Class 2 LTD Highlight Sheet

Plan Highlights Group Long Term Disability Insurance Goshen Community Schools COVERAGE FEATURES Disability income protection insurance provides a benefit for long term  Extended Disability Benefit disability resulting from a covered injury or sickness. Benefits begin at  Military Services Leave of Absence the end of the elimination period and continue while you are disabled  FMLA Continuation up to the maximum benefit duration.  Own Occupation Coverage – 24 Months  Rehabilitation Provision ELIGIBILITY  Residual and Partial Disability Each Active Full-Time Teachers working 20 hours or more per week,  Specific Indemnity Benefit except any person working on a temporary or seasonal basis.  Survivor Benefit – 3 months CONTRIBUTION REQUIREMENTS  Work Incentive & Child Care Provisions Coverage is 100% Employer Paid.  Worksite Modification Benefit ELIMINATION PERIOD VALUE-ADDED SERVICES 90 consecutive days of total disability.  Travel Assistance Services  ID Theft Recovery Services BENEFIT AMOUNT The benefit amount is equal to 66.67% of your monthly covered LIMITATIONS earnings, from a minimum of $100, to a maximum benefit of $4,167  Pre-Existing Condition Limitation: 3/12 per month.  Mental & Nervous Limitation – 24 months outpatient  Substance Abuse Limitation – 24 months MAXIMUM BENEFIT DURATION  Offsets: your benefit may be reduced by other income sources Benefits will not extend beyond the longer of your Social Security such as, but not limited to, Social Security, Workers Normal Retirement Age or Duration of Benefits below: Compensation, State Disability Plans Age at Disablement Duration of Benefits 61 or less To Age 65 62 3 1/2 Years 63 3 Years 64 2 1/2 Years 65 2 Years 66 1 3/4 Years 67 1 1/2 Years 68 1 1/4 Years 69 or more 1 Year www.reliancestandard.com This Plan Highlight is not a complete description of the insurance coverage. Insurance is provided under group policy form LRS-6564, et al. This is not a binding contract. Should there be a difference between this Plan Highlight and the contract, the contract will govern. The Certificate of Coverage will be made available to you that describes the benefits in greater detail; however a benefit will not be paid if caused or contributed by an exclusion listed in the Certificate. Reliance Standard Life Insurance Company is licensed in all states (except New York), the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Guam. In New York, insurance products and services are provided through First Reliance Standard Life Insurance Company, Home Office: New York, NY. Product features and availability may vary by state.