Insurance Ch - 6 Flashcards
If a person is covered by a private disability insurance policy, then he or she could also receive benefits from Social Security.
a. True b. False
TRUE
Disabled insureds generally continue to pay premiums while they receive benefits to avoid cancellation of the policy.
a. True b. False
TRUE
- Approximately 15 percent of the world’s population lives with a disability.
- In America, 57 million, or 1-in-5, live with disabilities.
- Thirty-eight million disabled Americans, or 1-in-10, live with severe disabilities.
- As people age, the likelihood of a disability increases significantly.
What are the 3 Sources of Disability insurance ?
Government
- Social security
- Workers Comp.
Employers: “paid with PRE-TAX “ so benefits are taxable when rec’d
- Sick leave
- Short term disability
- Long Term disability
Individual “ paid with POST TAX” so benefits are tax free when rec’d
- Personal Policy
DISABILITY INCOME INSURANCE
* Provides income to the insured in the event the insured is unable to work because of ________________.
- Social Security disability does ______ provide adequate coverage.
- Definition of disability is inability to engage in any ___________________________________________________, or
disability expected to result in death. - Waiting period of __________ before benefits are payable
DISABILITY INCOME INSURANCE
- Provides income to the insured in the event the insured is unable to work because of illness or injury.
- Social Security disability does not provide adequate coverage.
- Definition of disability is inability to engage in any “substantial gainful employment for a period of 12 months of longer,” or disability expected to result in death.
- Waiting period of 5 MONTHS before benefits are payable
AMOUNT OF COVERAGE
Premiums for individual disability policies are ____________ ?
AMOUNT OF COVERAGE
Generally 60 - 70% of Gross income
Premiums NOT tax deductible,
but BENEFITS = tax free
Terms of coverage
Short term
- Between 0 - 2 years
- 5 to 30 day elimination period (the period an insured must wait before receiving benefits).
Long Term
- Beyond 2 years
- Policy terms can range: 2 years, 5 years, or until age 65
DISABILITY INSURANCE UNDERWRITING
* Underwriting factors include: ???
- Occupation classification considers not just job title, but the types _______________________________________________ the insured engages in and the amount of time spent with each activity.
DISABILITY INSURANCE UNDERWRITING
* Underwriting factors include:
Age
Gender
Occupational classification
Earnings history
Medical history
Personal habits
Lifestyle
- Occupation classification considers not just job title, but the types of activities the insured engages in and the amount of time spent with each activity.
DISABILITY INSURANCE CHARACTERISTICS
- The financial planner will need to work with the client to structure the policy to fit the client’s ______ while still providing adequate protection.
- Policy characteristics to consider include: ??
DISABILITY INSURANCE CHARACTERISTICS
- The financial planner will need to work with the client to structure the policy to fit the client’s budget while still providing adequate protection.
- Policy characteristics to include:
Whether the policy covers both - ACCIDENT AND ILLNESS
The definition of disability
The elimination period - “ DEDUCTIBLE “
The benefit period
Other policy provisions
Disability definitions :
Own occupation
Any Occupation
Split Definition
DISABILITY INSURANCE DEFINITIONS
OWN Occupation____$$$_________________
* Considered disabled if insured cannot perform the duties of his “Own Occupation”
* More expensive, ideal for specialized, high paying fields
ANY Occupation____$___________________
* Considered disabled if insured cannot perform the duties of “Any Occupation” for which educated, experienced, or trained
* Less expensive premium
SPLIT Definition___$$____________________
* Own occupation for a fixed period of years (e.g., 5) then any
occupation . “ PAY LIKE OWN OCCUPATION FOR 5 YRS, THEN GOES TO “ANY OCCUPATION”
DISABILITY INSURANCE ELIMINATION PERIOD
- Represents ?
DISABILITY INSURANCE ELIMINATION PERIOD
- Represents the amount of time an insured must be disabled to
begin receiving payments under the policy. - Elimination period - is the DEDUCTIBLE .
- Longer elimination results in LOWER PREMIUMS .
DISABILITY INSURANCE BENEFIT PERIOD
Benefit Period ?
DISABILITY INSURANCE BENEFIT PERIOD
Benefit Period
- The period of time benefits continue to be paid while the insured is
disabled.
-The longer the benefit period, the higher the premium. - Short-term disability policies have shorter elimination periods and
benefit periods up to 2 years. - Long-term disability policies have longer elimination periods and
provide benefits for anywhere from 2 years to lifetime.
-To age 65 is a common benefit period
DISABILITY INSURANCE: PROVISIONS AND RIDERS (1 OF 3)
Waiver of Premium ?
Social Security Rider ?
DISABILITY INSURANCE: PROVISIONS AND RIDERS (1 OF 3)
Waiver of Premium__________________________________________
* Premium waived upon disability.
* Waiver of premium can be for policy’s life following a specified
elimination period.
Social Security Rider____“TO LOWER THE PREMIUMS”________
* If the insured qualifies for Social Security disability income, the
disability payments from the insurance company are reduced by
the amount paid by Social Security.
