Underwritten by New York Life Insurance Company
This Plan is available exclusively to IEEE members* under age 70 who are at FULL-TIME WORK, provided their ANNUAL GROSS EARNED INCOME is at least $20,000 for the proceeding 12 month period. In order to become insured, satisfactory evidence of insurability must be provided and the required premium must be paid.
"FULL-TIME WORK" means the active performance of the regular duties of your normal occupation for pay or profit on the basis of at least 30 hours per week at the place such duties are normally performed.
This coverage is only available for residents of the U.S. (except VT and territories), Puerto Rico and Canada (excluding Quebec). Note: This coverage is available to residents of Canada through Marsh Canada Limited. Stephen Fretwell, an employee of Marsh Canada Limited, acts as broker with respect to residents of Canada.
*Participation in the IEEE Member Group Insurance Program requires active IEEE membership status during the life of the plan.
Important Notice For Self-Employed Members: Please be advised that if you are applying for this Plan and you have been self-employed for less than one year coverage is limited to a $1,040 Monthly Benefit Option, with a 90-day Waiting Period under the Five-Year Plan.
HOW THE PLAN WORKS
Choose From Three Plan Options
All three plans pay monthly benefits while you are Totally Disabled. "Totally Disabled" means you are prevented by illness or injury from performing the material and substantial duties of your usual occupation, provided you are not otherwise working for pay or profit. Benefits begin at the end of the waiting period, provided you are Totally Disabled.
Note: Benefits for disabilities due to Mental Disorders or Chemical Dependency are limited to a maximum of 36 monthly payments, regardless of Plan choice.
Choose Your Plan
If you are Totally Disabled before age 63, benefits are payable up to age 65. There is a two year maximum benefit for Total Disabilities starting at ages 63 through 74.
Benefits are payable for up to five years for Total Disabilities commencing prior to age 60. For Total Disabilities starting at ages 60 through 62, benefits may continue up to age 65. For Total Disabilities starting at ages 63 through 74, benefits may continue for up to two years.
Inflation-Fighter Career Plan
This Plan offers disability coverage that, once benefits begin, can help keep pace with inflation. Monthly benefits will be adjusted annually from the date of disability if you are Totally Disabled prior to age 63. Adjustments may be made to the Monthly Benefit paid in the second and each succeeding year. The adjusted amount will be based on the Consumer Price Index for Urban Consumers (CPI-U), up to a maximum 5% increase per year and an overall maximum increase of one times the original benefit.*Once you are no longer disabled and the benefit payments stop, the Monthly Benefit returns to the original option amount.
Benefits are payable up to age 65 for Total Disabilities starting before age 63. For Total Disabilities starting at ages 63 through 74, the inflation-fighter feature is no longer applicable and benefits will be payable in accordance with the basic Career Plan (i.e., up to two years maximum).
*A "catch-up" feature allows disabled members to receive benefit increases in excess of the 5% annual maximum if the prior years' compounded rates of inflation were less then 5% annually. Contact the Administrator for additional details on this feature.
Choose Your Monthly Benefit - NEW Higher Limits Available
You now have a choice of Monthly Benefit Options, from $260 to $7,540 (in $130 units). However, members age 65-69 may not request a monthly benefit option in excess of $3,250. The option you choose, together with any other disability income insurance you may have, cannot exceed 60% of your AVERAGE MONTHLY INCOME. Also, if you have been self-employed for less then one year, your Monthly Benefit Option is limited to $1,040. Depending on your state of residence, you may be eligible to receive disability benefits under a state plan. You should check to see if your state offers this type of benefit.
NOTE: On the November 1 anniversary date on or immediately after reaching age 65, coverage in excess of $3,250 reduces to $3,250. On the November 1 anniversary date on or immediately after reaching age 70, coverage in excess of $1,560 reduces to $1,560.
ANNUAL GROSS EARNED INCOME means your wages, salaries, commissions, fees and other amounts received for personal services — before deduction of income or social insurance taxes and after deduction of the normal business expenses which are deductible for income tax purposes — for any 12 month period. It does not include income from interest, dividends, rent, royalties, annuities, other insurance or other unearned income. AVERAGE MONTHLY INCOME means 1/12 of your ANNUAL GROSS EARNED INCOME.
Your Choice of Waiting Periods
You also have a choice of four waiting periods before benefit payments begin: 30, 90,180 or 365 days. A waiting period is the number of consecutive days you must be Totally Disabled before benefit payments begin. You should choose one that will provide benefits when your employer-provided salary continuation plan runs out. Coverage with a longer waiting period is less expensive.
New Feature! Future Purchase Option
You expect that your salary will increase with time, and that means you'll have more to protect. Reserve a coverage increase now, for future activation, without additional medical underwriting for your future need.
This Future Purchase Option (FPO) is now available to IEEE members.
Eligible members, ages 18 - 46, may apply for this benefit when requesting initial coverage under the Plan. You will be underwritten now for the full amount applied for, both your Monthly Benefit for immediate activation upon approval and the future amount to be activated (converted) as an increase to your Monthly Benefit in the future. No medical underwriting will ever be required in the future to activate (convert) an in force FPO amount!
