PROTECTION solutions Do your employee s have income protection? What would they be able to live without if they were disabled and lost their ability to earn a paycheck? CAR GROCERIES HOME 65% of working Americans say they could not cover normal living expenses even for a year if their employment income was lost; 38% could not pay their bills for more than 3 months. 1 1 CDA, Disability Divide proprietary research March 2010 GVDIP Group voluntary DISABILITY insurance the right coverage their future in good hands ABJ19882 Page 1 of 6
group voluntary disability Allstate Benefits (AB) Group Voluntary Disability coverage provides a monthly cash benefit when employees suffer a sickness or off-the-job injury that leaves them totally disabled or partially disabled. Your Employees cannot predict if or when they will become disabled in their lifetime. But they can plan for a disability by having coverage in place to help provide an income should they become disabled due to a sickness or injury and are unable to work. Our coverage can help provide a monthly income when it is needed most. Disability benefits can offer peace of mind when a disability occurs. Below is an example of how benefits might be paid. * Jane and John are offered group disability coverage by their employer Jane chooses $3,000 in disability coverage. 8 months later she suffers a disabling injury, is air lifted to the local hospital emergency room, hospitalized (3 days), and is disabled for 6 months. John declines coverage. 6 months later he suffers a disabling back injury, is rushed to the hospital by ambulance, treated, hospitalized (2 days), and is disabled for 4 months. In addition to her medical coverage our disability insurance provided Jane the following: Total Disability Monthly Benefit - $3,000 John does not have disability coverage. His medical coverage will pay for a portion of his hospital expenses, but his monthly expenses while out of work will be paid out of his own pocket. i meeting their needs Our coverage offers employees support during a period of unexpected sickness or an off-the-job injury. You determine the benefit offering for your employees by choosing the Benefit Period, Elimination Periods, Riders, and whether or not Optional Certificate Provisions will be included Employees can choose a guaranteed issue ** monthly benefit ranging from $400 - $5,000, up to 60% of income A benefits representative can help employees determine the following: Monthly Benefit; Benefit Period; Elimination Periods for Accident and Sickness; and their Premium Employee benefits start the first day after the elimination (waiting) period, when they are totally disabled and cannot work Pregnancy is covered like any other sickness (must meet the definition for total disability and coverage must be in force for at least 9 months) benefit coverage Terms and conditions for each benefit will vary. Total Disability - Pays when totally disabled. Monthly benefit starts after the waiting period has been satisfied. Disability must begin while actively at work. Benefits continue while totally disabled up to the length of the benefit period. Partial Disability - Pays 50% of the monthly benefit when partially disabled immediately after at least one month of total disability. Payments continue while partially disabled for up to 3 months, but not beyond the maximum benefit period. Concurrent Disability - Pays one monthly benefit even if the employee is disabled due to more than one cause. Being disabled due to more than one cause will not extend the time benefits are paid. Recurrent Disability - Pays when disabled from the same or related cause within 6 months without a new waiting period or maximum benefit period. Pregnancy - Pays for a pregnancy if total disability first begins after the employee s coverage has been in force for at least 9 months. Organ Donor - Pays if totally or partially disabled due to the employee serving as an organ donor to someone else in an organ transplant procedure. Waiver of Premium - Pays the premium after monthly disability benefits are payable for 30 days in a row, for as long as monthly benefits are payable. Page 2 of 6 ABJ19882 *The example shown may vary from the plan you choose to offer your employees. Their individual experience may also vary. This example assumes that Jane and John have medical insurance and did not receive disability income from other sources during the same time period. **Employee must apply for coverage during their initial enrollment period to be eligible. If enrolling after the enrollment period evidence of insurability will be required.
