|
Disability Insurance Explained
A Disability Income Plan pays a monthly
benefit if you are unable to work because of a sickness or
accident on or off the job. This monthly Benefit Amount
will begin after a specified Waiting Period and will
continue for a specified Benefit Period. Your eligibility
for benefits will be determined by your group policy including its
Exclusions and Limitations, Pre-Existing Conditions and
Coordination of Benefit provisions.
Back to Top
Why You Need These Plans
While major medical insurance saves you from high
medical bills, it does not provide you with money for the personal
expenses required for your home and family, like mortgages,
tuition, food, and clothing costs, should you become disabled.
Likewise, if you become disabled, you need the protection of
business overhead coverage to cover necessary expenses such as
rent, salaries, and supplies, to help keep your firm open while
you recuperate.
Back to Top
How Much Disability Insurance
Do I Need?
Determine how much you need to take care of all
your monthly living expenses. Subtract from that all income from
any other sources. The result will be the approximate amount of
needed monthly benefit.
For a further in depth discussion on how much
disability insurance you need, we suggest you consult one of the
many independent resources available, such as The Life and Health
Insurance Foundation for education. They are a non-profit
independent source for information on this topic, which includes
an interactive needs calculator.
They can be found at http://www.life-line.org/build/didisability_insurance/.
Life and Disability product needs will differ
between individuals and change over time. These web pages and
links to other sites are provided for educational purposes only.
For more information, please call the toll-free AIA Trust hotline
1-800-255-8215 between Monday and Friday, 8 a.m. to 5 p.m.
Central time.
Back to Top
How These Plans Work
You may choose up to $5,000 coverage (in $100
increments) per month for personal disability and up to $10,000 in
monthly cash benefits for business overhead coverage. All benefits
are paid directly to you.
The personal disability plan allows you to choose
from one of two plans. Plan I can pay benefits up to age 65 and
Plan II can pay benefits for up to 2 years. Your business overhead
coverage also provides a choice in benefit periods of either 1
year or 2 years.
Back to Top
How Much Will It Cost?
Click here to download a printable
version (Adobe pdf) of the AIA Trust Personal Disability Insurance
Plan rate chart.
Click here to download a printable
version (Adobe pdf) of the AIA Trust Business Overhead Protection
Plan rate chart.
Back to Top
Who Is Eligible to Apply?
If you are a member of AIA, under age 60, actively
at work at least 20 hours a week, are a U.S. resident and are not
on active duty in the military ... you are eligible to apply for
these coverages. All coverage is subject to approval by New York
Life.
Back to Top
How Do I Apply for Coverage?
Click
Here for a printable application for AIA Trust Income
Guard Disability Insurance Plan. Please refer to the plan
information below for a complete description of the program.
Applications must be completed, signed and
returned by mail to:
AIA Trust Insurance Program
c/o Affinity Insurance Services, Inc.
300 S. Wacker Dr. 7th Floor
Chicago, Illinios 60606
Or
If you wish, you can contact one of our
representatives directly at the AIA Trust hotline 1-800-255-8215
– Mon-Fri 8AM-5PM Central Time.
Before completing an application, be sure to
review the plan information for eligibility, options and a
complete description of the coverage. This coverage is only
available to active dues paying AIA members.
Coverage cannot be bound or made effective until
review, underwriting and approval of your completed application by
the insurance company. Click here to
view Affinity Insurance Services License Information.
To view the rates and application above, you will
need Adobe® Acrobat® Reader. Adobe®
Acrobat® Reader is a free, and freely distributable
software that lets you view and print Portable Document Format
(pdf) files. Click on the icon below to download a copy.
Back to Top
When Do Benefits Begin?
Benefits will begin on the first day of a covered
total disability after completion of the applicable Waiting
Period. Benefits will continue until the earlier of (a) the day
the insured ceases to be totally disabled or (b) the end of the
maximum benefit period.
