FAQ

Frequently Asked Questions

Can I count on sick leave pay and sick leave banks instead of purchasing disability insurance?

Sick leave pay and sick leave banks can be used during a disability but there are many limitations:

  • Younger workers generally have not accumulated enough days to cover an average disability such as a health condition, accident or pregnancy-related disability.
  • On average, more than one in five disabled employees are out of work for more than five years.[1] It would be impossible to accumulate five years of sick leave or borrow that much from a sick leave bank.
  • There are limits on the number of days members can draw from a sick leave bank.
  • Pay from sick leave banks is generally not a full day’s pay.
  • Receiving days from a sick leave bank is subject to committee approval, not based on a physician’s diagnosis.
  • Pregnancy is usually not covered by sick leave banks.

 

What about PSERs disability insurance plan?

PSERs is the Public School Employees Retirement System that has a disability insurance component. You must be working for 5 years before becoming eligible for coverage under this plan. Once covered, the plan has limited benefits.

 

Could I just take a sabbatical if I became disabled?

Yes, however similar to the sick banks, your leave must be board approved, rather than approved by a physician. You also must be working for 7 years to be eligible, leaving newer employees unprotected. Also, the sabbatical requires you to return to work which means if you were permanently disabled, you could not use a sabbatical.

 

What about Social Security, Workers Comp and other insurance plans?

  • Only 36% of the 2.8 million workers who applied for Social Security Disability Insurance benefits in 2011 were approved.[2]
  • Workers’ Compensation provides benefits ONLY if a disability is a result of an on-the-job accident, injury or occupational disease. Close to 90% of disabling accidents and illnesses are not work related.[3]
  • Health Insurance covers medical services and prescriptions; it does not replace income if you cannot work.
  • Unemployment Compensation is for those who are physically and mentally able to work.

 

Are there any medical questions?

If you are a new hire or a newly eligible employee you can purchase this plan without medical questions or tests if you apply within the eligibility period and participation requirements are met. Also if you choose to change the plan option you are currently enrolled in (moving to a lower elimination period) you must answer medical questions. Please note that coverage may be denied based upon your answers to the medical questions. 

What is the Medical Premium Expense Benefit (MPEB)?

Most PSEA Disability Plans include a feature called MPEB. If you become totally disabled for more than 60 days, are still covered under your employer’s health insurance and are receiving regular medical care, MPEB will contribute up to a specific amount per month toward your monthly health insurance premium payments for 17 months.

Is maternity coverage offered?

Pregnancy, childbirth and related medical conditions are covered the same as any other illness. Coverage may continue up to 6 weeks for natural childbirth, 8 weeks for cesarean delivery or longer if there are complications.

 

What is an “elimination period”?

An elimination period is the time between when your disability begins and the time you are eligible to receive benefits. No benefits are paid during the elimination period. There are several elimination period options to choose from.

 

Is income tax withheld from my benefit payments?

If you pay for this insurance with post-tax dollars, the benefit is not subject to income tax. Please see your tax adviser for complete advice.

 

Do I have to continue to pay the insurance premium after I become disabled?

The Waiver of Premium feature waives your disability insurance premium payment during a disability. This begins as soon as you start receiving benefits and continues while you are disabled.

 

What if I earn income while I’m disabled such as Social Security income?

As with most disability insurance plans, benefits are reduced by other income you may receive during a disability, including employer-sponsored sick leave pay, Social Security or a State Retirement Disability benefit plan. Please note that if you choose option #6, there is no offset for sick leave pay which means you can receive your full disability benefits and your sick leave pay at the same time. 

 

How much coverage is available?

Long-Term Disability benefits replace a fixed percentage of your salary – typically 50-60% – up to a maximum monthly amount. See the plan options page to view the coverage options, rates and maximum monthly benefit.

[1] Guide to Disability Income Insurance, America’s Health Insurance Plans, 2013.

[2] 2011 Social Security Administration, Office of Chief Actuary, ssa.gov/OACT/STATS/dibStat.html

[3] Council for Disability Awareness, CDA 2012 Long Term Disability Claims Review.

 

The Group Long Term Disability Insurance referenced in this advertisement is for Certificate form number GLDI-C200-(12/06), underwritten by Madison National Life Insurance Company, Inc., Madison, WI.  For complete details including all benefits, limitations and exclusions, refer to the Certificate issued through the group policyholder.

© PSEA Disability. All Rights Reserved

All benefits are subject to the terms of the certificate of insurance coverage.