Long Term Disability

This plan provides monthly income if you become totally disabled due to a covered injury or sickness, helping replace a portion of your lost earnings while you’re unable to work.

You can choose a monthly benefit between $100 and $1,200, based on your income and eligibility. Benefits replace up to 75% of your pre-disability earnings.

Benefits begin after a 28-day elimination period (28 consecutive days of total disability).

Benefit duration depends on your age and whether the disability is caused by an injury or sickness:

For disabilities caused by an injury:

Before age 63: Benefits last up to the earlier of 5 years or age 65

Ages 63–69: Benefits last up to the earlier of 2 years or age 70

For disabilities caused by sickness:

Benefits last up to the earlier of 2 years or age 70

Disability benefits are not payable after age 70 for any cause.

The Extended Plan offers longer benefit periods for certain disabilities.

For disabilities caused by an injury:

Before age 63: Benefits continue to age 65

Ages 63–69: Benefits last up to the earlier of 2 years or age 70

For disabilities caused by sickness:Benefits last up to the earlier of 5 years or age 70

Yes. Both plans offer:

Monthly benefits from $100 to $1,200A 28-day elimination period

You are eligible if you:

• Are under age 65
• Actively work at least 30 hours per week
• Are a U.S. resident

Yes, your spouse or domestic partner may apply if they:

• Are under age 65
• Are not legally separated or divorced from you
• Actively work at least 30 hours per week
• Have worked full-time for at least 30 days before coverage starts
• Are a U.S. resident

If both spouses are eligible, each may apply, but coverage cannot be duplicated.

Your disability benefit is reduced by certain Other Income Benefits, such as:

• Social Security disability benefits
• State disability benefits
• Retirement disability benefits
• Income from work or an employer

Your total disability benefit will never exceed 75% of your pre-disability earnings.

Yes. If other income benefits reduce your monthly benefit below 15% of your selected benefit, the plan will still pay 15% of your monthly benefit.

Here’s a simple illustration:

• Pre-disability monthly earnings: $3,000
• 75% maximum benefit: $2,250
• Social Security disability: – $1,100
• State disability benefit: – $500
• Total monthly benefit paid: $650

(This example is for illustration only and may not reflect every situation.)

Yes. The plan pays benefits for all covered total disabilities, whether caused by an injury or a sickness.

Yes. The plan includes a Rehabilitative Employment Benefit.

If you return to work while still considered totally disabled:

• You’ll receive your full monthly benefit minus 50% of any income earned
• Your total income (work income + benefit) cannot exceed 100% of your pre-disability earnings
• If it does, the benefit is reduced to stay within that limit

This helps you transition back to work without losing all your benefits at once.

You or your spouse’s coverage begins on the first day of the month following the Administrator’s approval of your application, provided you are Actively At Work, meet any applicable evidence of insurability requirements, and have paid your premium. If on the date you or your spouse are to become covered, you or your spouse are not Actively At Work, coverage will not begin until the date you are Actively At Work for 1 month.

As long as you’re Actively At Work, except due to Total Disability covered by the Policy, pay your premiums when due, and the Master Policy remains in force, you can keep this plan until you reach age 70. If you cease to be Actively at Work due to a temporary lay-off or leave of absence, your coverage will continue for 26 weeks, provided you pay the required premium.

The Policy does not cover Disability or loss caused by intentionally self-inflicted Injury, suicide or attempted suicide, while sane or insane; pregnancy or childbirth, except Complications of Pregnancy; war or act of war, whether declared or undeclared; or Your commission or attempted commission of a felony.

Benefits will not be paid for any loss or period of Total Disability that begins during the first year of your insurance and which is a result of a Pre-existing Condition. A Pre-existing Condition means any Disability, diagnosed or undiagnosed, for which medical care is received by you: within the one-year period prior to the date your insurance starts; or with respect to any increase in coverage, within the one-year period prior to the effective date of your increase in coverage.

If you cease to be Totally Disabled and return to work for a total of 10 days or less during the Elimination Period, the Elimination Period will not be interrupted. Periods of Disability separated by at least 3 months, during which You are Actively at Work, will be considered separate Periods of Disability.

Disability of Totally Disabled means disability which: 1) during the Elimination Period and the first 60 months during which Total Disability Benefits are payable, wholly and continuously prevents you or your spouse from performing the essential duties of you or your spouse’s occupation.

An elimination period means the number of consecutive days at the beginning of any one period of Total Disability which must elapse before benefits are payable.

“Actively at Work” means means you or your spouse are performing all the essential duties of your or your spouse’s occupation for wage or profit on a full-time basis (at least 30 hours per week).

“Any Occupation” means any occupation for which you or your spouse are qualified by education, training or experience, and that has an earnings potential greater than the lesser of: the amount of you or your spouse’s Pre-Disability Earnings and the benefit period percentage; or the maximum monthly benefit.

Current Monthly Earnings are the monthly earnings you or your spouse receive from you or your spouse’s employer, and other employment, while you or your spouse are Totally Disabled.

Pre-Disability Earnings depend on how you earn income:

1. for sole proprietor, partners, and shareholders in a S-Corporation means the monthly average of earnings reported as “net earnings from self-employment” for federal income tax purposes for,  the 3 tax year(s) immediately prior to the last day You were Actively at Work before You became Disabled; or the 1 tax year immediately prior to the last day You were Actively at Work before You became Disabled if employed for less than 3 calendar years; or with respect to Partners and shareholders in a S-Corporation, the average draw during their period as a partner or shareholder, if less than the above period;
2. for all others not defined above means your regular gross monthly rate of pay based on your statement of wages earned and taxes withheld (Form W-2) for the one-year period immediately prior to the last day you were Actively At Work before you became Totally Disabled; or the total number of calendar months immediately prior to the last day you were Actively At Work before you became Totally Disabled, if less than the above period.

“Injury” means bodily injury resulting directly from accident and independently of disease or bodily infirmity which occurs while you or your dependents are covered under the policy. Loss resulting from:

• sickness or disease, except a pus-forming infection which occurs through an accidental wound; or
• medical or surgical treatment of a sickness or disease; is not considered as resulting from Injury.

A Sickness means a Disability or loss which is (1) caused by any condition, illness, disease or disorder of the body; any infection, except a pus-forming infection of an accidental cut or wound or bacterial infection resulting from an accidental ingestion of a contaminated substance; hernia of any type unless it is the immediate result of an accidental Injury covered by the Policy; or Complications of Pregnancy; or (2) caused by any medical or surgical treatment for a condition shown in item (1) above.

Yes. Acceptance into the plan is subject to medical evidence of insurability as determined by The Hartford ¹. Depending on your age, the amount of coverage you request, and your answers on the application, a medical examination, medical test(s), or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at your convenience and at no expense to you. ¹The Hartford Financial Services Group, Inc. (NYSE: HIG) operates through its subsidiaries under the brand name, The Hartford, and is headquartered in Hartford, Connecticut. For additional details, please read The Hartford’s legal notice at www.thehartford.com.

No. This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services.

This information explains the general purpose of the insurance described, but in no way changes or affects Master Policy ADD-13265 and ADD-13266 as actually issued. In the event of a discrepancy between this information and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.

A.G.I.A., Inc. is the Plan Administrator that administers the insurance plan on behalf of the Hartford Life and Accident Insurance Company for the benefit of the Group Policyholder. NASW Assurance Services, Inc. is compensated for the placement of insurance and for the services it provides to customers on behalf of the insurance company, in addition to other compensation it may receive. Compensation is paid to or retained by the Group Policyholder NASW Assurance Services, Inc. directly or indirectly for services associated with this insurance program.

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