Nine out of 10 deaths and nearly three-fourths of the disabling injuries suffered by workers occurred off the job. 2 2 Injury Facts 2010 Edition, National Safety Council. RIDER BENEFITS You choose the rider benefits offered to your employees. You have the option of allowing your employees to choose whether or not they want to include the Increasing Benefit Period Rider or Survivor and Accident Rider. Return of Premium Due to Layoff - Provides a refund of premiums if laid off during the first 6 months of coverage. Must surrender coverage. On-the-Job Accident Disability* - Pays when totally disabled due to an on-the-job injury. Family Medical Leave & Doula Services - FMLA benefit pays 25% of the monthly disability benefit, up to $500 for 12 weeks if on leave to provide full-time care for child, spouse, or parent (family member) or for employee s own serious health condition. Doula benefit pays $250 for a professional to care for employee during pregnancy, childbirth, or following birth. Increasing Benefit Period - Increases the benefit period by 1 month for each year coverage is in force, for up to 6 increases. Survivor and Accident - Pays 3 times the monthly disability benefit if death occurs from a sickness (while receiving disability benefits), or an accident. Pays a one time monthly benefit if disability is caused by an accident while driving or riding as a passenger in a car.** OPTIONAL CERTIFICATE PROVISIONS You choose whether or not Portability or Mental Nervous Disorder are included or excluded from the employee s coverage. Portability - Coverage continues with the loss of a job or a change in the place of employment, as long as premiums are paid to AB. Mental Nervous Disorder - Removes this exclusion from the base policy coverage. COVERAGE SPECIFICATIONS This section explains some specifics of the coverage. Termination of Coverage - Each employee s coverage ends on the date the certificate is canceled; the last day premium payments were made; the last day of active employment, except as provided under the Temporary Layoff, Leave of Absence or Family and Medical Leave of Absence provision; the date they or their class is no longer eligible; upon discovery of fraud or material misrepresentation when filing a claim. Portability Privilege - Coverage may be continued under the Portability Provision when coverage under the certificate ends. How We Calculate The Monthly Benefit - We follow the process below to calculate the monthly benefit: (1) Multiply the monthly earnings by 60%. (2) Subtract deductible sources of income from item 1. (3) Determine the lesser of item 2 and the maximum monthly benefit amount issued to the employee. (4) Pay the greater of item 3 or $100. Deductible Sources of Income - The amount that the employee receives, or is eligible to receive, as disability income payments under any: (1) individual disability income policies; or (2) other group insurance coverage. Pre-Existing Condition Limitation - We do not pay benefits for disability that starts within 12 months of the effective date from a pre-existing condition. The employee will have a pre-existing condition if: (a) their disability began during the 12 months after the effective date of coverage. (b) they received medical treatment, consultation, care or services, including diagnostic measures, took prescribed or over the counter medications or followed treatment recommendations in the 12 months prior to the effective date of coverage, or the date an increase in benefits would be effective. (c) Symptoms existed in the 12 months prior to the effective date, or the date an increase in benefits would be effective. Certificate and Rider Exclusions - (a) We do not pay benefits for disabilities caused by, contributed by or resulting from: (1) Bipolar, delusional, psychotic, somatoform, eating or anxiety disorders, schizophrenia, depression or mental illness. We do pay for Alzheimer s or similar forms of senile dementia if first manifested while coverage is in force. (2) war, participation in a riot, insurrection or rebellion. (3) Illegal activities or participation in an illegal occupation. (4) Intentionally self-inflicted injury or action. (5) Substance abuse, to include abuse of alcohol, alcoholism, drug addiction or dependence upon any controlled substance. (6) Participation in aeronautics except as a fare *Benefits for disabilities covered by workers compensation reduced 50%. **Must have Allstate Auto Insurance to receive this one time benefit. ABJ19882 Page 3 of 6
