LONG TERM DISABILITY BENEFIT INFORMATION HC13GPIN 13 B-21114 (11/25) DEFINITION OF DISABILITY You are considered disabled when we review your claim and determine that, due to your sickness or injury, both of the following are true: • You are unable to perform all the material and substantial duties of your regular occupation. • You have a 20% or more loss in your indexed monthly earnings. After the regular occupation period, you are considered disabled when we review your claim and determine that, due to your sickness or injury, you are unable to perform the duties of any gainful occupation for which you are reasonably qualified based on your training, education and experience. The loss of a professional or an occupational license or certification does not, in itself, constitute disability. You must be under the appropriate care of a doctor in order to be considered disabled. We may require you to be examined by one or more doctors, other medical practitioners or vocational experts of our choice. We will pay for this examination. We can require an examination as often as it is reasonable to do so. We may also require you to be interviewed by our authorized representative. Your failure to comply with this request may result in denial or termination of benefits. ACCUMULATION OF ELIMINATION PERIOD You must be continuously disabled through your elimination period. Your elimination period is as stated in the BENEFITS AT A GLANCE and is the period of continuous disability you must satisfy before you are eligible to receive benefits under the policy. If you return to work while satisfying your elimination period, you may satisfy your elimination period within the accumulation period. The accumulation period is as stated in the BENEFITS AT A GLANCE. The days that you are not disabled will not count toward your elimination period. If you do not satisfy the elimination period within the accumulation period, a new period of disability will begin. The elimination period and the accumulation period begin on the first day of your disability. Benefits for a payable claim begin the day after the elimination period is completed. SATISFYING YOUR ELIMINATION PERIOD IF YOU ARE WORKING If you are working while you are disabled, the days you are disabled will count toward your elimination period. WHEN YOU RECEIVE PAYMENTS You will begin to receive payments when we approve your claim, providing the elimination period has been met and you are disabled. We will send you a monthly payment at the end of each month for any period for which we are liable. After the elimination period, if you are disabled for less than 1 month, we will send you 1/30th of your monthly payment for each day of your disability. AMOUNT OF PAYMENT A. IF YOU ARE DISABLED AND NOT WORKING, OR DISABLED AND WORKING AND YOUR DISABILITY EARNINGS ARE LESS THAN 20% OF YOUR INDEXED MONTHLY EARNINGS We will follow this process to figure your payment: 1. Multiply your monthly earnings by 66.7%. 2. The maximum benefit is $5,000 per month. 3. Compare the answers from Step 1 and Step 2. The lesser of these two amounts is your gross monthly payment. 4. Subtract from your gross monthly payment any deductible sources of income.
Monthly Disability Income Insurance Plan for Noblesville Schools Employees Page 13 Page 15