Most federal employees who are looking to enroll in their group short term disability are not even sure of the questions that they should ask. We have put these questions together to help answer some of those questions. Much of them relate to products we offer and that relate to what you would find with AFLAC, Manhattan Life, GPM Life Insurance, etc.
ENROLL NOWSTD is a form of insurance that pays part of your income from a covered accident or covered sickness. If you unable to perform the material duties of your “own” occupation, not “any” occupation. The definition of “own” occupation in my option is the most important part of any STD policy. Why, a lot of polices that you can buy say “any” occupation, that means that if you can’t perform the material duties of you occupation but you can do some kind of other work, i.e.; answer the phones, go work at a fast food restaurant or “any” job, then you are not disabled. The definition of “own” means, you cannot “do your job”, in laymen's terms, the position you were hired to perform.*
To stay within the guide lines, you can replace 60% of you gross salary. Ex: $50,000 a year gross salary x 60% = $30,000 a year, $30,000 ÷ 12 months = $2,500 a month. You can apply for $2,500 a month disability insurance.*
The best part about STD is who OK’s your claim form; it’s not your supervisor, it’s not Human Resources, it is not any one from the federal government it is your doctor. Your doctor is the “gate keeper”; this is who you would like to approve any claim form. They are an unbiased outside party, this is the best way to get paid for STD.*
The elimination period is the waiting period before you start getting paid for a covered disability claim. Ex: all elimination periods are shown in a “fraction”; a 14/14 means the “14” is the waiting period for accidents and the other(2nd) “14” is the waiting period for sickness. In this example, 14/14, the client would get paid after seven days (14 day waiting period) for a covered accident and get paid for a sickness (14 days waiting period) after 14 days; these are calendar days not work days.*
Yes, accidents and sickness are covered. In fact, all claims fall under accidents or sickness. Accidents are covered off the job (because you have worker’s comp at work), covers sickness on and off the job. About three-fifths of the disabling injuries suffered by American workers in 2000 occurred off the job.*(* National Safety Council, Report on Injuries in America, 2001) Sickness is almost never covered by workers compensation.*
Yes, maternity is covered the same as any other sickness. Benefits for a normal pregnancy are provided on the same basis as for any other Sickness. Complications of pregnancy are also covered after the effective date of the policy. If you get pregnant before effective date of the policy, you may not be covered. Benefits are paid in addition to FMLA, family medical leave act. In most cases, the insured is covered for disability for maternity for the following; 8 weeks of coverage for C-section, cesarean section or 6 weeks for normal child birth minus the waiting period. For most cases, a employee that takes the shortest waiting period for sickness, will get the most disability payments, shortest waiting period means more benefits. If your doctor deems it necessary for you to be out of work for a longer period of time, that may also be covered*. To make sure there is no question that maternity will be covered, make sure the policy is in effect for at least a month before getting pregnant.
If you are pregnant now, you will not be covered on a new policy - that would be considered a pre-existing condition. Pre-existing conditions are covered after 12 months on our Guaranteed Issue polices.*
Pre-existing conditions will be covered after 12 months if the applicant can answer the questions on the application and approved by underwriting. If you can’t answer the questions and get a policy issued, we have “guaranteed issue disability coverage for federal employees” policies available. Pre-existing Conditions are Injuries or Sickness which a physician has treated or for which a physician has advised treatment within 12 months prior to the Employee’s date of certificate. It is also one which would cause a person to seek diagnosis or care within the same 12-month period.*
No, in most cases if not all, there is no exam or blood work necessary for coverage.*
No, since the premium payments are paid through payroll and are not “pre-taxed”, the benefits will not be taxed. Some benefits federal employees have are “pre-taxed” like health insurance. If you were to “pre-tax” payments for STD, they would be taxable, but since they are not, you do not have to worry about this.*
No, this is another great feature about STD. Some polices that you can buy make you use up all sick time, annual time, comp time or any other benefits that you have before they will pay benefits. Not STD, these polices will pay in addition to most all other benefits. If you have a STD policy, you can keep your sick, annual and comp time and use it at a later date. As a federal employee, you can “sell” you’re sick time back the federal government to help with your retirement pension when the time comes to retire.*
Yes, some disability policies, long term disability (LTD), are harder to get paid compared to STD. Most STD polices have a shorter elimination period, the waiting time to get paid, LTD also sometimes have different definitions on disability, this makes harder to get through underwriting. Most if not all LTD polices will never cover Maternity which falls under sickness, this may not seem like a big deal, but as we have said for years, “if a STD policy covers Maternity, they will almost cover anything”.*
Read your policy pages, your effective date is stated on the policy pages, you are not covered for an accident or sickness till after that date.*
Yes, all insurance products that we offer are through payroll deduction. Most polices we offer are sold as a “group”, this is the only way a federal employee can sign up for these coverage’s. All polices that we offer are also “portable”, when you leave employment with the federal government, you can keep all coverage’s at the same rate, and the cost does not increase. This is a great benefit for someone that moves to another job or retires; they can keep the coverage’s they have enjoyed for years. We have also had employees that are ready to retire, contact us, sign up for coverage and get covered to get the group rates.*
All approved claims monies are paid to you, the policy owner. No money is paid to any doctors or hospitals, the only way this money would be paid to any doctor or hospital is you, the policy owner, would have to assign them. Some disability policies are written that any claim payments have to be paid to a mortgage holder, a car payment or paid to some type of lien holder. The STD polices that we offer, when you file an approved claim, all payments are paid to you, the owner of the policy.*
Short Term Disability pays. Long Term Disability rarely pays. Why? Short Term Disability, in most cases, pays when you are unabe to work your "own" occupation and your doctor agrees. Long Term Disability most times asks can you work "Any" occupation, meaning can you work "Any" job: answering phones, blowing up balloons or "Any" job. And Long Term Disability also asks can you not perform 2 ADL's, Activities of Daily Living. Meaning you can't bathe, cook, dress yourself... It is hard to get paid with Long Term Disability.*
* Certain restrictions, limitations and exclusions apply
