Class 3 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 Computer Techs, Maintenance and Nurses  Specific Indemnity Benefit working 20 hours or more per week, except any person working on a  Survivor Benefit – 3 months temporary or seasonal basis.  Work Incentive & Child Care Provisions CONTRIBUTION REQUIREMENTS  Worksite Modification Benefit Coverage is 100% Employer Paid. VALUE-ADDED SERVICES ELIMINATION PERIOD  Travel Assistance Services 90 consecutive days of total disability.  ID Theft Recovery Services BENEFIT AMOUNT LIMITATIONS The benefit amount is equal to 66.67% of your monthly covered  Pre-Existing Condition Limitation: 3/12 earnings, from a minimum of $100, to a maximum benefit of $4,163  Mental & Nervous Limitation – 24 months outpatient per month.  Substance Abuse Limitation – 24 months  Offsets: your benefit may be reduced by other income sources MAXIMUM BENEFIT DURATION such as, but not limited to, Social Security, Workers Benefits will not extend beyond the longer of your Social Security Compensation, State Disability Plans Normal Retirement Age or Duration of Benefits below: 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.