Policy # 95.0 Archived Version:
Long Term Total Disability Program

Revision date of this archived policy:
July 11, 2002

Note: This is not a current version of the policy. View current version. »

95.1 Policy
  The University provides long term disability coverage for regular full-time employees on the first day of the month after completion of one year of full-time employment under the long term total disability program. To be covered, an employee must be actively at work on this date. The long term total disability (LTD) program is intended solely to make monetary benefits available to an employee in the event of long term total disability and is not a job protection program.
  95.1.1 Subject to approval of the Employee Benefits Office, a new employee who has been covered by a reasonably comparable employer-sponsored long term disability plan within six months preceding employment at the University may be covered as of the date of employment at the University. The Employee Benefits Office’s approval is based on a review of a written description of the prior plan and proof of coverage.
  95.1.2 Under this plan, total disability is defined as the inability of the employee, by reason of sickness or bodily injury, to engage in any occupation for which the employee is reasonably fitted by education, training, or experience for more than six (6) full calendar months.
  95.1.3 The University may decide to outsource certain administrative functions of the long term disability program to a third party plan administrator.
  95.1.4 The University and the authorized plan administrator have the right to require medical and/or vocational examinations under this policy.
    95.1.4.1 The University and the plan administrator may require that a participant undergo some suitable rehabilitative training program which would consider the nature and limitations of the disability.
  95.1.5 Long term disability eligibility terminates as follows:
  1. Upon the termination of regular full-time employment,
  2. On the first day of the seventh (7th) month of an approved leave without pay,
  3. Upon discontinuation of the program by the University, or
  4. Upon retirement.
  95.1.6 Long term disability payments are provided under two (2) separate income benefit components of the program.
    95.1.6.1 The initial payments are made by the University and are a continuation of basic regular salary. These payments begin upon approval of the claim, as of the date of the onset of the disability and continue until the first day of the month following six (6) calendar months.
      95.1.6.1.1 For faculty, the six (6) months of pay is a faculty member’s six (6) months of sick leave.
      95.1.6.1.2 For a staff employee, the employing department is responsible for making the initial six (6) months of pay.
    95.1.6.2 After the initial six (6) calendar months, primary and supplemental benefits are paid in accordance with the formula described in 95.1.8.2 through 95.1.8.5.
  95.1.7 Long term disability payments under the plan cease at the earliest of the following occurrences:
  1. At the time the long term disability ceases, as defined in 95.1.2 in this policy;
  2. In the age sixty-five (65) birth month if the onset of the long term disability condition occurred prior to age sixty (60);
  3. For long term disabilities arising on or after age sixty (60), the duration of LTD payments is as follows:
     
    1. Age 60 up to age 61: 60 months;
    2. Age 61 up to age 62: 48 months;
    3. Age 62 up to age 65: 36 months;
    4. Age 65 up to age 68: 24 months;
    5. Age 68 up to age 70: 18 months;
    6. Age 70 up to age 72: 15 months; or
    7. Age 72 and thereafter: 12 months.

    NOTE: These monthly periods of payments in 95.1.7.3 include the waiting period of six (6) months.

     

