WakeWise: Wake County Benefits Information

Short Term Disability Income Protection Insurance Plan
County of Wake

Policy # 149570-003


Please read carefully the following description of your Short Term Disability Income Protection insurance plan, underwritten by Unum Life Insurance Company of America.

Your Plan

 

Eligibility

You are eligible for coverage if you are an active employee working a minimum of 20 hours per week.

Weekly Benefit Amount

STD Benefit Options:

You can elect coverage amounts between $100 - $600 per week, in $50 increments, not to exceed 66.667% of your weekly earnings.

Your disability benefit may be reduced by deductible sources of income and any earnings you have while disabled.  Deductible sources of income may include such items as disability income or other amounts you receive or are entitled to receive under: workers compensation or similar occupational benefit laws; state compulsory benefit laws; automobile liability and no fault insurance; legal judgments and settlements; certain retirement plans; salary continuation or sick leave plans; other group or association disability programs or insurance; and amounts you or your family receive or are entitled to receive from Social Security or similar governmental programs.

Definition of Disability

 

You are disabled when Unum determines that:
·    you are limited from performing the material and substantial duties of your regular occupation due to your sickness or injury; and
·    you have a 20% or more loss in weekly earnings due to the same sickness or injury.

The loss of a professional or occupational license or certification does not, in itself constitute disability.

You must be under the regular care of a physician in order to be considered disabled.

Elimination Period

The Elimination Period is the length of time of continuous disability which must be satisfied before you are eligible to receive benefits.  You can elect one of the following elimination period options:

Plan 1:  30 days for disability due to an injury
30 days for disability due to a sickness

Plan 2:  15 days for disability due to an injury
15 days for disability due to a sickness

Benefits begin the day after the elimination period is completed.

Benefit Duration

If you meet the definition of disability you may receive a benefit for 26 weeks.

Taxation

The taxability of benefits depends on how premium was taxed during the plan year in which you become disabled. Whether you pay 100% of the premium or you and your Employer share in the cost, if premium for the plan year is paid with post-tax dollars, your benefits will not be taxed.  If premium for the plan year is paid with pre-tax dollars, your benefits will be taxed. If premium for the plan year is paid partially with post-tax dollars and partially with pre-tax dollars, then a portion of your benefits will be taxed.

Limitations/Exclusions/ Termination of Coverage

 

Pre-existing Condition Exclusion

You have a pre-existing condition if:

  • you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines in the 3 months just prior to your effective date of coverage; and
  • the disability begins in the 12 months after your effective date of coverage.

Instances When Benefits Would Not Be Paid

Benefits would not be paid for loss resulting from:
·    war, declared or undeclared, or any act of war;
·    active participation in a riot;
·    intentionally self-inflicted injuries;
·    loss of a professional license, occupational license or certification;
·    commission of a crime for which you have been convicted;
·    any period of disability during which you are incarcerated;
·    an occupational injury or sickness,(this will not apply to a partner or sole proprietor who cannot be covered by law under Workers' Compensation or any similar law);
·    pre-existing condition.  This applies to new coverage and increases effective 1/1/05 and forward.

Termination of Coverage

Your coverage under the policy ends on the earliest of the following:
·   The date the policy or plan is cancelled;
·   The date you no longer are in an eligible group;
·   The date your eligible group is no longer covered;
·   The last day of the period for which you made any required contributions;
·   The last day you are in active employment except as provided under the covered layoff or leave of absence provision.  Please see your Plan Administrator for further information on these provisions.
Unum will provide coverage for a payable claim which occurs while you are covered under the policy or plan.

Next Steps

 

How to Apply

To apply for coverage, complete your enrollment form within 31 days of initial eligibility date.
If you are not a newly eligible employee and you wish to enroll in the plan for the first time or change your current election, you can do so only during an annual enrollment period set by your Benefits Department.  Please see them for details.
Please note:  increases in coverage, reducing the elimination period, and new coverage elections, are subject to the pre-existing condition exclusion, explained above.

Delayed Effective Date of Coverage

Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.

Questions

If you should have any questions about your coverage or how to enroll, please contact your Plan Administrator.

This plan highlight is a summary provided to help you understand your insurance coverage from Unum.  Some provisions may vary or not be available in all states.  Please refer to your certificate booklet for your complete plan description.  If the terms of this plan highlight summary or your certificate differ from your policy, the policy will govern. For complete details of coverage, please refer to policy form number C.FP-1, et al.
Underwritten by:
Unum Life Insurance Company of America 2211 Congress Street, Portland, Maine 04122, www.unum.com

©2007 Unum Group.  All rights reserved.  Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.

 

 

 

Open Enrollment:
2009 Open Enrollment Information
2009 Rates

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Wake County, NC