LONG TERM DISABILITY
The plan provides for long-term income continuation if you become disabled and cannot perform some of the material duties of your regular occupation on a full-time basis subject to certain conditions and limitations. Please refer to the plan document for further details. Benefits commence after three months after the onset of the disability. The benefit is 60% of your basic monthly earnings to a monthly maximum of $7,500 for the first two years, then 40% after year two. If elected, the employee pays 100% of the Long Term Disability premium.
VOLUNTARY LONG-TERM DISABILITY
PREMIUM CALCULATION
Monthly Pay
$__________
/ 100.00
= $________
Rate per $100.00
x __ .69___
X 12______
/ 26_______
Weekly Premium =$___________
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