Kontosis is a retired physical education teacher who was employed with the Prince George’s County Public School System. During her employment, Hartford underwrote three group disability insurance policies for Kontosis: Policy No. GLT-675844 (the “group policy”), Policy No. AGP-5630 (the “association policy”), and Policy No. AGP-5295 (the “second association policy”). Although all three policies were underwritten by Hartford, Hartford operated each policy independently of the other in accordance with the respective terms of each. The group policy provided for a maximum benefit of sixty percent of the policyholder’s monthly pre-disability earnings up to a maximum of $5,000.00 per month, and a minimum benefit of the greater of $100 or 10% …show more content…
This includes any such benefits for which the Insured Person or the Insured Person’s family is eligible or that are paid to the Insured Person, to a third party on the Insured Person’s behalf, pursuant to any: a) temporary or permanent disability benefit under a Workers’ Compensation Law, occupation disease law, or similar law; b) governmental law or program that provides disability or unemployment benefits as a result of the Insured Person’s job with the employer; c) plan or arrangement of coverage, whether insured or not, as a result of employment by or association with the Employer or as a result of membership in or association with any group, association, union or other organization; . . . f) disability benefits under the United States Social Security Act . . .or similar plan or act that the Insured Person or, the Insured Person’s spouse and children are entitled to receive because of the Insured Person’s disability. Other Income Benefits also means any such payments that are made to the Insured Person, his or her family or to a third perty on his or her behalf, pursuant to any: . . . d) retirement benefits under the United States Social Security Act . . . or similar plan or act that the Covered Person recieved because of his or her retirement, unless the Insured Person was receiving them prior to becoming Disabled. Other income benefits is similarly defined under the group policy. The parties agree that under both
Aii) a) These are just a few, of many, aspects of employment covered by law:
Third party – Reimbursement payments made by an insurance company that provides benefits for the
5. Not making a reasonable accommodation for the disabilities of employees or denying employment opportunities to them because of the duty to accommodate their disabilities.
The presence of medical conditions, classified as disabilities by the Americans with Disabilities Act as, “…a physical or mental impairment that
Question 5. 5. (TCO D) John Savage is a 35-year-old accountant who earns $72,000 per year. His monthly take-home pay is $4,500. His wife Jessica works part-time at their church but has no employee benefits. John's firm has a group short-term disability plan, which will provide him with 65% of his gross monthly pay for 2 years only. What would you advise John regarding his potential need for additional disability insurance, including the type, amount of benefits, or other policy provisions? (30 points total) (Points : 30)
Individuals that are younger than sixty-five are eligible if they have permanent disabilities, are diagnosed with end-stage renal disease, or amyotrophic lateral sclerosis, known as ALS (Medicare, 2014). According to an article by Juliette Cubanski and colleagues (2015) the four different parts of Medicare have varying eligibility requirements. Coverage under Part A and B is automatic when a Medicare-eligible individual applies for Social Security, or Railroad retirement benefits (Cubanski, et al., 2015). All individuals that are sixty-five and up are eligible for Part A, regardless of their health, and medical history, or their income. In addition, individuals must be U.S citizens or permanent legal residents with at least five years of continuous residence (Cubanski, et al., 2015). Nonelderly individuals that receive social security disability insurance become eligible after a twenty-four month waiting period (Medicare, 2014). The article (2014) states that individuals that are diagnosed with end-stage renal disease, or ALS are eligible for Medicare without a waiting period. Part B of Medicare is voluntary, however individuals that are eligible for Part A also qualify for Part B benefits (Cubanski, et al., 2015). Many Part A beneficiaries that are entitled to the benefits are automatically enrolled into Part B, however they may choose to decline. Those individuals 65 and older who are not entitled to
a. Pay a portion of an individual’s medical expenses according to the terms in the policy
a) If he has not a basic occupation designed to insure his insure his present and future livelihood;
1. Occupation and working ability of the Claimant, if this has changed, since the injury, previous occupation of the Claimant.
Employers operate disability management programs because it gives them a structured way to manage workplace costs associated with workplace illness and injury. Costs can be controlled through maintaining skilled workers and limiting absences to maintain a productive workforce. The program is also thought to “prevent workplace injury and illness and to accommodate workers in a manner that facilitates early and safe return to work.” (Management of Occupational Health and Safety, 2011, 329) I also feel that employers operate disability management programs as a way to keep themselves out of financial hardship and legal issues which could stem from a workplace injury or illness.
To determine if the insured person elected this benefit, review the Rate Class and Endorsement/Rider
2) The duration of benefits many maximum time a disability income policy will pay benefit may be a few years, to age 65 or for life. 3)The amount of benefits which means for the amount that is equal to 60/70 percent of your gross pay. 4) Accidents & Sickness Coverage that some disability income policies will pay only for accidents, but you need to be able to be insured for both of them. 5) Guaranteed Renewability will help protect you against your insurance company trying to drop you if something was to happen to you or you become poor. Due to Mark insurance only allowing him 2 weeks of sick time, he need to look for more insurance that would cover him if he needs to be off longer than those two weeks. If he was to get the accidents and sickness coverage he needs to make sure that he have both plans so it will pay him for both things when he has to be off. The guaranteed renewability insurance will help him if he was to lose his job or need help with living, so this would be another good insurance for him and his family. This could affect the Lawrences in a good way by helping them out and in a bad way but not having the right coverage needed for
There are different income protections like one that pays one immense sum, another that pays the worker in little quantities for a long-term, and little quantities payments but short-term. The first one is critical illness insurance, which only pays once, but covers a few serious illnesses that affect the worker’s ability to work. The second is short-term income protection, it covers a restricted time of about two to five years of coverage plus they cover fewer illnesses than the other two. The third is income protection insurance, this type of coverage protects the worker if they fall ill or an injury stops them from working until they retire, pick themselves up, die, or the policy ends. This policy covers a percentage of the income earned
Workers’ compensation provides compensation benefits to employees for disabilities due to personal injury or disease sustained while in the performance of their duty. The purpose of Alabama’s Workers’ Compensation laws is to ensure proper payment of benefits of employee’s injuries on the job or who contract a work related illness and encouraged safety in the workplace. These benefits include payment of medical expenses and compensation for wages loss. Dependents are also entitles to payment of benefits of employees who die from work-related injuries or diseases. An employer that has five or more employees is required to have worker’s compensation insurance. Workers’ compensation is designed to protect workers
The position will also offer other employee benefits and allowances as a motivation for the workforce. The company will offer medical insurance where the employees will be sponsored for half the amount incurred as medical expenses. The medical cover offered by the company also covers the immediate