If information in this chart differs from information in the Long Term Disability Plan Book, the plan book will prevail.
|Definition of Disability||First 24 months: inability to perform the material duties of your own occupation due to a sickness, injury, or pregnancy.
Thereafter: you are unable to perform the material duties of any gainful occupation for which you are reasonably able through education, training, and/or experience.
|Monthly Benefit||60% basic monthly UW appointment salary (maximum insurable salary is $400 per month basic, $10,000 per month optional).|
|Benefit Offsets||Benefits can be reduced by amounts received from Workers Compensation, Social Security, retirement, earnings paid by your employer, or other group coverage.|
|Disability Caused by HIV||Covered, subject to the pre-existing condition clause.|
|Drug Addiction/Alcoholism||Maximum 24-month benefit period.|
|Mental and Nervous Disorders||Maximum 24-month benefit period unless confined to hospital.|
|Pregnancy/Delivery||Covered, unless pre-existing condition.|
|Working While Disabled||Yes, if schedule is reduced due to disability. Additional Return to Work Incentive available once receiving LTD Benefit.|
|Cost of Living Benefit||Yes|
|Pre-Existing Conditions||Definition: A pre-existing condition is one for which you have consulted a physician, received medical treatment or services, or taken prescribed drugs or medication during the 90 days preceding the effective date of coverage.
Coverage for such a condition would be available after insurance is in effect for 12 consecutive months, if you are actively at work at least one full day after the end of the 12-month Exclusion Period.
|Waiting Period||Options: 30, 60, 90, 120, 180, 240, 300, 360 days.|
|Maximum Benefit Period||Normal benefits to age 65; duration of benefits decreases progressively from age 65 to 69. After age 69, maximum is 12-month duration of benefits.|
|Monthly Premiums||Premiums are a percent of pay and vary with waiting period and retirement plan eligibility.|
|Exclusions||War; intentionally self-inflicted injury while sane or insane.|
|Death Benefit||If you are receiving benefit payments at time of death, survivor benefits could continue for a maximum amount of three times your monthly LTD Benefit.|
|Conversion Privilege After UW Employment Ends||No|
|Name of Insurance Company||Standard Insurance Co.
900 Southwest Fifth Ave.
Portland, OR 97204
|More Information||For specific details about the plan, refer to the Long Term Disability Plan Book.|