SALARYGAP® Standalone Plan
A Bundled Package of Coverage
SALARYGAP® is a Bundled Package of insurance benefits designed to replace a portion of your lost income as the result of a qualifying:
• Disability (due to injury or illness)
• Involuntary Unemployment (due to lay-off, termination by employer, strike or lockout)
• Salary Gap (following a qualified Involuntary Unemployment, your new salary upon reemployment is at least 15% less than your salary before your Involuntary Unemployment).
Eligibility
Who’s Eligible:
– You must be age 18-69 to apply.
– You must be actively employed for at least 12 months and working at least 30 hours per week.
Who’s Not Eligible:
– You are ineligible for SALARYGAP® if you are self-employed, a seasonal worker or an independent contractor.
– You have received a verbal or written notice of impending termination of employment, general notice of company downsizing/layoffs, impending/threatened strikes/lockout or other forms of work stoppage;
– You are ineligible for Disability insurance coverage if within the last 12 months You have received medical advice, medical diagnosis, medication, treatment or surgery from a Physician for back, neck, or spine disorders, depressive disorder, schizophrenia, AIDS, AIDS Related Complex (ARC), any HIV infections or any condition of the heart, arteries, or lungs.
Waiting Period (30 Days)
The Waiting Period is the number of consecutive days following a qualifying event before benefits begin. After the Waiting Period, benefits are retroactive to the incurred date of the qualifying event.
Vesting Period (180 Days)
The Vesting Period is the number of days following the Policy Effective Date, or the effective date of any increase in benefit amount, wherein any claim that is incurred is not eligible for benefits. This applies to Involuntary Unemployment coverage only.
Monthly Benefit
Is the maximum amount We will pay for each month of Disability, Involuntary Unemployment, or Salary Gap.
You select your Monthly Benefit from $100 to a maximum of $2,500, up to 60% of your Monthly Salary* (whichever less).
• Can be used to pay any bill or expense (paid directly to you)
• Monthly Benefit can be assigned
The total aggregate monthly benefit for this coverage cannot exceed $2,500 or 60%, whichever is less, of Your Monthly Salary* from your occupation.
Should the total aggregate Monthly Benefit issued to You under any one (1) or more policies with Us exceed the maximum benefit, coverage under the policy will be reduced to the maximum benefit shown above and a proportionate share of any premium charged for the excess coverage will be refunded to You or coverage will be cancelled and the full amount of premium charged will be refunded less any claims paid.
*Monthly Salary is equal to Your regularly reoccurring Monthly Salary* excluding any non-regular compensation such as overtime, periodic bonuses or commission based income.
Benefit Period
It is the longest period of time for which We will pay a Monthly Benefit for continuous Disability, Involuntary Unemployment, or Salary Gap from the same cause while your SALARYGAP® policy is in force.
Your Choice of Benefit Periods:
• 6-month Benefit Period
• 12-month Benefit Period
Disability Benefits
Disability means that the Insured is:
• Unable to perform the material and substantial duties of the occupation held when the Insured became Disabled; and
• Under the continuous care of a licensed Physician other than You or a Family Member; and
• Not working for wages or profit during the Disability; and
• Disabled longer than thirty (30) consecutive days
When You are Disabled, We will pay the monthly benefit as follows:
• You must become Disabled while your SALARYGAP® policy is in force;
• You must remain Disabled for the thirty (30) consecutive day Waiting Period. After 31 days benefits are retroactive to the incurred date of the qualifying event;
• Monthly Benefits for Disability will stop when Monthly Benefits have been paid for the entire Benefit Period you selected or, if earlier, on the date You are no longer Disabled;
• Monthly Benefits can be assigned;
• Each month of continuous Disability will be calculated from the date Disability began to the same date in each subsequent month. For periods of Disability that are less than one (1) month, We will consider each day of Disability to be 1/30th of a month;
• If You incur a qualifying Disability and a qualifying Involuntary Unemployment event, only one benefit will be paid at a time.
