DISABILITY INSURANCE GUARDIAN SHORT TERM DISABILITY INSURANCE
Short Term Disability Benefits
Employee Coverage*
Plan (Employee Choice)
PREMIER PLAN 1
VALUE PLAN 3
Benefit Amount
66.67% of gross income up to $6,500 per month
Benefits Begin (Accident/Sickness)
1 st day/8 th day
30 th day/30 th day
Duration of Benefits Definition of Disability
26 weeks
22 weeks
Own Job
12 month look back/12 month limiting period, 2 week limited benefit for pre- existing conditions; Continuity of coverage waives the pre-existing condition clause if employee has had Short Term Disability coverage through current employer for 12 months. If the Short Term Disability is paid for by the group, then the pre-existing condition limitation does not apply.
Pre-existing Condition
Waiver of Premium
Not included
Teleguard
Included – allows employee to begin the claims process with one phone call Non-occupational – does not cover on-the-job accidents or illnesses
Coverage Type
Minimum Hours Worked
20 hours per week
Sample Monthly Rates*
PREMIER PLAN 1 1/8
VALUE PLAN 3 30/30
Annual Income Monthly Benefit
$18,000 $27,000 $36,000 $45,000 $54,000 $63,000 $72,000 $81,000 $90,000 $99,000
$1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $5,500 $6,000 $6,500
$27.00 $40.50 $54.00 $67.50 $81.00 $94.50 $108.00 $121.50 $135.00 $148.50 $162.00 $175.50
$12.00 $18.00 $24.00 $30.00 $36.00 $42.00 $48.00 $54.00 $60.00 $66.00 $72.00 $78.00
$108,000 $117,000+
Monthly rates and benefits shown are approximate
*The services, exclusions, and limitations listed above do not constitute a contract and are a summary only. The Guardian plan documents are the final arbiter of coverage. This document is a summary of the major features of the referenced insurance coverage. It is intended for illustrative purposes only and does not constitute a contract. The insurance plan documents, including the policy and certificate, comprise the contract for coverage. The full plan description, including the benefits and all terms, limitations and exclusions that apply will be contained in your insurance certificate. Coverage terms may vary by state and employer-sponsored plan. The premium amounts reflected in this summary are an approximation; if there is a discrepancy between this amount and the premium deducted from your paycheck, the latter prevails.
SUMMARY OF PLAN LIMITATIONS AND EXCLUSIONS • We do not pay benefits for charges relating to a covered person: taking part in any war or act of war (including service in the armed forces) committing a felony or taking part in any riot or other civil disorder; intentionally injuring themselves or attempting suicide while sane or insane; or for the voluntary use of any poison, chemical, prescription or non-prescription drug or controlled substance unless it has been prescribed by a doctor and is used as prescribed. • We do not pay benefits during any period in which a covered person is confined to a correctional facility; an employee is not under the care of a doctor; an employee is receiving treatment outside of the U.S. or Canada; the employee’s loss of earnings is not solely due to disability. • During the exclusion/limitation period, this disability plan does not pay charges relating to a pre-existing condition. If this plan is transferred from another insurance carrier, the time an insured is covered under that plan will count toward satisfying Guardian’s pre-existing condition exclusion /limitation period. Please refer to the plan details for specific time periods. A pre-existing condition includes any condition for which an employee, in a specified period of time prior to coverage in this plan, consults with a physician, receives treatment, or takes prescribed drugs. • In order to be eligible for coverage; employees must be legally working (a) in the United States or (b) outside the United States, for a U.S. based employer in a country or region approved by Guardian. Subject to state specific variations. • This policy provides disability income insurance only. It does not provide "basic hospital," "basic medical," or "major medical" insurance as defined by the New York State Insurance Department. • This proposal is subject to satisfactory financial evaluation. • Please refer to certificate of coverage for full plan description; plan documents are the final arbiter of coverage. Insurance Department. • This proposal is subject to satisfactory financial evaluation. • Please refer to certificate of coverage for full plan description; plan documents are the final arbiter of coverage. GP-1-STD-15; GP-1-STD-15-NM; GP-1-STD-15-OR.
Made with FlippingBook Digital Publishing Software