DISABILITY INSURANCE: PROVISIONS AND
RIDERS (2 OF 3)
Residual Benefits ?
Cost of Living Adjustment (COLA) Rider ?
DISABILITY INSURANCE: PROVISIONS AND RIDERS (2 OF 3)
Residual Benefits____________________________
* If insured goes back to work at reduced pay, the policy will pay a
percentage of the difference between current income and income
prior to disability.
- Some policies pay an amount equal to the percentage
reduction in income x the maximum total disability benefit.
Cost of Living Adjustment (COLA) Rider______________
* Benefits increase based on changes in the consumer price index
(CPI).
DISABILITY INSURANCE: PROVISIONS AND
RIDERS (3 OF 3)
Future Increase Rider__________________
Automatic Increase Rider_____________
DISABILITY INSURANCE: PROVISIONS AND RIDERS (3 OF 3)
Future Increase Rider__________________
* Permits the insured to increase the monthly benefit as the
insured gets older, and income increases.
Automatic Increase Rider_______________
* Automatically increases the monthly benefits by a stated
percentage every year.
DISABILITY INSURANCE: COMMON EXCLUSIONS
* Common exclusions include: ?
DISABILITY INSURANCE: COMMON EXCLUSIONS
War Self-inflicted injuries Work-related injuries Criminal activities Driving a vehicle while intoxicated Pre-existing conditions
GROUP DISABILITY INSURANCE
* Can be provided on a _____________________ basis, and in many
cases both short-term and long-term policies are provided.
- One advantage is that premiums are typically much lower than the
premiums on individual coverage. - Employers may pay for the premiums for the employees or may
permit the employees to pay for the coverage via payroll deduction. - Discrimination is ______________; therefore, the Summary Plan
Description (SPD) must be consulted to determine the benefits
available for the particular client.
GROUP DISABILITY INSURANCE
* Can be provided on a short-term or long-term basis, and in many
cases both short-term and long-term policies are provided.
- One advantage is that premiums are typically much lower than the
premiums on individual coverage. - Employers may pay for the premiums for the employees or may
permit the employees to pay for the coverage via payroll deduction. - Discrimination is permitted; therefore, the Summary Plan
Description (SPD) must be consulted to determine the benefits
available for the particular client.
GROUP DISABILITY INSURANCE:
SOCIAL SECURITY OFFSET
- To avoid providing employees with benefits that exceed their usual
earnings, employers usually _____________________________________ with benefits and income from other sources. - Group disability benefits may be reduced in part or in full _________________________
GROUP DISABILITY INSURANCE:
SOCIAL SECURITY OFFSET
- To avoid providing employees with benefits that exceed their usual
earnings, employers usually integrate long-term disability income
benefits with benefits and income from other sources. - Group disability benefits may be reduced in part or in full by
Social Security benefits
TAXATION OF GROUP DISABILITY INSURANCE
PAYMENTS
- Premiums paid by the insured with after-tax dollars
Benefits received under the policy will ______ subject to income tax. - Premiums paid by the insured with pre-tax dollars or premiums were paid by an employer.
Benefits provided under a policy ________t to income tax. - Employer and employee share the cost of coverage (and the
employee pays with after-tax dollars).
Benefits are __________________________________________pro rata). - Special tax treatment for equity partners in partnerships, and greater than 2% shareholders in Sub-Chapter S Corporations.
TAXATION OF GROUP DISABILITY INSURANCE
PAYMENTS
- Premiums paid by the insured with AFTER TAX money ,
Benefits received under the policy will be TAX FREE. - Premiums paid by the insured with PRE-TAX dollars or premiums were paid by an employer.
Benefits provided under a policy will be TAXABLE - Employer and employee share the cost of coverage (and the
employee pays with after-tax dollars).
Benefits are partially taxable and partially tax-free (pro rata). - Special tax treatment for equity partners in partnerships, and greater than 2% shareholders in Sub-Chapter S Corporations.
DISABILITY INSURANCE SUMMARY
CHARACTERISTIC DESIRABLE COVERAGE
Amount of Benefit
Benefit
Covered Causes of Disability
Elimination Period Depends
Definition of Disability
Renewability
Integration w/ Social Security =
DISABILITY INSURANCE SUMMARY
CHARACTERISTIC DESIRABLE COVERAGE
Amount of Benefit = 60-70% of gross pay
Benefit = Term Work Life Expectancy
Covered Causes of Disability = Injury & Sickness
Elimination Period Depends = on Emergency Fund
Definition of Disability = “ Own Occupation”- the best
Renewability = Non-cancelable or guaranteed renewable
Integration w/ Social Security = May be desirable to reduce premiums
Any Occupation - Type of disability insurance policy that ?
Any Occupation -
Type of disability insurance policy that provides benefits to a policyowner if he or she is unable to perform the duties of any occupation for which he or she is suited by education, training, or experience.
Automatic Increase Rider - A provision that ??
Automatic Increase Rider
A provision that automatically increases the monthly benefit by a stated percentage each year.