Summary of Benefits: Employer-Paid Long Term Disability Insurance

Offered by Life Insurance Company of North America Employer-Paid Long Term Disability Insurance Summary of Benefits Prepared for: Elkhart Community Schools Class 3 Eligibility: All active Employees of the Employer classified as Superintendent, regularly working a minimum of 30 hours per week in the United States, who are citizens or permanent resident aliens of the United States. Employee: You will be eligible for coverage the first of the month following the date of hire. Available Coverage: Gross Monthly Disability Maximum Gross Monthly Benefit Waiting Period Maximum Benefit Period Benefit Benefit Please refer to the “How Long Benefits Last” 66.67% of your monthly $10,000 90 Days section below for more covered earnings details. Additional Features Family Survivor Benefit – If you die while receiving benefits, we will pay a survivor benefit to your lawful spouse, eligible children, or estate. The plan will pay a single lump sum equal to 3 months of benefits. Important Definitions and Policy Provisions: Disability - “Disability” or “Disabled” means if solely because of a covered injury or sickness, you are unable to perform the material duties of your regular occupation or you are unable to earn 80% or more of your covered earnings from working in your regular occupation. We will require proof of earnings and continued disability. Covered Earnings - “Covered Earnings” means your wages or salary, not including bonuses, commissions, overtime pay and other extra compensation. When Benefits Begin - You must be continuously Disabled for 90 days before benefits will be payable for a covered Disability. How Long Benefits Last - Once you qualify for benefits under this plan, you continue to receive them until the end of the benefit period or until you no longer qualify for benefits, whichever occurs first. Should you remain Disabled, your benefits continue according to the later of your Social Security Normal Retirement Age, or the following schedule, depending on your age at the time you become Disabled. Age at Commencement of Disability Duration of Benefit Period Age 62 or younger To age 65 or the date the 42nd monthly benefit is payable, if later. 63 years 36 monthly payments 64 years 30 monthly payments 65 years 24 monthly payments 66 years 21 monthly payments 67 years 18 monthly payments 68 years 15 monthly payments 69 years or older 12 monthly payments When Coverage Takes Effect - Your coverage takes effect on the later of the policy’s effective date, the date you become eligible, the date we receive your completed enrollment form if required, or the date you authorize any necessary payroll deductions if applicable. If you’re not actively at work on the date your coverage would otherwise