Worksite Modification Benefit RSL standard: 100% to $2,000 If than the standard, provide details. Extended Disability Benefit If an insured has reached the maximum duration of benefits, the Extended Disability Benefit will provide benefits for an additional period (60 months) provided that the insured meets all requirements for the benefit. Indicate whether this benefit is included. (Yes/No) Definition of Disability Indicate whether an insured must be disabled from "Own Occ" or "Own Job". Note: Fully Insured LTD must be Occ”. “Own SS Qualifier Does the client's plan require SS acceptance in order to Note: Applies to ASO Only pay benefits? Governance Indicate whether the plan Note: Applies to ASO Only qualifies as ERISA or Work Incentive Benefit If the policyholder offers a Work Incentive Benefit as part of their Rehabilitation plan, provide details of the benefit structure. An example of a standard plan is: During the first 12 months of Rehabilitative Employment during which a Monthly Benefit is payable, we will not offset earnings from Rehabilitative Employment until the sum of: (1) the Monthly Benefit prior to offsets with Other Income Benefits; and (2) earnings from Rehabilitative Employment; exceed 100% of the Insured's Covered Monthly Earnings. RSL Standard: Child Care Credit $250 per month until the child reaches 14 years of age If there is an additional, ADL Benefit payable benefit if an insured cannot perform two or more activities of daily living. (Yes/No) Indicate the ADL Maximum ADL Maximum Benefit Amount Benefit. Indicate the ADL Benefit ADL Percent Percent. Indicate the Pre-Existing ADL Pre-Ex Condition Limit. Example: 3/12, 6/12 or NONE.
Worksite Modification Benefit RSL standard: 100% to $2,000 If than the standard, provide details. Extended Disability Benefit If an insured has reached the maximum duration of benefits, the Extended Disability Benefit will provide benefits for an additional period (60 months) provided that the insured meets all requirements for the benefit. Indicate whether this benefit is included. (Yes/No) Definition of Disability Note: Fully Insured LTD must be “Own Occ”. Indicate whether an insured must be disabled from "Own Occ" or "Own Job". SS Qualifier Note: Applies to ASO Only Does the client's plan require SS acceptance in order to pay benefits? Governance Note: Applies to ASO Only Indicate whether the plan qualifies as ERISA or Work Incentive Benefit If the policyholder offers a Work Incentive Benefit as part of their Rehabilitation plan, provide details of the benefit structure. An example of a standard plan is: During the first 12 months of Rehabilitative Employment during which a Monthly Benefit is payable, we will not offset earnings from Rehabilitative Employment until the sum of: (1) the Monthly Benefit prior to offsets with Other Income Benefits; and (2) earnings from Rehabilitative Employment; exceed 100% of the Insured's Covered Monthly Earnings. Child Care Credit RSL Standard: $250 per month until the child reaches 14 years of age ADL Benefit If there is an additional, payable benefit if an insured cannot perform two or more activities of daily living. (Yes/No) ADL Maximum Benefit Amount Indicate the ADL Maximum Benefit. ADL Percent Indicate the ADL Benefit Percent. ADL Pre-Ex Indicate the Pre-Existing Condition Limit. Example: 3/12, 6/12 or NONE.
COP%20-%20LTD%20FINAL%20082017.docx