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 typically be used during a disability but there are many limitations:

• Newer workers generally have not accumulated enough days to cover an average disability such as a health condition, accident, or pregnancy-related disability.
• There are often limits on the number of days members can draw from a sick leave bank.
• Receiving days from a sick leave bank may be subject to committee approval, not based on a physician’s diagnosis.

What about Public School Employees Retirement System 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 and meet all the eligibility requirements to be covered 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 10 years to be eligible, leaving newer employees unprotected. Taking a sabbatical during this time would you pay you 50% of you salary.1

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

• The average national rate of approval for initial disability claims is 36%..2
• Workers’ Compensation only covers time away from work if the disabling illness or injury was directly work-related.3
• To qualify as “able to work” an employee must be physically and mentally capable of work. If you are suffering from an illness or injury, you may not be eligible for unemployment benefits until you are once again able to work. to work related.4

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 for a specific period of time.

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 Disability 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.

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 cover 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.

Are Pre-existing Conditions covered?

The policy will not cover any Disability caused or contributed to by a Pre-existing Condition which begins in the first 12 months after your effective date. “Pre-existing Condition” means a mental or physical condition whether or not diagnosed or misdiagnosed for which you have consulted a Physician or other licensed medical professional, received medical treatment, services or advice, undergone diagnostic procedures, including self-administered procedures, or taken prescribed drugs or medications at any time during the 3 month period just before the effective date of your insurance under the Group Policy.

*MNL and NIS are not affiliated with PSERs and the content of this document has not been endorsed or approved by PSERs.

¹https://wwea.psealocals.org/Leaves/Sabbatical.aspx#:~:text=The%20employee%20on%20leave%20of,from%20all%20other%20school%20activities

²https://www.ssdrc.com/5-72.html

³www.disabilitycanhappen.org/wp-content/uploads/2019/05/DIAM2019_Facts.pdf

⁴https://www.nolo.com/legal-encyclopedia/collecting-unemployment-are-you-able-32445.html

This is a brief description of disability insurance. For complete details including all benefits, exclusions, and limitations, refer to Certificate form number GLDI-C200-(12/06) as issued to your employer.