Recurrent Periods of Disability
You are re-eligible for benefits from a new Disability if You have recovered from a Disability for which You have been paid benefits:
• If You have been Actively at Work for at least twelve (12) months since the recovery from the last period of Disability, You are required to satisfy a new Waiting Period; or
• If You have been Actively at Work for less than twelve (12) months since the recovery from the last period of Disability, the current period of Disability will be considered a continuation of the previous period and no new Waiting Period is required.
Medical Care Requirement
We will not pay benefits under this policy for any period of Disability during which You are not under the care of a licensed Physician. Such care must be appropriate, according to generally accepted medical standards, for the condition which is causing the Disability, and must be provided by a licensed Physician whose specialty is appropriate for Your Sickness or Injury.
What are the Exclusions for Disability Benefits?
This policy excludes benefits for disabilities that are:
• Due to hospitalization that occurs during the first ninety (90) days after the Policy Effective Date of this policy due to illness;
• A result of pregnancy or childbirth, except Complications of Pregnancy;
• A result of an intentionally self-inflicted Injury;
• A result of participation in a riot, civil unrest, or commission of an assault, battery or felony;
• A result of any dishonest, fraudulent, or criminal act, whether the Disability results directly or indirectly from such act;
• A result of war or any act of war (declared or undeclared); or
• A result of a pre-existing medical condition which means: You have been treated by, diagnosed by or consulted with, a licensed Physician or licensed chiropractor for the medical condition in the twelve (12) months before the Policy Effective Date or the effective date of any requested change by You in coverage and such condition becomes the cause of Disability within twenty-four (24) months after the Policy Effective Date or the effective date of any increase in benefit amounts.
Involuntary Unemployment Benefits
Involuntary Unemployment means Your total loss of salary or wages from layoff, termination by employer, strike or lockout as defined in the policy.
When You are Involuntarily Unemployed, We will pay the monthly benefit as follows:
• You must become Involuntarily Unemployed while your SALARYGAP® policy is in force;
• You must remain Involuntarily Unemployed for the thirty (30) day Waiting Period. After 31 days benefits are retroactive to the incurred date of the qualifying event;
• Your commencement of Involuntary Unemployment benefits starts once the definition of Involuntary Unemployment has been satisfied and Your state unemployment agency has approved and is paying Your claim for state unemployment benefits;
• Monthly Benefits for Involuntary Unemployment will stop when you are no longer unemployed or when Monthly Benefits for Involuntary Unemployment have been paid for the entire Benefit Period;
• Monthly Benefits can be assigned;
• Each month of continuous Involuntary Unemployment will be calculated from the date Involuntary Unemployment began to the same date in each subsequent month. For periods of Involuntary Unemployment that are less than one (1) month, We will consider each day of Involuntary Unemployment to be 1/30th of a month;
• Involuntary Unemployment benefits will be reduced as necessary so that Involuntary Unemployment benefits plus all government and/or private unemployment benefits shall not exceed the salary wages or employment income from employment held before Involuntary Unemployment started;
• If You incur a qualifying Disability event and a qualifying Involuntary Unemployment event, only one benefit will be paid at a time.
Recurrent Periods of Involuntary Unemployment
You are re-eligible for benefits from a new Involuntary Unemployment if You have returned to work from an Involuntary Unemployment for which You have been paid benefits:
• If You have been Actively at Work for at least twelve (12) months since returning to work from the last period of Involuntary Unemployment, You are required to satisfy a new Waiting Period; or
• If You have been Actively at Work for less than twelve (12) months since returning to work from the last period of Involuntary Unemployment, the current period of Involuntary Unemployment will be considered a continuation of the previous period and no new Waiting Period is required.
What are the Exclusions for Involuntary Unemployment?