paying passenger in a licensed aircraft provided by a common carrier and operating between established airports. (7) Voluntarily inhaling of fumes or gases. (8) Cosmetic surgery (complications are covered). (9) Pre-existing conditions during the first 12 months of coverage. (10) Occupational sickness or injury. (b) We will not pay a benefit for any period of disability during which the employee is incarcerated. Loss of professional or occupational license or certification does not, in itself, constitute a disability. Workers Compensation or State Disability Insurance - This certificate does not replace or affect the requirements for coverage by any workers compensation or state disability insurance. Definitions Total Disability - When, because of sickness or an off-the-job injury, the employee is unable to perform the material and substantial duties of their own occupation; and is under the regular care of a doctor; and is not working in any job for wage or profit. Partial Disability - The employee is partially disabled when AB determines that due to a sickness or injury the employee is: (1) unable to perform the material and substantial duties of their own occupation on a full-time basis, but is able to work on a part-time basis; and (2) is under the regular care of a doctor. Elimination Period - A period of continuous total disability which must be satisfied before the employee is eligible to receive benefits from AB. Own Occupation - The occupation the employee is performing when a period of disability begins. STATE VARIATIONS State Variations will apply where applicable. Speak with your Benefits Representative for full details.! Important Coverage Details The following items may be of interest when considering Group Voluntary Disability protection for your employees: 1. Off-the-Job accident and sickness coverage is available for employees only. Spouse is not eligible to purchase the plan. 2. Coverage is Guaranteed Issue (GI), or Evidence of Insurability (EOI) will be required if coverage is cancelled and employee is reapplying, or is applying for an amount of coverage over the GI limit, or is applying for coverage (or for an increase in the amount of coverage) during the re-enrollment period, or is applying for the coverage at any time after the initial enrollment period (late entrant). 3. Issue Age Bands: 18-49; 50-59; 60-64; 65-69; and 70+ 4. Issue Amounts: Range from $400-$5,000, not to exceed 60% of gross salary. Lower Issue Amounts: Will apply in states where state disability plans exist and/or when requesting reduced underwriting offers. 5. Benefit Periods: 3, 6, 12 and 24. 6. Underwriting Classes: Preferred Preferred Plus Preferred Platinum 7. Policy Changes: policy changes that are not consistent with the underlying group contract will not be allowed. (For example, an employee wants to increase their units purchased on a rider or purchase additional riders outside of the enrollment period.) Changes that are consistent with the group contract will be underwritten. 8. Minimum Participation Requirements: 25-999 - Greater of 20% or 10 lives. 1,000+ - 15% Renewal Participation Requirements: If participation is below the 10-life minimum, enrollment must be increased or the case will be cancelled. Individual Disability (DI5W) can be utilized, subject to simplified underwriting. 9. Rates: Rates are guaranteed for 12 months. ABJ19882 Page 4 of 6
Some things can t be marked on the calendar Like the day an accidental injury or sickness leaves an employee disabled. They cannot predict the day an injury or sickness will occur, but they can be financially prepared. Thinking ahead Undergoing a period of physical disability can present a great financial challenge to an employee s family. Often, it means the loss of an income for a period of time, that s where we can help. Our disability coverage can add that extra peace of mind by providing a monthly cash benefit that can help them pay their bills, their mortgage, or any other day-to-day living expense they may have, until they get back on their feet. Help them stay ahead of life s calendar! 90% of individuals asked say they value their ability to earn an income, but almost 40% said they haven t thought about how they would protect this all-important financial resource. * Our disability insurance can help employees cover expenses if the unexpected happens. It is never too early for an employee to prepare for their future. Page 5 of 6 ABJ19882 *CDA, Disability Divide proprietary research March 2010
This material is valid as long as information remains current, but in no event later than July 1, 2014. Group Voluntary Disability Income benefits provided by policy GVDIP, or state variations thereof. Rider benefits provided by policy forms GROPR, OADR1, FMDR1, IBDR1, and SADR1, or state variations thereof. The policy is underwritten by American Heritage Life Insurance Company (Home Office, Jacksonville, FL). This brochure highlights some features of the policy but is not the insurance contract. Only the actual policy provisions control. For costs and complete details, contact your Insurance Agent, or, contact Allstate Benefits at: 1-800-521-3535 or, go to allstateatwork.com. This brochure is for use in All states where Group Voluntary Disability and Optional Riders are available for sale. This is an Employer brochure and it is not to be distributed to employees. Allstate Benefits is the marketing name used by American Heritage Life Insurance Company (Home Office, Jacksonville, FL), a subsidiary of The Allstate Corporation. 2011 Allstate Insurance Company. www.allstate.com or allstateatwork.com. Page 6 of 6 ABJ19882