SAMPLE CONTRACT COMPARISON

 

Benefit

Your Plan Here

Competitor A

Competitor B

Eligibility

All Active Full Time Employees

 

 

Definition of Earnings

Salary (Bonus and Commissions can be included)

 

 

Benefit %

50%, 60%, 66 2/3%

 

 

Monthly Maximum Benefit

Up to $15,000 (underwriter approval above $10,000)

 

 

Minimum Benefit

Greater of 10% or $100

 

 

 

Social Security Offset

Primary, Family, All Sources, Back Door

 

 

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

 

 

Other Benefits Not Offset

·         Pension Plans

·         401(k) Plans

·         Individual Disability Policies

·         Thrift Plans

·         Profit Sharing

·         IRA

·         TSA

·         Employee paid portion of retirement benefits

 

 

Elimination Period

90 or 180 Days (total disability never required)

 

 

Benefit Duration

ADEA1/SSNRA

 

 

Definition of Disability

2 Year Own Occupation

3 Year Own Occupation

5 Year Own Occupation

Own Occupation to Age 65

 

 

 

 

 

 

 

 

 

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).

 

 

Zero Day Residual

Included

 

 

Work Incentive Benefit

12 months, up to 100% replacement of pre-disability earnings allowed

 

 

Family Care Credit

$350/month for the first 12 months;  $175/month thereafter

 

 

Rehabilitation Incentive/Benefits

Hartford will pay for necessary rehab expenses (beyond what the medical plan pays for) to facilitate a return to work.

 

 

Indexation

Lesser of CPI or 10%

 

 

Survivor Benefit

3 months Lump Sum (gross benefit)

 

 

Waiver of Premium

Once benefits begin

 

 

Temporary Recovery

15 days for 90 Day EP

30 days for 180 Day EP

 

 

Recurrent Disability

6 months

 

 

Benefit Reduction Freeze

After initial deduction from other income sources the benefit will not be reduced due to any COLA from other income benefits

 

 

Worksite Modification

Up to $2,000

 

 

 

Continuity of Coverage

No Loss No Gain

 

 

FMLA Compliance

Yes

 

 

Extension of Benefits

Yes

 

 

Mental & Nervous

24 months during lifetime (outpatient)

 

 

Drug & Alcohol

24 months during lifetime (outpatient)

 

 

Mandatory Rehab

Yes

 

 

 

Self-Reported/Soft Tissue & CFS

Not available

 

 

 

Pre-existing Conditions

3/3/12

 

 

Prudent Person Wording

No

 

 

Exclusions

·         War or act of war

·         Commission of felony or illegal occupation

·         Intentionally self-inflicted

 

 

Rate Guarantee

2 Years

 

 

Cancellation Provision

·         Fewer than 10 lives

·         Non-payment of premium

·         Below minimum participation

 

 

Managed Disability

Yes

 

 

Early Intervention

Yes

 

 

Will pay for Rehabilitation beyond what medical plan pays

Yes

 

 

Telephonic Claims Submission

Yes (100+ lives)

 

 

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)

 

 

EFT

Yes

 

 

 

W2 & FICA Tax Reporting

Yes

 

 

Financial Strength

A+     AM Best     

AA+  Fitch

Aa3    Moody's

AA    Standard & Poors

#2 in Group Disability Sales

 

 

 

 

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