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- What is long term disability (LTD) insurance?
- Who is eligible?
- What will the FEDERAL FIRST LTD Insurance Program cover?
- What is included in "base earnings" as it applies to this program?
- How is the FEDERAL FIRST LTD Insurance Program different from Workers’ Compensation?
- What other benefits do you provide?
- What is not covered?
- If I become disabled, how soon will my benefits begin?
- Once I receive FEDERAL FIRST LTD benefits, will my premiums be waived?
- How are my monthly benefits determined?
What is long term disability insurance?
Long term disability insurance, underwritten by Aetna Life Insurance Company (Aetna), offers benefits that replace a portion of your reported monthly salary if you are unable to work due to a disability.
An eligible member is:
- An active, benefited employee working at least 20 hours a week for one of the following: Department of Justice and Homeland Security, Treasury Department and Department of Homeland Security, Department of Veterans Affairs, Federal Judiciary; and
- a member of one of these sponsoring associations: Department of Justice Recreation Association, Treasury Department Recreation Association, Nurses Organization of the Veteran Affairs, National Conference of Bankruptcy Clerks, Federal Court Clerks Association.
Members of the Federal Law Enforcement Officers Association (FLEOA) are also eligible.
What will the FEDERAL FIRST LTD Insurance Program cover?
FEDERAL FIRST'S LTD Insurance Program considers your most recently reported monthly salary when providing benefits if you are unable to work due to a disability. Benefit payments will be reduced by other sources of income that you receive, such as Workers’ Compensation, Accumulated Sick Leave, CSRS or FERS disability retirement benefits.
What is included in "base earnings" as it applies to this program?
Base monthly earnings means your rate of reported monthly earnings on the day before disability begins.
- For Department of Justice and Homeland Security (DJRA) base earnings include locality pay, scheduled overtime, availability pay, hazard and danger pay for law enforcement officers (if applicable).
- For Treasury Department and Homeland Security (TDRA) base earnings include locality pay, scheduled overtime, availability pay, hazard and danger pay for law enforcement officers (if applicable).
- Members of Federal Law Enforcement Officers Association (FLEOA) base earnings include locality pay, scheduled overtime, availability pay, hazard and danger pay for law enforcement officers (if applicable).
- For Federal Judiciary Employees (NCBC) base earnings include locality pay, scheduled overtime, availability pay, hazard and danger pay for law enforcement officers (if applicable) and net transcript fees for court reporters.
- For Department of Veterans Affairs (NOVA) base earnings include locality pay, scheduled overtime, availability pay, hazard and danger pay for law enforcement officers (if applicable), performance pay for physicians and dentists, and special or market pay for physicians, dentists and nurse executives.
Excluded are commissions, awards, bonuses, non-scheduled overtime or any other extra compensation.
How is the FEDERAL FIRST LTD Insurance Program different from Workers’ Compensation?
Workers’ Compensation plans cover injuries that take place while you’re at work. FEDERAL FIRST’s LTD Program covers most disabilities. The payment is yours even if your illness or injury takes places off the job. It helps fill the financial gaps left by Workers’ Compensation.
What other benefits do you provide?
If you participate in the FEDERAL FIRST LTD Insurance Program and are totally disabled, the FEDERAL FIRST Program offers these helpful programs and services through Aetna.
- Return to work incentive: During the first 12 months of part-time work while disabled, you can receive full benefits. You’re eligible – as long as your combined income and disability benefits do not exceed your monthly pre-disability earnings.
- Rehabilitation incentive: You’ll get an extra 10% of your monthly benefit if you enter an Aetna-approved rehabilitation program to help you get back to work. The incentive is limited to $500 monthly for up to six straight months for each period of disability.
- Back-to-work services: Medical, vocational, rehabilitation and disability specialists are ready to help. They’ll work with you, your doctor(s) and your employer to help you return to health and work as soon as it’s medically safe. That could mean better job protection – and continued pension growth down the road.
- Survivor benefit: If you die while getting long-term disability payments, your family could get a lump-sum benefit equal to six months of payments.
- No premiums during disability: Once you begin receiving long-term disability benefits, you can stop paying premiums and still be insured.
Aetna Long Term Disability insurance policies typically do not cover disabilities caused by:
- Self-inflicted injuries
- Injuries received while committing a crime
- Driving while intoxicated
- Rebellion, insurrection, or taking part in civil commotion,
- Acts of war.
No benefit is payable for any disability that is caused by or contributed to by a "pre-existing condition" and starts before the first to occur of:
- the end of the first 24 months following your effective date of coverage; or
- the end of a period of 12 months in a row, following your effective date of coverage, during which you have received no treatment or services and have taken no prescribed drugs or medicines for that condition.
A disease or injury is a pre-existing condition if, during the 12 months before your effective date of coverage, it was diagnosed or treated; or services were received for the diagnosis or treatment of the disease or injury; or you took drugs or medicines prescribed or recommended by a physician for that condition. If you were enrolled in the prior FEDERAL FIRST LTD program, you will receive credit for the time you were covered under that program.
To learn more about Pre-existing Conditions, please see our Pre-existing Conditions Limitations.
Other Exclusions and Limitations are listed in the policy. Please review carefully.
If I become disabled, how soon will my benefits begin?
Benefits are not payable immediately following the start of disability. The time immediately following the start of a disability is called an elimination period. You must satisfy the elimination period of the Option you elected. The elimination period for:
- Option 30 is 30 days of disability
- Option 60 is 60 days of disability
- Option 90 is 90 days of disability
If you remain disabled and file a claim with Aetna to determine if you qualify for benefit, benefits can be paid once the elimination period has been satisfied. Allotment payments are required during your elimination period.
Once I receive FEDERAL FIRST LTD benefits will my allotments be waived?
Yes. Your allotment payments will be waived once you satisfy the elimination period and are eligible to receive a disability benefit.
How are my monthly benefits determined?
Payments are provided the first 24 months if you’re unable to do the material duties of your own occupation solely because of disease or injury and your work earnings are 80% or less of your adjusted predisability earnings.
Payments can continue after 24 months if you can’t work at any reasonable occupation solely because of disease or injury. A reasonable occupation is any gainful activity for which you are or may become reasonably fitted by education, training, or experience and which results in (or is expected to result in) an income of more than 80% of your adjusted predisability earnings.
Payments may be reduced by benefits received from other sources. Examples are Workers’ Compensation, Social Security or the Federal Retirement System benefits. Monthly benefits are available after your elimination period, based on the benefit option you enroll in. Benefits do not accrue during the elimination period.