amount equal to six times the basic monthly benefit. Any part of this total amount remaining after the first claim will be available for a second claim. Not available Not available Not available Benefit Period 2,5,10 years, to age 65 and 67. 1,2,5 or 10 years, to age 65, to age 67, to age 70 2,5 or to 10 years, to age 65, to age 67, to age 70, or lifetime with graded benefits. 1,2,5 or 10 years, to age 65, to age 67, to age 70 Elimination Periods (Days) 60,90,180,365 30,60,90,180,365,730 90, 180, 365, ,60,90,180,365. Coverage for Mental Disorder/Substance Abuse No time limitation on coverage for mental disorder and/or substance abuse in the base contract Depending on the occupation, either a two-or-five year limitation for mental disorder and substance abuse is applied to the contract. A two-year limitation on coverage for mental disorder/substance abuse is automatically attached for some occupations. Other products in MetLife's portfolio may also apply a two-year limitation. When the MDSA rider is added to the policy, payment of MDSA claims is limited to a total of 24 months during the insured's lifetime. Indexed Cost of Living Rider Choice of three or six percent with compounded Choice of three percent with simple interest or six interest. CPI-U indexing is used and an indexed cost of percent with compound interest. An indexed cost of living benefit purchase is available following a period living benefit purchase is only available with the six of disability, allowing the insured to retain the benefit percent indexed cost of living rider. increase in the event of a future claim. Choice of three cost of living riders: three A choice of three or six percent with compounded interest is offered. CPI-U percent with compounded interest, three indexing is used and a cost of living benefit purchase is available. percent with simple interest, or zero to ten percent indexed to Consumer Price Index (Urban Wage Earners and Clerical Workers) with compounded interest.
3 Feature The Standard (Protector Platinum) Ameritas Life (DInamic Foundation) MetLife (Income Guard) Principal's (HH750) Automatic Increase Benefit The Automatic Increase Benefit increases the policy's basic monthly benefit by 4%, compunded each year, during a five-year increase period. The benefit is included in the base contract at no extra cost. A four percent simple increase on each policy anniversary for a five-year period. This benefit is included as a rider with no extra cost. Five percent automatic increase rider and a fiveyear increase period offered at no cost at underwriting discretion. The Future Benefit Increase (FBI) Rider is available for no additional premium and renewable every six years. The increases are based in the CPI-U with a minimum of four percent compunded and maximum of 10% compounded. In addition to the CPI-U increase, the client may also be eligible for an additional benefit increase if eligible based on financial information. When combined, the CPI-U increase and the additional benefit increase cannot be greater than $500. FBI is available in conjunction with the Benefit Update Rider on the same policy. Future Purchase Option Available through issue age 50 and exercisable to age 55. The option date each year is the policy anniversary. Until the insured is age 45, he or she may buy all or part of the total increase option on any one option date. On or after age 45, the insured may buy up to one third of the total increase option on any one option date. The Future Increase Option Rider is available through issue age 50 and exercisable to age 55. The maximum increase that can be exercised on any policy anniversary is the lesser of one-half the base monthly benefit, or the amount for which insureds qualify for, based on their earnings at the time they apply for the increase and the published financial underwriting guidelines then in effect. Available through age 45. On each policy anniversary up to age 51, the insured may apply for up to one unit of increase. If all or part of the increase is not used, it may be carried forward to the next option date but not beyond that date. Maximum unit of incease varies depending on occupation class. The maximum total increase through age 41 is three times the basic benefit. For ages it is the lesser of $6,000 or three times the basic benefit. Every year the insured may apply for an amount equal to one unit of increase or for part of that amount. Cap is two units of increase on each option date if there is sufficient carry-over. An Advanced Option Benefit is available until the 3rd option date following the effective date of the rider or the option date on or following the insured's 40th birthday. The Benefit Update Rider is available at no additional premium. This rider allows the insured to increase policy benefits every three years up to the maximum issue and participation limits, up to age 55, without medical evidence of insurability. There is no cap for this benefit except for issue and participation limits. The benefit update with an advance option allows the insured to take the next scheduled benefit update option early with a loss or reduction of his/her group long term disability or at least a 50% increase in sustainability earnings since the later of the policy issue date or the last adjustment to increase their total disability benefits. The benefit update is available in conjunction with the Future Benefit Increase Rider on the same policy. Presumptive Disability Benefits Lifetime benefits are payable for presumptive disability if the maximum benefit period is at least to age 65. Presumptive disability must be a total and permanent loss. No lifetime presumptive benefits are offered in the contract. Presumptive loss is not required to be irrecoverable. Benefits are payable up to but not beyond the maximum benefit period. Presumptive disability must be a total and permanent loss. Lifetime benefits are payable for presumptive disabilites if the maximum benefit period is to age 65 or longer. Presumptive disability must be a total and permanent loss. Catastrophic Disability Benefits Pays benefits if unable to perform two of six activities of daily living (ADL's), presumptively disabled, or cognitively impaired. Pays catastrophic benefits if cognitively impaired or unable to perform two of six ADL's. Castrophic benefits are not paid for presumptive disabilities. ADL's are not covered. Pays catastrophic benefits if presumptively disabled or if the insured has Alzheimer's disease or other irreversible form of senility or dementia, aphasia, hemiparesis, paraplegia, or quadriplegia. Pays a benefit in addition to base monthly benefit (and social insurance substitute benefit, if part of the policy) if the insured loses the ability to perform two or more activities of daily living without assistance; becomes cognitively impaired; or becomes presumptively disabled under the terms of the policy.
4 Feature The Standard (Protector Platinum) Ameritas Life (DInamic Foundation) MetLife (Income Guard) Principal's (HH750) Exclusions & Limitations Intentionally self-inflicted injury, sickness or injury War; incarceration; related to suspension, revocation, Due to an act of war, whether declared or Intentional, self-inflicted injury; Commission of or your attempt to commit a due to war, commiting or attempting to commit an assault or felony, actively participating in a violent surrender of professional license; active military service; self-inflicted injury; 12 months benefit cap if undeclared; due to pregnancy or childbirth, but will cover disability due to complications of criminal act; suspension, revocation or srrender of your professional license or certification; 90 days normal pregnancy; Active military duty during a disorder or riot, for the first 90 days of disability due living outside Canada and the U.S. pregnancy; due to any loss MetLife has excluded military action or conflict (policy restored if duty ends within five years after to pregnancy or childbirth, while you are confined for any reason to a penal or correctional institution, loss or restriction of a professional license, occupation license, or certification, and for more than 12 months for each period of continuous disability while the insured resides outside the United States or Canada. by name or specific description; due to the insured committing, or attempting to commit, a felony; existing while the insured is legally incarcerated or detained ; or caused by an intentionally self-inflicted injury. 24 months maximum coverage for all combined periods during the insured's lifetime while outside the U.S., its possessions and Canada. the policy suspension).
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