SAMPLE CONTRACT COMPARISON
|
Benefit |
Your Plan Here |
Competitor A |
Competitor B |
Eligibility |
All Active Full Time Employees |
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Definition of
Earnings |
Salary (Bonus and Commissions can be included) |
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Benefit % |
50%, 60%, 66 2/3% |
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Monthly Maximum
Benefit |
Up to $15,000 (underwriter approval above $10,000) |
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Minimum Benefit |
Greater of 10% or $100 |
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Social Security
Offset |
Primary, Family, All Sources, Back Door |
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Other Offsets |
· Workers Comp · Compulsory Benefit act or laws for which employee is eligible · Another Group Insurance Plan · Retirement plan Disability Benefits · No Fault Auto · Portion of settlement or judgement, less associated costs |
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Other Benefits Not Offset |
· Pension Plans · 401(k) Plans · Individual Disability Policies · Thrift Plans · Profit Sharing · IRA · TSA · Employee paid portion of retirement benefits |
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Elimination Period |
90 or 180 Days (total disability never required) |
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Benefit Duration |
ADEA1/SSNRA |
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Definition of
Disability |
2 Year Own Occupation 3 Year Own Occupation 5 Year Own Occupation Own Occupation to Age 65 |
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Definition of Disability (continued) |
Disabled means you are prevented by accidental bodily injury, sickness, menatl illness, substance abuse, or pregnancy from performing one or more of the essential duties of your occupation, and as a result, your current monthly earnings are less than 80% of your pre-disability earnings. With 2 year own occ, after 24 months you must be prevented from performing one or more of the duties of any occupation for which you are qualified by education, training, or experience (60% earnings test). |
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Zero Day Residual |
Included |
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Work Incentive
Benefit |
12 months, up to 100% replacement of pre-disability earnings allowed |
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Family Care Credit |
$350/month for the first 12 months; $175/month thereafter |
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Rehabilitation
Incentive/Benefits |
Hartford will pay for necessary rehab expenses (beyond what the medical plan pays for) to facilitate a return to work. |
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Indexation |
Lesser of CPI or 10% |
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Survivor Benefit |
3 months Lump Sum (gross benefit) |
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Waiver of Premium |
Once benefits begin |
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Temporary Recovery |
15 days for 90 Day EP 30 days for 180 Day EP |
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Recurrent
Disability |
6 months |
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Benefit Reduction
Freeze |
After initial deduction from other income sources the benefit will not be reduced due to any COLA from other income benefits |
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Worksite
Modification |
Up to $2,000 |
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Continuity of
Coverage |
No Loss No Gain |
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FMLA Compliance |
Yes |
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Extension of
Benefits |
Yes |
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Mental & Nervous |
24 months during lifetime (outpatient) |
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Drug & Alcohol |
24 months during lifetime (outpatient) |
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Mandatory Rehab |
Yes |
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Self-Reported/Soft
Tissue & CFS |
Not available |
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Pre-existing
Conditions |
3/3/12 |
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Prudent Person
Wording |
No |
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Exclusions |
· War or act of war · Commission of felony or illegal occupation · Intentionally self-inflicted |
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Rate Guarantee |
2 Years |
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Cancellation
Provision |
· Fewer than 10 lives · Non-payment of premium · Below minimum participation |
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Managed Disability |
Yes |
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Early Intervention |
Yes |
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Will pay for
Rehabilitation beyond what medical plan pays |
Yes |
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Telephonic Claims
Submission |
Yes (100+ lives) |
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Social Security Appeals
Assistance Certified Rehab
Coordinators Vocational Rehab Nurses Disability Nurses Physician
Consultants |
Yes Yes Yes Yes Medical case management is outsourced (physicians must be practicing medicine) |
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EFT |
Yes |
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W2 & FICA Tax
Reporting |
Yes |
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Financial Strength |
A+ AM Best AA+ Fitch Aa3 Moody's AA Standard & Poors #2 in Group Disability Sales |
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Key Differentiators:
· Function-based vs. Impairment-based claims model
· No self-reported, soft tissue, or subjective limitations
· Medical case management model utilizes contracted physicians who are in private practice
· Single definition of disability eliminates the need for separate definitions of Total, Partial/Residual/Rehab
· 12 month Work Incentive Benefit (vs. 24 month WIB) encourages return to work without encouraging permanent part-time duty as a career path
· State-of-the-art benefits technology to expedite claim payments