Back to Top
How Long Can the AIA Trust
Disability Income Plan Pay Benefits?
Plan I pays: For covered total disabilities
commencing prior to age 64, the plan pays benefits for up to a
maximum of two years. For disabilities commencing at age 64,
benefits are possible for 1 year.
Plan II pays: For covered total
disabilities commencing prior to age 60, bene ts can be paid up to
age 65* and for up to a maximum of two years if you become totally
disabled from ages 60–63. One year for disabilities commencing at
age 64.
*Maximum benefit for disabilities due to
mental/nervous conditions and drug and alcohol abuse is 24 months.
Back to Top
Endorsed by The American
Institute of Architects
This Disability Plan has the endorsement of the AIA, as do all the
insurance and financial programs sponsored by The AIA Trust.
Back to Top
Portability
These plans are not dependent on any firm, employer or location.
Once enrolled, you may take them with you from firm to firm, from
city to city, from state to state... wherever you go.
Back to Top
For Every Risk You Take: AIA Trust Disability
Insurance Plans...for you, your family—and your firm.
Disability Income Protection
for AIA Members
Your ability to earn an income may be your most valuable asset.
Your family's lifestyle, your home, your children's education, and
your retirement may all hinge on your ability to work and earn an
income. What if you suddenly become too sick or hurt to work, how
would you continue your lifestyle? With out an income, years of
hard-earned savings could evaporate in a matter of months, even
weeks. That's why your association wants to help you to protect
your income and your family's financial security with Disability
Income Protection insurance.
Back to Top
How Much Coverage Is
Available?
You may choose monthly benefits of up to $5,000
(in $100 increments), provided the benefit you select does not
exceed 60% of your net monthly earnings in addition to any other
disability income coverage you may have or have applied for.
Back to Top
Are There Any Exclusions or
Plan Limitations?
Yes. The AIA Trust Disability Income Insurance Plan does not cover
disabilities due to:
- Any period of a Disability during which time the insured is
not under the direct care and treatment of a licensed Physician;
- Attempted suicide or intentionally self-inflicted injury,
while sane or insane (Missouri residents: the exclusion for
"self-inflicted injuries" is not applicable to injuries caused by
an attempted suicide while insane);
- Pregnancy, except for any complications resulting from
pregnancy;
- Declared or undeclared war, including resistance to armed
aggression;
- Injury occurring in consequence of riding as a passenger or
otherwise in any vehicle or device for aerial navigation, except:
a. While riding on any government-owned aircraft used for
transportation of passengers; or b. While riding as a fare-paying
passenger in any aircraft having a United States Air Worthiness
Certificate, or its foreign equivalent;
- More than one disability at the same time. For example, we
will not be liable for a disability due to sickness when benefits
are already being paid for a disability due to Injury, nor will
we pay for a disability due to Injury when benefits are being
paid for a disability due to Sickness. In addition, any
disability caused by both Injury and Sickness will not exceed the
Maximum Disability Benefit Period as defined in your schedule;
- Participation in an illegal occupation or attempt to commit a
felony;
- Any condition which is excluded by a waiver or impairment
rider attached to the Insured's certificate.
Benefits for disabilities due to mental or
emotional disorders, alcoholism or drug addictions are limited to
no more than 24 months.
No more than six monthly income benefits will be
payable if the insured is outside the home area when those
benefits are payable. The home area is defined as the U.S.,
Canada, Puerto Rico and the Virgin Islands.
Back to Top
What Is a Waiting Period?
The Waiting Period is the initial, continuous period of a Covered
Total Disability which must be completed before such Covered Total
Disability benefits become initially payable. You have a choice of
three waiting periods: 60 days, 90 days or 180 days.
Back to Top
What Are Some Important
Definitions?
