Disability A
Can be partial or totally disabled in the EP
What is residual?
Susan pays her disability premium on a post-tax basis. Will the claims department take out taxes?
Yes
Name the 3 states we provide statutory( STD benefits to and the one we provide only on an ASO basis?
Hi, NJ, NY CA VDI on ASO basis.
What do require for experience on ASO plans?
Incidence or number of claims.
60% to 70%
Typical Disability Income Replacement
If You return to Active Work before completing Your Elimination Period and then become Disabled, you will have to complete a new Elimination Period.
Partial
Benefits will not be paid if your Disability begins in the first 12 months following the effective date of your coverage; and your Disability is caused by, contributed to by, or the result of on-going Condition.
Pre-Existing Exclusion
When do we typically quote a non-integrated plan?
Quoting on top of CA SDI plan.
Provision that limits benefit payments for conditions that previously existed.
Pre-Existing Limitation
Reduces Duplicate Income
Offsets
If you have another Disability, and after your prior Disability ended, you returned to work for your Employer.
Recurrent Disability
If my current booklet has 1 of these 3 things then I will need to provide a Compass quote?
. Portability, no minimum participation, heaped commissions.
On what type of incurral exhibit do I need to input the run date?
Incurred Claims Analysis
Weight given to a group's actual claims
What is Credibility
Affects Net Income
Taxation
What is the partial calculation where I can receive 100% of my benefit?
Workplace incentive.
If I have monthly paid claims and the group was effective with the current carrier during one of my experience periods used , What do I need to make sure the tool reflects.
Immature Claims
On a gross up plan will the benefits be taxable?
No
Lives, Number of claims, covered payroll, benefit volume, length of experience period
Credibility drivers
50% to $170 to 26 weeks
NY DBL
If you mark yes under school hospital in the FI tool what does this do?
Extends the EP to the latter of the EP or sick time.
If I am working 85% of my regular work schedule, how much disability will I receive if my weekly salary is 1000 and my benefit is 60% and I bring home $850,00 a week.
Not consider disabled. $0 benefit.
Disability billing Methods
What is First Dollar and Excess
The portion of an employee’s pre-disability earnings replaced by disability benefits.
Disability Income Replacement
Typically maintain 50% income replacement structure, just increases benefit cap
Enriched / Enhanced DBL Options