After a specified elimination period during which an member is “totally disabled” and unable to perform the essential duties of their own occupation, the member may qualify for Long-Term Disability (LTD) benefits. If the LTD claim is approved, select group benefits may continue under the Waiver of Premium provision, please consult your benefits booklets for details.
- Premiums for Long-Term Disability will be waived commencing the first of the month following completion of the LTD elimination period, until such time as the disabled member returns to active full-time employment, or reaches age 65.
- Subject to the Recurrent Disability provision under this benefit, LTD coverage will be reinstated upon the member’s return to work and premiums will be charged commencing on the first of the next month.
- If the member’s benefit coverage is terminated during the Short-Term Disability period, and then the LTD claim is denied, the member must be treated as a new member upon return to Active Work with your employer, meaning the waiting period must be served, and the Pre-Existing Condition limitation starts over.
Tip!
- Even if your plan does not have Disability benefits, it is important to advise GroupHEALTH as soon as possible when a member becomes disabled, so we can assist you and the member, in the application for Waiver of Premium, if applicable.
- If a member turns 65 while receiving Disability benefits, you must advise them of their right to convert to an individual insurance policy.