Earnings mean net monthly earnings after business expenses
before taxes. If you have incorporated your practice, earnings
include the cost to the corporation of your fringe benefits and
your share of total contributions to corporate surplus for the
preceding 12 months. Income from investments, royalties, etc. or
other income for which no service or work is per formed is not
included in earnings.
Pre-disability Earnings mean your average
monthly earnings for the 12 or 24 months, whichever period
produces the higher average, prior to the onset of your
Disability. To help prevent inflation from artificially increasing
post disability earnings, New York Life will increase
"pre-disability income" upward to reflect increases in the
Consumer Price Index (CPI-U) up to 8 percent, compounded annually.
Back to Top
AIA Personal Disability
Insurance Plan Rates
|
AIA Personal Disability
Insurance Plan Rates—Semi-annual Rates Per $1,000 of
Coverage
new marketed plan rates effective 01/01/2002
|
|
Age
|
17–34
|
35–39
|
40–44
|
45–49
|
50–54
|
55–59
|
60–64
|
*65–69
|
70–74
|
|
60-day waiting period with
2-year benefit
|
$17.10
|
$17.10
|
$34.14
|
$34.14
|
$72.66
|
$72.66
|
$126.06
|
$138.06
|
$138.42
|
|
60-day waiting period with
benefits payable to 65
|
46.44
|
58.80
|
73.80
|
115.02
|
191.58
|
224.52
|
151.98
|
128.46
|
169.14
|
|
90-day waiting period with
2-year benefit
|
12.24
|
12.24
|
25.02
|
25.02
|
53.64
|
53.64
|
90.78
|
99.42
|
|
|
90-day waiting period with
benefits payable to 65
|
29.28
|
36.84
|
47.46
|
74.10
|
123.60
|
145.98
|
97.32
|
82.20
|
|
|
180-day waiting period with
2-year benefit
|
9.18
|
9.18
|
18.78
|
18.78
|
40.20
|
40.20
|
68.10
|
74.58
|
|
180-day waiting period with
benefits payable to 65
|
21.96
|
27.66
|
35.58
|
55.56
|
92.70
|
109.02
|
72.96
|
61.68
|
|
|
*renewal only
|
Click Here to download a printable
version (Adobe PDF) of this rate chart.
Back to Top
AIA Trust Business Overhead
Protection Plan for You and Your Firm
If you become disabled, your firm could continue until you return
to work. The AIA Trust Business Overhead Plan helps keep your
office open by providing you with benefits to pay your business
expenses such as rent and salaries, if you suffer a covered
disability.
Since you are one of the most important assets to
your firm, a disabling illness or injury that leaves you unable to
work would be financially devastating to your professional
practice.
This plan is especially important for sole
practitioners and single-professional firms. As well, if you are
set up in a partnership, your portion of the ongoing expenses
still continue whether or not you are working. If you can't work
because of an illness or injury, you'll need money to help pay
your firm's rent or mortgage, utilities, salaries, and other
covered expenses. Without this Business Disability Plan, you might
have to use up your savings, borrow money—or even close your
office.
Like most professionals, in the event that a
disabling illness or injury prevents you from working, your income
will cease—but your bills will continue. After the countless hours
you have invested in stabilizing the financial out come of your
firm, why risk leaving it unprotected? Fortunately, the AIA Trust
offers AIA Members Business Overhead Disability Insurance to help
you keep a disability from disrupting your professional life.
Back to Top
How Much Business Overhead
Expense Protection Coverage Is Available?
You can select up to $10,000 in $100 increments, up to 100% of
your business overhead expenses. However, the benefit amount you
receive will not exceed the least of (1) Actual eligible expenses
incurred; (2) Monthly average of eligible expenses for 6 months
prior to disability; (3) Amount of monthly benefits in force.
The amount selected together with any other
overhead expense insurance that you may have cannot exceed 100% of
the monthly average of eligible expenses that you incurred for the
6 months prior to requesting coverage.
Back to Top
What Are Eligible Overhead
Expenses?