This policy excludes benefits for Involuntary Unemployment:
• For independent contractors, meaning: a person who operates an independent business and who is not subject to the immediate direction and control of an employer;
• For self-employed, meaning: a person working for income coming directly from his or her own business, trade, profession or a partnership (a company or entity in which the individual has a ten percent (10%) or greater equity or ownership interest will be regarded as his or her own business);
• For a seasonal worker, meaning: a person whose occupation can be carried on only during certain seasons or fairly definite portions of the year and where the customary period of employment is less than one thousand (1,000) hours during the calendar year;
• Occurring in the Vesting Period. During the Vesting Period, at Your option following the denial of a claim, this policy can be cancelled for a full refund of premium;
• Due to a voluntary forfeiture of salary, wages or employment income;
• Due to a voluntary resignation or retirement;
• Due to Disability caused by accident, Sickness, disease, pregnancy or childbirth;
• Due to termination as a result of cause or willful misconduct (a transgression of some established and definite rule of action, a forbidden act or omission, or an act or omission involving dishonesty, or a dereliction of duty, active or passive, which is willful in character and beyond simple negligence), excessive absenteeism or tardiness, or criminal misconduct (unlawful behavior as determined by Local, State or Federal law);
• Resulting directly or indirectly from any dishonest, fraudulent or criminal act;
• Due to a circumstance known by the Insured prior to the effective date of protection; or
• Due to war or any act of war (declared or undeclared).
Salary Gap Benefits
Salary Gap occurs if during the Benefit Period for Involuntary Unemployment, or within thirty (30) days after the Involuntary Unemployment benefits cease, replacement employment involving at least thirty (30) hours of work per week occurs in which the Monthly Salary* reduction (difference between the salary before Involuntary Unemployment and the new salary upon reemployment) is at least 15%.
We will pay the Monthly Benefits as follows:
• You must experience a Salary Gap while your SALARYGAP® policy is in force;
• Your commencement of Salary Gap benefits starts once the definition of Salary Gap has been satisfied;
• Salary Gap benefits will be paid while the qualifying Salary Gap remains;
• Monthly Benefits for a Salary Gap will stop when the Insured no longer experiences a Monthly Salary* reduction from replacement employment that is at least 15%; or when Monthly Benefits for Salary Gap have been paid for the entire Benefit Period you selected;
• Monthly Benefits can be assigned;
• Each month of continuous Salary Gap will be calculated from the date Salary Gap began to the same date in each subsequent month. For periods of Salary Gap that are less than one (1) month, We will consider each day of Salary Gap to be 1/30th of a month;
• Salary Gap benefits will be reduced as necessary so that Salary Gap benefits plus salary, wages or employment income from replacement employment, plus any residual government sponsored unemployment benefits shall not exceed the salary, wages or employment income from employment held before Involuntary Unemployment started;
• If You incur a qualifying Disability event and a qualifying Salary Gap event, only one benefit will be paid.
Coverage
When can my coverage start?
Once you purchase your SALARYGAP® Standalone Plan coverage can start as early as 12:01 a.m. the following day.
Convenient Monthly Payment Plans
SALARYGAP® offers convenient monthly payment plans through your choice of:
• EFT (Electronic Funds Transfer) automatic payments directly from your financial institution (no transaction fees – you can save up to $60 per year).
• Recurring Credit Card ($5.00 per billing transaction)
• Direct Bill to your Home ($5.00 per billing transaction)
You pick the bill plan that works best for you!
When does my SALARYGAP® Standalone Plan End?
Your SALARYGAP® Standalone Plan is continuously renewed each month until;
• You stop paying the monthly due premium or,
• You reach age 70 (terminates the month following your 70th birthday)
Does the SALARYGAP® Standalone Plan have a 30-Day Right to Review Option?
You have a right-to-review your newly purchased Standalone Plan.
• You have a thirty-day right to review option with your new policy. Here is how it works:
– You have thirty (30) days to review your policy from the date You receive it.
– Within that time, You can deliver or mail it to Our home office or to Our authorized agent or agency for a prompt refund of all premiums.
– The policy will then be void from the Policy Effective Date of the policy.
– Any premium paid will be refunded back to the effective date of the policy.
B2CPDQUE – 052016
