Long-Term Disability (United Healthcare)

Long-Term Disability (United HealthCare)
Policy Number: 303972
Customer Service: 1-888-299-2070

LSU partners with UnitedHealthcare to provide affordable Long Term Disability coverage to help you continue to meet your family’s financial needs in the event of a disabling illness or injury. This benefit provides affordable coverage to protect the financial security of you and your family. If you become disabled and qualify for benefits, LTD coverage will pay you 60% of your monthly salary, up to a maximum of $12,000 per month. Disability benefits are paid if you are considered disabled, you satisfy a waiting period of 90 days and you exhaust your sick leave. If you enroll in this benefit as a New Hire, you are guaranteed coverage. If you do not enroll in your New Hire period, you can enroll at any time, subject to Evidence of Insurability. Coverage is not guaranteed.  

What is a Disability?
The Covered Person is Disabled or has a Disability when UnitedHealthcare determines that:

1. You are not Actively at Work and are unable to perform some or all of the Material and Substantial Duties of your Regular Occupation due to your Sickness or Injury; and
2. You have a 20% or more loss in Indexed Pre-Disability Monthly Earnings due solely to the same Sickness or Injury; and
3. You are under the Regular Care of a Physician.

How long do I have to wait before I can receive payment?
You must be disabled for at least 90 days and have exhausted your sick leave before you can receive a Long Term Disability Insurance benefit payment.

What if I can work during my disability?
Total disability is not required during the waiting period. You can continue to work periodically for up to 45 days without beginning the waiting period again.

How long will my disability payments continue?
For as long as you remain disabled, or until you reach your Social Security Normal Retirement Age (as stated in the 1983 revision of the United States Social Security Act), whichever is sooner. If your disability occurs at age 60 or above, your payments may be reduced. Disability must begin while the Covered Person is insured under the Policy. After 24 months of payments, the Covered Person is Disabled when We determine that due to the same Sickness or Injury, you are unable to perform some or all of the material and substantial duties of any Gainful Occupation for which you are reasonably fitted by education, training or experience and you continue to suffer a 20% or more loss in Indexed Pre-Disability Monthly Earnings due solely to the Sickness or Injury.

Eligibility
Any active LSUS employee is eligible for Long-Term Disability coverage provided the following:
- Employed at 75% of full-time effort or greater (at least 30 hours per week)
- Appointed for a duration of at least one semester or greater (121 days or greater)

Enrollment
New hires are guaranteed issue within their first 30 days of employment and will only need to complete an enrollment form to elect coverage. After the 30th day of employment with LSUS, employees will have to apply for coverage and will need to complete an enrollment form AND an Evidence of Insurability form.  The Evidence of Insurability form will then go through a medical underwriting process and may be approved or denied. It is very important to consider this coverage as state employees do not pay into social security and may not qualify for social security disability benefits. Employees may apply for long-term disability coverage at any time during the plan year.

Forms and Resources
1) Long Term Disability Summary of Benefits
2) Long Term Disability Plan Document - 60% benefit
3) Long Term Disability Premium Calculation Sheet
4) Long Term Disability Evidence of Insurability Form 
5) Long Term Disability Claim Form
6) Long Term Disability Portability Form

Pre-Existing Condition Restrictions
The Plan will not coverage any Disability during the first 12 months after your effective date of coverage that is caused by or contributed to, or resulting from, a Pre-Existing Condition or medical or surgical treatment for a Pre-Existing Condition.
Pre-Existing Condition means any Sickness or Injury for which you, within 3 months prior to your effective date of coverage:
1. were diagnosed by or received treatment from a legally qualified physician; or
2. had symptoms for which a prudent person would have sought treatment

Premiums
Your monthly premium is based on your salary. To calculate your monthly premium, divide your annual salary by 12. Multiply your monthly salary by 0.00362. Below are examples of monthly premiums based on the annual salaries shown. This will give you a range of what you can expect to pay for LTD coverage. Additional premium information can be found on this PDF.

Terminating Employees
Coverage terminates on the last day of the month in which the person is employed.

Portability
This plan is eligible for portability. Employees who have terminated coverage and wish to "port" coverage must submit the completed "Portability" form to UHC within 31 days of the last date of coverage. 

Long Term Disability (Grandfathered Plan)
Some employees are currently enrolled in a "grandfathered" LTD plan that pays a 66 2/3% benefit rather than a 60% benefit.  This benefit is no longer available to new hires. There is a separate summary of benefits and plan document for the grandfathered plan.
Click here to reivew the plan document for the 66 2/3's benefit. 
Click here to review the summary of benefits.