Long-Term Disability

Benefit highlights

We are pleased to offer income replacement benefits that take into consideration disability management through cost containment and rehabilitation. Below, we’ve highlighted some of the key features of LTD coverage:

  • Retro Disability Benefits: This innovative feature gives extra benefits to employees with serious LTD claims. It’s designed to help employees who are continuously hospitalized for 14 days or more at the onset of Total Disability and who complete the elimination period. When we pay the first Total Disability benefit, we will retroactively pay that claimant his or her LTD benefits from the first day the claimant was deemed totally disabled. This benefit is paid in a lump sum amount, and there are no offsets.
  • Innovative Return to Work incentives:
    • We can offer Zero-Day Residual benefits with no requirement of Total Disability before benefits are payable. Our Return to Work incentive allows combined earnings of up to 100% during the Return to Work period.
    • For customers who choose our Rehabilitation option, claimants who participate in a rehabilitation program approved by Sun Life Financial receive an additional 10% benefit.
  • Rehabilitation Services: We provide comprehensive Rehabilitation Services through our on-staff specialists. We offer customized Return to Work plans; physical, recreational, and vocational therapy; job search assistance; and financial assistance for worksite accommodations and other expenses.
  • Service Guarantees: We are pleased to offer an LTD Service Guarantee, which covers the accuracy and ERISA compliance of our claims processing as well as how quickly we respond to our customers’ phone calls. In addition, we include an overall satisfaction guarantee to ensure that our customers are 100% satisfied with our service. Available to all 100% employer-paid and partially employer-paid plans.
  • An effective Social Security Assistance Program: We provide this service for all claimants.
  • Integrated Waiver of Premium processing: When the LTD plan is offered in combination with our Group Life coverage, we automatically start the claims review process for claimants. This service helps make it easier for claimants to apply for Waiver of Premium benefits.
  • A wide range of optional features: Valuable options include a COBRA Continuance Premium Reimbursement Benefit, a Child Care Expense Benefit, a Child Continuing Education Expense Benefit, Cost of Living Adjustments, a Pension Contribution Benefit, an Assisted Living Benefit, Survivor Benefits, and Alternate Funding (for larger employers).

Exclusions

No LTD benefit will be payable for any Total or Partial Disability that is due to:

  • Intentionally self-inflicted injury.
  • War, declared or undeclared, or any act of war.
  • Active participation in a riot, rebellion or insurrection.
  • Committing or attempting to commit an assault, felony or other criminal act.
  • The Employee’s operation of any motorized vehicle while intoxicated.
  • A Pre-Existing Condition.

Pre-Existing Condition means during the look back period prior to the Employee’s Effective Date of Insurance the Employee received medical treatment, consultation, care or services, including diagnostic measures, or took prescribed drugs or medicines.