Eligibility
All Federal Employees who: a) are under age 60 b) reside in the United States c) are Actively-At-Work on a full-time basis (at least 17.5 hours per week) and d) are not on active duty in any branch of the Military or Armed Forces of any country. Newly hired full-time Federal Employees within 45 days of their hire date, who work at least 17.5 hours per week, are eligible for Wright USA's Guaranteed Disability Income Insurance Protection Plan (benefits are subject to the policy's pre-existing condition limitation).
Acceptance into this plan is subject to medical evidence of insurability as determined by The Hartford. Depending on your age, the amount of coverage you request, and your answers on the application, a medical examination, medical test(s), or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at your convenience and at no expense to you.
Exclusions
Intentionally self-inflicted Injury, suicide or attempted suicide, while sane or insane.
Any Total Disability caused by pregnancy or childbirth, except: pregnancy that had its inception while you were covered under the policy; and the Total Disability is caused by, or contributed to, by the results of a complication of pregnancy.
Total Disability caused, or contributed to, by war or any act of war, except with respect to you, in the line of duty ("War" means declared or undeclared war and includes resistance to armed aggression.)
Injury sustained while riding on, boarding or alighting from, any aircraft: as pilot, crew member or student pilot, unless the Insured Person is flying on his or her Employer’s business in an aircraft certified as airworthy by the appropriate authority; the commission or attempted commission of a felony by you.
Any period of Total Disability during which you are not under the direct care and treatment of a licensed Physician; or any sickness contracted or Injury sustained while on full-time active duty as a member of the Armed Forces (land, water, air) of any country or international authority.
Limitations
Total Disability means disability which: a) during the Waiting Period and the first 24 months during which Total Disability Benefits are payable, wholly and continuously prevents you from performing the substantial and material duties of your usual occupation; b) after that, wholly and continuously prevents you from engaging in any and every occupation or employment for which you are reasonably suited by training. Education, or experience; and, c) require the regular care of a Physician; and you are not engaging in any occupation for wage or profit.
Successive Periods of Disability: Periods of Disability due to the same or related medical causes and separated by less than 6 months during which you are Actively-at-Work will be considered one Period of Disability.
Concurrent Disabilities: Benefits during any Period of Disability as the result of: more than one sickness; or more than one accident; or both sickness and accident will be considered the same as if the disability resulted from only one cause.
Period of Disability means a continuous length of time during which you are disabled under this plan.
During the first year of coverage, losses incurred for Pre-Existing Conditions are not covered. A Pre-Existing condition means any injury or sickness including pregnancy: diagnosed or undiagnosed, for which you have received medical care within the 12 month period prior to your coverage effective date or date of an increase in coverage. During that time, benefits for all other accidents or illnesses will be paid under the policy provisions. You are urged to consider this limitation before dropping any coverage you may have until the waiting period is over.
Maximum Payment Period: For total disability beginning before age 61 to age 62. Age 61 and over 12 months.
If you are Totally Disabled due to Mental or Nervous Disorders, alcoholism, or drug abuse, the Maximum Payment Period will be reduced to 2 years during your lifetime unless you are confined in a hospital or other institution licensed to provide care and treatment for that disability.
Actively-at-Work means you are performing the regular duties of an occupation for wage or profit on a full-time basis (at least 17.5 hours a week).
The plan has an Offset Provision which means benefits payable as a result of your disability will be the lesser of the monthly benefit amount or the monthly benefit Amount minus any other income benefits. However, if your monthly benefit amount would reduce to less than $200 per month due to other income Benefits, then the minimum Monthly Benefit Amount under this benefit will be $200 per month.
The example in the table directly below is for purposes of illustrating the effect of benefit reductions and is not intended to reflect the situation of a particular claimant under the Policy.
Insured’s monthly [Pre-Disability Earnings/Basic Monthly Pay] |
|
Long term disability benefits percentage |
|
Unreduced maximum benefit |
|
Less Social Security disability benefit per month |
|
Less state disability income benefit per month |
|
Total amount of long term disability benefit per month |
|
Termination
Your coverage ceases when the Master Policy is no longer in force, when you cease to be Actively-at-Work except due to disability covered by the policy, premiums are not paid, or you are no longer an employee with the Federal Government. Basic Monthly Insured Salary means your regular monthly rate of pay including Administratively Uncontrollable Overtime (AUO) or Availability Pay, but not counting commissions, bonuses, other overtime pay or any fringe benefit or extra compensation, in effect on the last day of active employment prior to becoming Disabled, and upon which the required premium has been paid. If your rate of pay changes, your benefit amount will be adjusted on the premium due date you pay the premium applicable to the new rate of pay and benefit amount. Total Disability- If you become Totally Disabled as the result of an Injury or Sickness while covered under the Policy, we will pay the Monthly Benefit Amount due for the period of Total Disability. The period of Total Disability must require the regular care of a physician.
Special Provisions
This Plan has a Survivor Income Benefit. If you die: a.) After completing the Waiting Period; or b.) while receiving a Monthly Benefit; under the Total Disability Benefit we will pay a Survivor Income Benefit Amount. The Benefit Amount will be based on the Covered Person's age at the time of death as follows: If the Covered Person dies prior to attaining age 60, the benefit will be the lesser of: twenty-four times the Covered Person's monthly benefit amount payable after offsets including assumed benefits; or, $30,000. If the Covered Person dies on or after attaining age 60, the benefit amount will be the lesser of: a.) twelve times the Covered Person's monthly benefit amount payable after offsets, including assumed benefits; or b.) $15,000. The Survivor Income Benefit will be paid: a.) to the beneficiary designated by you; or, b.) if no beneficiary has been designated: 1.) to your surviving spouse; 2.) if no surviving spouse, in equal shares to your surviving children; 3.) if no surviving spouse or surviving children, to your estate.
Please Note: This website explains the general purpose of the insurance described, but in no way changes or affects the policy Master Policy #5389 & 5391 as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured indivdual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.
Additional Information
The Civil Service Employee Benefit Association (CSEBA) and Special Agents Trust for Insurance (SATI) are group policyholders of this insurance program. Both organizations make available voluntary risk management products and services, other voluntary benefits, and educational services to current and former federal employees. Wright USA acts as the program administrator for both CSEBA and SATI.
Wright USA is the Plan Administrator and Insurance broker that administers the insurance plan on behalf of the Hartford Life and Accident Insurance Company for the benefit of the Group Policyholder. Wright USA is compensated for the placement of insurance and for the services it provides to customers on behalf of the insurance company, in addition to other compensation it may receive.
Underwritten by:
Hartford Life and Accident Insurance Company
Simsbury, CT 06089
Policy Form #SRP-1311 A (5389) & Policy Form #SRP-1311A (5391)
The Hartford® is the The Hartford Financial Services Group, Inc. and its subsidiaries including issuing company Hartford Life and Accident Insurance Company.
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