Group Disability Flashcards
(31 cards)
What is needed for a group insurance to be in force?
A group of insured persons must be established along with the conditions that qualify the group
How does the insurance company prove enrollment?
The insurance certificate is issued to the insured person.  in Quebec the employer must provide a copy of the policy and an information booklet.
How do you enrol in a group insurance plan without evidence of insurability?
When was due so within 30 days of becoming eligible for the plan.
Who manages the group insurance contract?
Contract management is facilitated by the fact that the employer holds much relevant information on its employees and his best position to manage the contract.
How much disability is accepted in a group disability insurance plan? What are the conditions?
Total disability. Be insured person must not receive work income, except for rehabilitation programs recognized by the insurer, and must receive care from a healthcare professional on a regular basis.
How does short term group disability insurance coverage defer from other group insurance?
Lesser benefits and a shorter elimination period.
What are the usual benefits for short-term group disability insurance coverage?
Benefits are normally 2/3 of remuneration with a set maximum amount. Benefits are paid weekly and the benefit. Is usually 15 to 26 weeks (half a year).
How often are benefits paid? How long is short term group disability insurance benefit period usually?
Benefits are paid weekly. The benefit period is usually 15 to 26 weeks.
What is the elimination period?
 it’s the waiting period before the first benefit is paid
Hope long is the elimination period for short term group disability insurance?
Typically 0 to 90 days
Do exclusions and restrictions apply to short term or long-term coverage?
Both
The following exclusions and restrictions, apply to both short-term and long-term coverage:
- Injury and illness resulting from an assault or criminal act
- Leave taken to receive aesthetic care
- Suicide
- Self inflicted injury
- Accidental injury or illness occurring during a temporary layoff, lockout or strike if the members coverage has not been maintained during the layoff, lockout or strike
- Injury or illness due to participation in a riot, war ,civil unrest or uprising
- If a plan, member is under treatment for drug dependence or alcoholism, the insured may agree to provide coverage
What is the effect of pre-existing illness when it comes to disability insurance?
The insurer may decide to exclude pre-existing illnesses from disability insurance. If the group to be insured does not already have such coverage at the time of the agreement.
This exclusion cannot be made when changing insurers upon the expiry of a contract (as members of the former plan have acquired privileges )
How are group plans taxed?
An employer who sets up a group insurance plan rather than individual policies for employees will have tax benefits
- the premiums are deductible for the business
- the premiums are not a taxable benefit for the employee
- the benefits are taxable for the employee
What happens at taxation if the premiums are paid by the employee?
In the case of consolidated disability insurance contract, where the employee pays the premiums, the benefits paid in the event of disability are not taxable.
If the employer pays a portion of the premiums, the employee will be taxed on the portion of the benefits that exceeded the portion paid by the employee.
In a group disability insurance plan, where the employer and employee pay premiums, who gets taxed and how much?
The premiums paid by the employer are deductible for the business (but not for employee)
The employee ye will be taxed on the portion of the benefits that exceeded the portion paid by the employee.
What is business disability insurance?
This is when the employer considers protecting their business in the event of a disability. The disability may be of an employee or a business owner.
What are three types of business disability insurance?
- Key person coverage
- Disability buyout coverage
- Overhead expense coverage
What is key person coverage?
Key person coverage protects businesses from financial losses that may result from the disability of key persons in an organization.
Does key person coverage have an elimination period? If so, how long is it normally?
Yes, there is normally a 30 day elimination. Before the first benefit is paid.
How long are benefits received in the case of a key person coverage?
After the 30 day elimination period, the benefits normally receive for 12 months.
What is disability buyout coverage?
It protects businesses from the long-term disability of a partner or owner. It allows the disabled partners shares to be brought out over a long period. The buyout is accomplished through periodic payments or a lump sum payment.
The disability buyout coverage is guaranteed and cannot be canceled. The contract can be renewed until the 65th birthday of each insured.
What is overhead expense coverage?
It is a business disability insurance that allows for the reimbursement up to a certain limit of the expenses incurred by business to continue providing services, if the owner becomes disabled
Which business disability insurance cannot be used to protect the owner, a.k.a. if the owner becomes disabled?
The key person coverage cannot be used to cover the owner. The owner cannot be the key person. There are other coverages for the owner or owners.