  4. Death; or
  5. Failure of the employee to comply with provisions and requirements of the plan.
  95.1.8 The benefit formula for LTD payment is as follows:
    95.1.8.1 For months one (1) through six (6), the benefit formula is one hundred percent (100%) of the employee's base salary, less offsets.
    95.1.8.2 For months seven (7) through eighteen (18), the benefit formula is ninety percent (90%) of the employee's base salary, less offsets.
    95.1.8.3 For months nineteen (19) through thirty (30), the benefit formula is eighty percent (80%) of the employee's base salary, less offsets.
    95.1.8.4 For months thirty-one (31) through forty-two (42), the benefit formula is seventy percent (70%) of the employee's base salary, less offsets.
    95.1.8.5 For months forty-three (43) and thereafter, the benefit formula is sixty percent (60%) of the employee's base salary, less offsets.
  95.1.9 Long Term Disability Benefits Payments
    95.1.9.1 Primary Benefit Payments The University’s long term disability trust pays sixty percent (60%) of the basic regular monthly salary, less any offsets. Trust payments are made at the end of the month. Offsets include, but are not limited to the following:
      95.1.9.1.1 Social security disability payments to which the participant or any dependent of the participant is or would be entitled upon timely application;
      95.1.9.1.2 Workers compensation payments, awards, and/or settlements;
      95.1.9.1.3 Payments, awards and/or settlements of other disability plans covering the eligible participant;
      95.1.9.1.4 Damages or settlements recovered in third party actions; and
      95.1.9.1.5 Any other recovery through subrogation.
    95.1.9.2 Supplemental Benefit Payments
The University supplements the benefits paid in conjunction with the primary plan formula by an amount that produces benefits from all sources equal to the benefit formula as specified in 95.1.8 for the first forty-two (42) month period. University supplemental payments are also made at the end of the month.
    95.1.9.3 Retirement Contributions
The participant’s and the University’s retirement contributions, in an amount based on the participant’s base salary at the onset of disability, are made by the LTD program to the participant’s retirement plan each month.
  95.1.10 The University reserves subrogation rights should the disability condition arise as a result of third party negligence.
    95.1.10.1 Failure to protect the University's rights may result in a denial of all benefits under this program.
  95.1.11 This disability program does not cover total long term disability conditions that arise from or in conjunction with the following: (a) War or any act of war, declared or undeclared; or (b) An intentionally self-inflicted disability.
95.2 Delegation
  95.2.1 Administration of the long term disability insurance program is a function of the Employee Benefits Office of Human Resource Services.
  95.2.2 The appropriate administrator in the Employee Benefits Office shall be the approval authority for long term disability income payments.
95.3 Procedure
  95.3.1 Coverage of an employee is automatic after satisfaction of the requirements in 95.1 or 95.1.1.
  95.3.2 To apply for benefits under this program, an employee shall contact the Employee Benefits Office and complete the required application.
    95.3.2.1 An employee applying for benefits under this program shall also make application for social security disability benefits. If social security benefits are initially denied, one shall make at least three (3) application attempts.
    95.3.2.2 An employee applying for benefits under this program shall have ceased all University work before the application will be processed.
    95.3.2.3 In the event an employee applying for benefits under this program is also making application for benefits under the University workers' compensation program, the University reserves the right to hold the long term disability application in abeyance until the workers' compensation claim has been settled.
  95.3.3 An employee has an appeal right if a claim is denied. The appeal shall be made, in writing, within sixty (60) days of the denial by the Employee Benefits Office. The appeal shall be sent to the Director of Human Resource Services.
  95.3.4 University payments made to employees during the first six (6) months are charged to the department where the employee's salary was budgeted as of the date of the onset of the disability.
    95.3.4.1 University supplemental payments for months seven (7) through forty-two (42) are charged to an account established for that purpose and administered by the Employee Benefits Office.
  95.3.5 Payment shall be made for up to one year's vacation accrual in the event a participant ceases to receive disability benefits due to retirement, death or being declared no longer disabled.
    95.3.5.1 Vacation leave shall be paid from the University’s fringe benefit pool.
  95.3.6 For an employee applying for benefits under this policy, the employee's position shall be held open, until a final decision on the employee’s eligibility for LTD income payments is made.
  95.3.7 Health Care Coverage
    95.3.7.1 A person approved for LTD income payments may continue to participate in the University health care plan provided the person was enrolled in the University health care plan as of the date of the onset of the disability.
    95.3.7.2 A person who was eligible to receive the health credit as of the date of the onset of the disability shall continue to receive the health credit while receiving LTD income payments. The eligible person shall be responsible for payment of any amount above the credit for the plan in which the person is enrolled.
    95.3.7.3 The dependents and family members of an eligible person may be enrolled in the University health plan, provided the dependents or family members were enrolled as of the date of the onset of the disability.
    95.3.7.4 If a person receiving LTD income payments drops health care coverage through the University plan or if dependents or family members are dropped from the University health plan, the person, dependents or family members may not enroll in the University health plan again.
    95.3.7.5 When a person who has been receiving LTD income payments retires, that person and the dependents and family members shall participate in the University health plan in accordance with regulations that cover retirees’ participation.
    95.3.7.6 Coverage for the LTD eligible person and dependents and family members under the University health plan terminates when a person is no long eligible to receive LTD income payments. The right to continue coverage shall be in accordance with federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).
    95.3.7.7 If one qualifies for Medicare health insurance because of a disability or age, one shall enroll in Medicare parts A and B as soon as one is eligible. Medicare will be the primary payer as long as a person is not actively at work and continues to qualify for Medicare.
  95.3.8 Other Benefits
    95.3.8.1 Dental coverage for a LTD eligible person and dependents and family members shall continue as long as the required payments to the plan are made. The eligible person, dependents and family members shall have been enrolled in a plan when the eligible person is approved for LTD income payments and must continue enrollment. Plan changes are permitted only during open enrollment.
    95.3.8.2 Coverage for the basic life insurance, the optional life and the accidental death and dismemberment offerings continue as long as the eligible person makes the required payments for the plans. No increase in the level of coverage is permitted for the option life program.
    95.3.8.3 Coverage for the other voluntary benefits continues as long as the required payments are made.
    95.3.8.4 The time a person receives benefits under the LTD plan counts toward years of service relating to retirement matters.

Archived Versions of this Policy

Previous version: revised 04-01-2008
Previous version: revised 10-01-2006
Previous version: revised 04-01-2006
Previous version: revised 07-11-2002
Previous version: revised 04-01-1990