Products Flashcards
Accidental Death & Dismemberment (AD&D)
AD&D is most commonly a separate coverage that is sold in conjunction with Life Insurance. and is designed to pay a benefit in addition to the Life Benefit in the event of death due to an accident. The dismemberment portion pays a benefit for loss of sight, speech or hearing, or severance or loss of use of limbs, etc. due to an accident. Sometimes referred to as Double Indemnity. OA offers an Accidental Dismemberment and Loss of Sight provision in the Disability Policy. It is paid when an Accidental Injury (see above) occurs resulting in loss of sight, or severance of a limb and is awarded a certain number of monthly benefit payments listed in a schedule.
Advice to Pay (ATP) / Administrative Services Only (ASO)
A service provided to an employer for a fee when they have a self-funded disability plan. The employer bears all the risk for claims. The Third Party Claims Administrator advises the employer on a claimant’s eligibility for disability benefits, as well as the duration of payments.
See “Self-insured claims ASO” Job Aid for additional detail.
CorePlus Long-Term Disability – Core
An insurance policy that protects an employee from loss of income if they are unable to work due to illness, injury, or accident for a long period of time. This is typically sold in conjunction with a Plus, or buy-up plan, is usually non-contributory, and offers the employee a modest level of protection.
CorePlus Long-Term Disability – Plus
An optional insurance policy offered by OA that protects an employee from loss of income if they are unable to work due to illness, injury, or accident for a long period of time. This is sold as a contributory buy-up option in conjunction with a Core plan. The employee must request this coverage and is responsible to pay the premium.
CorePlus Short-Term Disability – Core
An insurance policy offered by OA that protects an employee from loss of income if they are unable to work due to illness, injury, or accident for a short period of time, usually 26 weeks or less. This is typically sold in conjunction with a Plus, or buy-up plan, is usually non-contributory and offers the employee a modest level of protection.
CorePlus Short-Term Disability – Plus
An optional insurance policy offered by OA that protects an employee from loss of income if they are unable to work due to illness, injury, or accident for a short period of time, usually 26 weeks or less. This is sold as a contributory buy-up option in conjunction with a Core plan. The employee must request this coverage and is responsible to pay the premium.
Employee Assistance Program (EAP)
A voluntary, work-based program that offers free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related problems.
Long-Term Disability
An insurance product that protects those covered from loss of income by providing an elected amount or percentage of their pre disability earnings as defined by the Policy, if they are unable to work due to illness, injury, or accident under certain terms and conditions, for a long period of time, and coverage was elected prior.
One Lump Sum Disability
An insurance policy that provides a onetime lump sum benefit -Unlike Traditional, Voluntary or Worksite plans where benefits are paid out periodically over time, the benefit for this plan is paid all at once.
To be eligible for benefits, typically the insured must become Permanently and Totally Disabled (PTD) within the period of time called the Benefit Eligibility Period. This is a defined time-period following the EP in which an employee must be permanently and totally disabled to qualify for a benefit. The insured must be expected to be unable to perform the material and substantial duties of any occupation for which they are reasonably fitted by training, education, or experience on a full-time basis for a continuous period of not less than a pre-defined amount of time, typically 24 months.
Short-Term Disability (STD)
An insurance policy that helps to protect an employee from loss of income if they enroll for coverage ahead of time, and are unable to work due to illness, injury, or accident for a short period of time, usually 26 weeks or less. This is sometimes called a Traditional plan, and it can be offered on a contributory or non-contributory premium basis.
Voluntary Long-Term Disability
An optional insurance policy that protects an employee from loss of income if they are unable to work due to illness, injury, or accident for a long period of time. The employee must request this coverage and is required to pay the premium. This is an older product and is no longer actively sold. It was replaced with Worksite Long-Term Disability.
Voluntary Medium-Term Disability
This is not a product, but a plan type that was created for billing purposes in GAIN. This plan type was used for employees who elected a Voluntary Short-Term plan that had characteristics of both a short- and long-term plan, typically a short elimination period and a benefit duration of 52 weeks or more.
Voluntary Short-Term Disability
An optional insurance policy that protects an employee from loss of income if they are unable to work due to illness, injury, or accident for a short period of time, usually 26 weeks or less. The employee must request this coverage and is required to pay the premium. This is an older product and is no longer actively sold. It was replaced with Worksite Short-Term Disability.
Worksite Long-Term Disability
An employer sponsored optional insurance policy that protects an employee from loss of income if they are unable to work due to illness, injury, or accident for a long period of time. The employee must request this coverage and is required to pay the premium.
Worksite Short-Term Disability
An employer sponsored optional insurance policy that protects an employee from loss of income if they are unable to work due to illness, injury, or accident for a short period of time, usually 26 weeks or less. The employee must request this coverage and is required to pay the premium.
