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Provider information
Insurance provider: Industrial Alliance
Policy number: 24500
For all claim inquiries, please do not hesitate to contact your 平特五不中 disability management advisor.
Long-term disability coverage
As an eligible employee, coverage is mandatory.
The first six months of your disability are covered by the short-term disability (STD) plan. If a disability keeps you away from work for longer than six months, the听long-term disability (LTD)听plan will provide you with a regular income.
Under the terms of the LTD Plan, you will receive a monthly non-taxable disability income equal to:
- 60% of the first $3,000 of your covered monthly earnings, plus
- 45% of the balance of your covered monthly earnings
- The maximum monthly benefit payable is $5,325听subject to applicable reductions.
However, the overall maximum must not exceed 87% of the covered net earnings determined at the end of the elimination period of disability.
The LTD benefit is payable bi-monthly and, if your claim is accepted, the insurer will confirm the benefits amount you are eligible for in their acceptance letter.
"Covered monthly earnings" means the gross monthly basic salary, provided that the basic salary for a Participant on an approved leave of absence shall be computed in accordance with the current practice or policy. Covered Earnings will include the certification premium, the lead premium, the scarcity premium and Summer Hours, but will exclude any other premium, or any other supplementary, sessional or overtime payments.听
Termination of benefits
Reasons for the termination of benefits, including but not limited to, are:
- The date on which you cease to be disabled;
- The last day of the month in which your attain age 65 or upon retirement if earlier;
- The date on which you no longer meet the definition of disability as per the contract;
- The date on which you fail to submit to an examination by the physician designated by the insurer;
- The date on which you fail to provide evidence of disability required by the insurer;
- The date on which you refuse to participate in a rehabilitation program or to engage in rehabilitation employment which the insurer and its consulting physicians deem reasonably appropriate.
Additional Information
Examples of monthly LTD benefit calculation
For a yearly covered earnings total of $80,000, a monthly LTD benefit would be $3,450:
| percentage | benefit |
|---|---|
| 60% x $3,000 |
$1,800.00
|
| 45% x $3,667 |
$1,650.00
|
| Total | $3,450.00 |
For a yearly covered earnings total of $40,000, a monthly LTD benefit would be $1,950:
| Percentage | Benefit |
|---|---|
| 60% x $3,000 |
$1,800.00
|
| 45% x $333 |
$ 听 150.00
|
| Total | $1,950.00 |
Additional sources of income
The LTD Plan is intended to top up disability benefits available to you elsewhere. As such, any benefits you receive from the LTD Plan will be reduced by:
- benefits payable from Workers' Compensation
- disability benefits under any other government program
- income replacement benefits payable under any Motor Vehicle Insurance Law, or Criminal Injuries Compensation Act
- wages or remuneration payable from any employer
You must apply for disability benefits under whichever of the above plans might be appropriate. Please note that payments received from C/QPP are taxable.
In no case can the benefit you receive from all sources exceed 87% of your covered net earnings at the end of your six months of STD benefits.
You must comply with the plan requirement on an ongoing basis. If you don't, your benefit payments could be interrupted.听
Who pays for LTD coverage
You pay the full cost of your LTD coverage through payroll deduction. Because you pay the full cost of this coverage, any disability benefits you receive under the LTD Plan are tax-free. See听Rate summary for information on costs.
Please note that your Group Life and Accident Insurance premium payments will be "waived" while you are eligible for benefit payments under the LTD Plan. In addition, your pension contributions will be paid by the University. You may keep your coverage under the Health and Dental Plans by continuing to pay your share of the cost.
In the case of an active member whose employment terminates while they are in receipt of LTD payments, the continuation of the Pension Plan, Health Plan and Dental Plan shall not extend beyond the employment end date.
Defining disability
You are considered disabled during the first 24 months of your LTD leave if the insurer determines that you are incapable of performing the essential duties of your own occupation. You must continue to be treated by a physician during this 24-month period.
After receiving LTD benefits for 24 months, you are considered disabled if the insurer determines you are incapable of performing any occupation for which you are reasonably suited (or could become suited) by education, training or experience.
Recurring disability
If you have a recurrence of the same or a related disability within six months after you return to work, it will be considered a continuation of your previous period of disability. As such, you will apply directly for LTD benefits. Medical proof of your disability will, once again, be required.
If you become disabled for a different cause鈥攐r if you return to work for more than six consecutive months before becoming disabled again鈥攖he process will start over. You will apply first for benefits under the STD Plan before LTD payments resume.
Rehabilitative employment
One of the main objectives of the LTD Plan is to get you back on your feet as quickly as possible. Experience shows that rehabilitative employment is one of the best ways of doing just that.
Any LTD payments you receive will be reduced by 50% of the net income you earn through rehabilitative employment. Your total disability income from all sources, excluding individual insurance policies, can't exceed 100% of your net pre-disability earnings.
What the plan doesn't cover
The plan does not cover any disability resulting from the following causes:
- any period during which you are not under the continuous care and treatment of a surgeon or licensed physician
- any injury or illness resulting from civil unrest, insurrection or war, whether war be declared or not, or participation in a riot
- attempted suicide or voluntary self-inflicted injury, while sane or insane
- flight or attempted flight on board an airplane or other aircraft if the participant is part of the crew or performs any function relating to the flight, or participates in the flights as a parachutist
- injury or illness resulting from committing, attempting to commit, or provoking an assault or criminal offence
Drug and alcohol provision
If disability results from drug addiction or alcoholism, the monthly disability benefits will be payable provided that:
- the participant is confined in a hospital or is satisfactorily participating in a rehabilitation program deemed appropriate by the insurer;
- the participant is also suffering from an organic disease which would cause disability even if the drug addiction or alcoholism would cease.