Any approved FPO amount, in $130 increments up to $2,600, even if not activated (converted), is subject to the Plan maximum and the 60% of AVERAGE MONTHLY INCOME limitation.
Whether you choose Plan 65 or Plan 5, the FPO amount is pended in that status until your decision to activate either a portion or the entire amount of the FPO to increase your Monthly Benefit. While pended with FPO status, you pay the very attractive FPO rate. Upon activation/conversion, the entire amount of the new, increased Monthly Benefit is subject to the full rate basis. The FPO is not available with the Inflation-Fighter Plan.
You may request a conversion of an FPO amount to increase your Monthly Benefit only during the year of your even age, from age 24 to age 48. (Age is determined as attained age on the nearest November 1, except on the initial effective date, which recognizes attained age on that date.) You will need to contact the Administrator to request this conversion/activation. An FPO amount that has not been converted to increase the Monthly Benefit is not eligible for claim payment consideration.
The FPO option will be terminated at age 50 and the eligibility to convert/activate the FPO amount ends.
If you die— from any cause— while receiving benefits for Total Disability, a death benefit equal to three times the Monthly Benefit Option in force on the date of your death will be paid to your surviving relatives in the following order of survival: your spouse; or your children, equally; or your brothers and sisters, equally; otherwise, if there is no surviving relative, to the executor or administrator of your estate.
Organ Donation Benefit
If you have been insured under the Plan for at least six months and undergo a surgical procedure to donate an organ for transplant, you will be considered Totally Disabled. No waiting period will apply, and benefits will be payable from the first day of Total Disability. However, any portion of your Monthly Benefit Option which became effective in the six months immediately prior to such organ donation will not be payable for this Total Disability.
This benefit is designed to help certain disabled members return to the work force. Under this provision, a professional rehabilitation staff reviews case histories and identifies individuals who appear to have the greatest likelihood of rehabilitation. Individuals selected by New York Life Insurance Company are offered the option of participating in a rehabilitation program at no cost to them. Participation is voluntary and benefits are not reduced due to participation in this program.
Partial Disability Benefits
While you are recovering from a Total Disability, you may be eligible to receive a partial disability benefit even though you return to work. If you return to work immediately following a period of Total Disability for which benefits were payable, you may continue to receive your monthly disability benefit until the earlier of the end of the maximum benefit period for Total Disability, or 24 monthly payments. However, the amount of your Monthly Benefit Option, together with all other disability benefits and income you earn that month, cannot exceed 80% of your average AVERAGE MONTHLY INCOME for the 12 months before Total Disability started.
Waiver of Premium
After you have been Totally Disabled for six consecutive months and you begin to receive benefits for Total Disability, all future premium contributions under the Plan will be waived for as long as you receive benefits for that disability.
Benefits for Recurring Disability
Successive periods of disability that are due to the same or related causes will be considered a single period of disability unless separated by a return to FULL-TIME WORK for three consecutive months or more.
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ADDITIONAL PLAN PROVISIONS
Exclusions and Limitations
The Plan does not provide benefits for: any disability that occurs during or is due or related to intentionally self-inflicted injury while sane or insane [Missouri Residents: This exclusion is not applicable to injury caused by an intentionally self-inflicted injury while insane] declared or undeclared war or any act thereof, military service, pre-existing condition (see below) or your incarceration or participation (except as a victim) in an illegal occupation/activity or the commission of a crime; or any disability that is due or related to pregnancy or childbirth (except complications thereof), or any impairment or disease specifically excluded from your coverage.
The Plan limits benefits for disabilities due to Mental Disorders and Chemical Dependency to a maximum of 36 monthly payments.
No benefits will be paid unless the disability occurs while you are insured under the Plan and you are under the care of a licensed physician or surgeon other than yourself (or member of your immediate family or household) during the period of disability.
Preexisting Condition Limitation
PREEXISTING CONDITION is an injury or sickness for which you consulted a doctor, received any medical services or supplies, or took any medication during the 12 months immediately before becoming insured under this plan. Benefits are not payable for a disability which is classified as a PREEXISTING CONDITION until the end of the earlier of 12 consecutive months during which you have not consulted a doctor, received medical services or supplies, or taken any medication for the condition; 24 consecutive months during which you have been insured under this Plan.
Note: Residents of MD and NC: Any reference to "performing normal activities" is replaced by the requirement that the health status of any proposed insured person remains the same as stated in your application.
You will become insured on the date specified by New York Life Insurance Company provided the first premium contribution has been paid, satisfactory evidence of insurability has been submitted, and you are actively performing the normal activities of a person in good health of like age on that date. If you are not performing your normal activities as required, coverage will not become effective until the day you are performing such normal activities provided such date is within three months of the date insurance would have been effective and you are still eligible for insurance. Payment of a premium contribution for insurance does not mean there is any coverage in force before the effective date as specified by New York Life Insurance Company.
Note: There are instances where New York Life Insurance Company may be able to offer insurance, at the same cost, by eliminating coverage for a specific impairment or disease.
