Most federal employees who are looking to enroll in their group short term disability are not even sure of the questions that they should ask. We have put these questions together to help answer some of those questions.
STD is a form of insurance that pays part of your income from a covered accident or covered sickness. If you are unable to perform the material duties of your "own" occupation, not "any" occupation. The definition of "own" occupation in my option is the most important part of any STD policy. Why, a lot of polices that you can buy say "any" occupation, that means that if you can't perform the material duties of you occupation but you can do some kind of other work, i.e.; answer the phones, go work at a fast food restaurant or "any" job, then you are not disabled. The definition of "own" means, you cannot "do your job", in laymen's terms, the position you were hired to perform*.
To stay within the guide lines, you can replace 60% of you gross salary. Ex: $50,000 a year gross salary x 60% = $30,000 a year, $30,000 ÷ 12 months = $2,500 a month. You can apply for $2,500 a month disability insurance.*
The best part about STD is who OK's your claim form; it's not your supervisor, it's not Human Resources, it is not any one from the federal government, it is your doctor. Your doctor is the "gate keeper"; this is who you would like to approve any claim form. They are an unbiased outside party, this is the best way to get paid for STD*.
The elimination period is the waiting period before you start getting paid for a covered disability claim. Ex: all elimination periods are shown in a “fraction”; a 7/7 means the “7” is the waiting period for accidents and the other(2nd) “7” is the waiting period for sickness. In this example, 7/7, the client would get paid after seven days (7 day waiting period) for a covered accident and get paid for a sickness (7 days waiting period) after 7 days; these are calendar days not work days.*
Yes, accidents and sickness are covered. In fact, all claims fall under accidents or sickness. Accidents are covered off the job (because you have worker’s comp at work), covers sickness on and off the job. About three-fifths of the disabling injuries suffered by American workers in 2000 occurred off the job.*(* National Safety Council, Report on Injuries in America, 2001) Sickness is almost never covered by workers compensation*.
Yes, maternity is covered the same as any other sickness. Benefits for a normal pregnancy are provided on the same basis as for any other Sickness. Complications of pregnancy are also covered after the effective date of the policy. If you get pregnant before effective date of the policy, you may not be covered. Benefits are paid in addition to FMLA, family medical leave act. In most cases, the insured is covered for disability for maternity for the following; 8 weeks of coverage for C-section, cesarean section or 6 weeks for normal child birth minus the waiting period. For most cases, a employee that takes the shortest waiting period for sickness, will get the most disability payments, shortest waiting period means more benefits. If your doctor deems it necessary for you to be out of work for a longer period of time, that may also be covered*. To make sure there is no question that maternity will be covered, make sure the policy is in effect for at least a month before getting pregnant.*
If you are pregnant now, you will not be covered on a new policy - that would be considered a pre-existing condition. Pre-existing conditions are covered after 12 months on our Guaranteed Issue polices.*
Yes, premium is waived if you are disabled for more than 90 days or the elimination period, which is longer. Waiver of Premium (Long-Term only) Premiums may be waived while you are disabled based on the length of your disability and the plan selected.*
Pre-existing conditions will be covered after 12 months if the applicant can answer the questions on the application and approved by underwriting. If you can’t answer the questions and get a policy issued, we have “guaranteed issue disability coverage for federal employees” policies available. Pre-existing Conditions are Injuries or Sickness which a physician has treated or for which a physician has advised treatment within 12 months prior to the Employee’s date of certificate. It is also one which would cause a person to seek diagnosis or care within the same 12-month period.*
No, in most cases if not all, there is no exam or blood work necessary for coverage.*
No, since the premium payments are paid through payroll and are not “pre-taxed”, the benefits will not be taxed. Some benefits federal employees have are “pre-taxed” like health insurance. If you were to “pre-tax” payments for STD, they would be taxable, but since they are not, you do not have to worry about this.*
Yes, some disability policies, long term disability (LTD), are harder to get paid compared to STD. Most STD polices have a shorter elimination period, the waiting time to get paid, LTD also sometimes have different definitions on disability, this makes harder to get through underwriting. Most if not all LTD polices will never cover Maternity which falls under sickness, this may not seem like a big deal, but as we have said for years, “if a STD policy covers Maternity, they will almost cover anything”*
For most insurance to be effective, you have to include a month’s premium with application, because we use payroll and you get paid every two weeks, it will take, in most cases, two or three bi-weekly payments before the policy goes into effect* and you get your policy. Sometimes your payroll may start very fast or like most agencies, it can take some time for payroll to get started, every agency is different, that is why it can take three bi-weekly payments before the insurance company gets a month’s premium. Read your policy pages, your effective date is stated on the policy pages, you are not covered for a accident or sickness till after that date. Please be patient.*
Depending on range, date, of the application was signed, see chart.. Read your policy pages, your effective date is stated on the policy pages, you are not covered for an accident or sickness till after that date.*
Yes, all insurance products that we offer are through payroll deduction. Most polices we offer are sold as a “group”, this is the only way a federal employee can sign up for these coverage’s.*
All approved claims monies are paid to you, the policy owner. No money is paid to any doctors or hospitals, the only way this money would be paid to any doctor or hospital is you, the policy owner, would have to assign them. Some disability policies are written that any claim payments have to be paid to a mortgage holder, a car payment or paid to some type of lien holder. The STD polices that we offer, when you file an approved claim, all payments are paid to you, the owner of the policy.*
Short Term Disability pays. Long Term Disability rarely pays. Why? Short Term Disability, in most cases, pays when you are unabe to work your "own" occupation and your doctor agrees. Long Term Disability most times asks can you work "Any" occupation, meaning can you work "Any" job: answering phones, blowing up balloons or "Any" job. And Long Term Disability also asks can you not perform 2 ADL's, Activities of Daily Living. Meaning you can't bathe, cook, dress yourself... It is hard to get paid with Long Term Disability.*
No, you do not have to re-enroll in any of the plans. So long as you keep paying for the policy, they stay in effect.*
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