Elimination Period / Benefit Duration (accident/sickness)

1^st day accident, 8^th day sickness, 26 week benefit period

Weekly Benefit Percentage

66 2/3% of Weekly Earnings

Maximum Weekly Benefit

$1,200.00

Minimum Weekly Benefit

The Minimum Weekly Benefit will not apply if an employee is in an Overpayment situation or is receiving income from employment.

$50.00

Social Security Integration

Full Family

Pre Existing Condition Limitation

None

Gainful Earnings

80%

Work Incentive Benefit:

Provides financial incentives when working while partially disabled. This benefit includes:

No offset for rehabilitation or part-time earnings until total income (benefits plus earnings) exceeds 100% of pre-disability earnings.

Rehabilitation Incentive: while participating in approved rehabilitation program, the monthly benefit, before reduction for other income benefits, is increased by 10%

Family Care Expenses: while participating in approved rehabilitation program, up to $60 per week for eligible Family Care expenses incurred by an employee for each eligible family member during the family care period.

Partial Disability Benefit:  With a 20% earnings loss, elimination period may be satisfied with part-time employment (commonly referred to as "zero day residual").

Allows up to 100% of pre-disability earnings replacement

Available after 4^th week of disability

Included

Temporary Recovery

90 days

Continuity of Coverage

Provided for groups where this plan will replace a plan in force on the day immediately preceding the effective date of this plan.  See Benefits Description for details.

Waiver of Premium

Included

Mandatory Rehabilitation

Included

Occupational Benefits:

Benefits are payable for any disability:

·        Which happens in the course of any work performed by an employee for wage or profit, or

·        For which an employee is eligible to receive benefits under any Workers' Compensation or any similar law.

No

Exclusions

Disability resulting from:

·        War, insurrection, or rebellion

·        Active participation in a riot

·        Intentionally self-inflicted injuries or attempted suicide

·        The commission of a felony, or

·        Elective treatment or procedures, such as, but not limited to:

o       Cosmetic surgery or treatment primarily to change appearance

o       Invitro fertilization

o       Embryo transfer procedure

o       Artificial insemination

o       Sex-change surgery

o       Reversal of sterilization

o       Liposuction

o        Radial keratotomy