When Coverage Ends
Your insurance may remain inforce until the November 1 anniversary date on or immediately after you reach age 75, provided you: (a) do no cease FULL-TIME WORK other then for reasons of disability; (b) remain an IEEE member; (c) continue to pay premium contributions when due; (d) do not enter full-time active duty in the armed forces (coverage may be restored upon termination of active duty status, subject to policy guidelines); or (e) you do not elect to terminate your coverage; or (f) the group plan is not terminated or modified by the Policyholder or New York Life Insurance Company to end insurance for the group of insureds to which you belong.
Renewal Payments And Claims
Once you are accepted into the Plan, you will have a 31-day grace period for your payment of renewal premium contributions. When you want to submit a claim, call or write the Administrator for claim forms.
Certificate Of Insurance
This information is only a brief description of the principal provisions and features of the Plan. The complete terms and conditions are set forth in the group policy issued by New York Life to the Trustee under Trust Agreement with the Institute of Electrical and Electronics Engineers.
When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the Plan.
"30-Day Free Look"
If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will receive a full refund—no questions asked!
How New York Life Obtains Information and Underwrites Your Request for Group Disability Income Insurance
In this notice, references to “you” and “your” include
any person proposed for insurance. Information regarding insurability will be
treated as confidential. In considering whether the persons in your request
for insurance qualify for insurance, we will rely on the medical information
you provide, and on the information you AUTHORIZE us to obtain from your physician,
other medical practitioners and facilities, other insurance companies to which
you have applied for insurance and MIB, Inc. (“MIB” formerly known
as Medical Information Bureau). MIB is a not-for-profit organization of insurance
companies, which operates an information exchange on behalf of its members.
When you apply for insurance or submit a claim for benefits to a MIB member
company, medical or nonmedical information may be given to MIB, Inc., and such
information may then be furnished by MIB to member companies.
Your AUTHORIZATION may be used for a period of 24 months from the date you
signed the application for insurance, unless sooner revoked. The AUTHORIZATION
may be revoked at any time by notifying the New York Life in writing at the
address provided. Your revocation will not be effective to the extent New York
Life or any other person already has disclosed or collected information or taken
other action in reliance on it, or to the extent that New York Life has a legal
right to contest a claim under an insurance certificate or the certificate itself.
The information New York Life obtains through your AUTHORIZATION may become
subject to further disclosure. For example, New York Life may be required to
provide it to insurance, regulatory or other government agencies. In this case,
the information may no longer be protected by the rules governing your AUTHORIZATION.
MIB and other insurance companies may also furnish New York Life, its subsidiaries
or the Plan Administrator with non-medical information (such as driving records,
past convictions, hazardous sport or aviation activity, use of alcohol or drugs,
and other application for insurance). The information provided may include information
that may predate the time frame stated on the medical questions section, if
any, on this application. This information may be used during the underwriting
and claims processes, where permitted by law.
New York Life may release this information to the Plan Administrator, other
insurance companies to whom you may apply for life and health insurance, or
to whom a claim for benefits may be submitted and to others whom you authorize
in writing, however, this will not be done in connection with with test results
concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency
Virus (HIV). We may also make a brief report of your protected health information
to MIB, Inc. but, we will not disclose our underwriting decision.
New York Life will not disclose such information to anyone except those you
authorize or where required or permitted by law. Information in our files may
be seen by New York Life and Plan Administrator employees, but only on a “need
to know” basis in considering your request. Upon receipt of all requested
information, we will make a determination as to whether your request for insurance
can be approved.
If we cannot provide the coverage you requested we will tell you why. If you
feel our information is inaccurate, you will be given a chance to correct or
complete the information in our files. Upon written request to New York Life
or MIB, you will be provided with non-medical information. Generally, medical
information will be given either directly to the proposed insured or to a medical
professional designated by the proposed insured. Your request is handled in
accordance with the Federal Fair Credit Reporting Act procedures. If you question
the accuracy of the information provided by MIB, you may contact MIB and seek
a correction. MIB’s information office is: MIB, Inc. 50 Braintree Hill
Park, Suite 400, Braintree, MA 02184-8734, telephone (866) 692-6901 (TTY 866
346-3642). For Canadian residents the address is: MIB Information Office, 330
University Avenue, Suite 501, Toronto, Ontario, Canada M5G 1R7, telephone (416)
597-0590. Information for consumers about MIB may be obtained on its Web site
For NM Residents: PROTECTED PERSONS 1 have a right of access to certain CONFIDENTIAL ABUSE INFORMATION 2 we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.
1 PROTECTED PERSON means a victim of domestic abuse; who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured or prospective insured person.
2 CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured family member, employer or associate of a victim of domestic abuse or a person with whom the applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.
If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life Insurance Company.
|New York Life Insurance Company
IEEE is compensated in connection with this sponsored group plan to provide and maintain this valuable membership benefit.
Underwritten by New York Life Insurance Company, under Group Policy No. G-12150-2, on Policy Form GMR-FACE/G-12150-2
About New York Life Insurance Company.
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