Eligible Overhead Expenses include, but are not limited to:
- Rent
- Mortgage payments on business premises (principal and
interest)
- Salaries of employees
- Principal and interest on existing business loans
- Monthly average of taxes on premises
- Maintenance of existing business equipment
- Leasing costs for existing furniture and equipment
- Principal and interest for existing equipment
- Insurance premiums (pro-rated)
- Depreciation of office furniture and equipment
Back to Top
What Expenses Are Not
Included
- Salaries, fees drawing accounts, personal expenses, profits
or other remuneration to yourself or your partner.
- Income taxes, or any expense you would not be reasonably
expected to incur while disabled
- Salaries of all persons hired after the disability began
- Charges for professional services of individuals in the same
profession as the insured
If you are incorporated, a partner, or a joint
tenant, overhead expenses include only your share of them.
Back to Top
When Will My Benefits Be
Paid?
Benefits will start on the 31st day of a covered disability. They
are payable up to the maximum benefit period of 12 or 24 months
depending on which plan you selected.
30/12 Plan: Benefits begin on the 31st day
of a covered disability and are payable up to the maximum benefit
period of 12 months.
30/24 Plan: Benefits begin on the 31st day
of a covered disability and are payable up to the maximum benefit
period of 24 months.
Back to Top
AIA Business Overhead
Expense Protection Plan Rates
|
AIA Business Overhead
Expense Protection Plan—Semi-annual Rates Per $100 of
Coverage
new marketed plan rates effective 01/01/2002
|
|
Member Age
|
Under 35
|
35–44
|
45–54
|
55–64
|
60–64
|
|
30/12 Plan
|
$1.38
|
$2.52
|
$4.98
|
$8.04
|
$11.22
|
|
30/24 plan
|
1.80
|
3.36
|
6.30
|
10.26
|
11.85
|
Click Here to download a printable
version (Adobe PDF) of this rate chart.
Back to Top
What Is "Total" Disability?
"Total" Disability means: Benefits are payable if you are disabled
due to a covered injury or illness and unable to perform the
substantial and material duties of your regular occupation of your
architectural practice or regular occupation and are under the
regular care of a licensed physician and are not gainfully
employed in any occupation. If you voluntarily elect to enter
another occupation because you cannot practice as an architect or
if you return to work on a part-time basis, then you are no longer
"totally" disabled and the residual disability formula is applied.
Back to Top
What Is A Residual
Disability?
When you resume your practice or enter a new occupation after a
covered disability, you may find your earnings are not what they
once were. Perhaps your former clients have gone elsewhere, or
you're starting your new job from scratch. But even when your
Disability benefits have stopped, you may be able to offset your
lower income by receiving a Residual Benefit.
If you return to work after a covered disability
that lasted at least 30 days, you may be entitled to receive a
Residual Benefit if:
- You did not receive the regular Disability Benefit for the
full maximum period applicable to the disability, and
- Your current average earnings during the most recent six
months after the Disability ends are no more than 75 percent of
your pre-disability average earnings (as defined below). No residual benefits will be
payable until the waiting period has been satisfied.
The Residual Benefit is a percentage of your
regular Long-Term Disability Benefit, equal to the percentage
reduction of your current average monthly earnings.
However, for each month that the percentage
reduction is 75% or more of your pre-disability income, the Plan
will pay the full Disability Benefit.
Your Residual Benefit is paid for as long as the
regular Disability Benefit would have been paid if the underlying
disability had continued, or until your current average monthly
earnings exceed 75 percent of your pre-disability earnings, if
this is sooner.
Back to Top
Residual Benefit Examples
- Your last monthly Disability Benefit: $2,000
- Your current earnings are reduced by: 40% (Multiply $2,000 by
.40)
- Your Residual Benefit is: $800 a month
- Your last monthly Disability Benefit: $4,000
- Your earnings one month are reduced by: 80% (Because this
percentage reduction is 75 percent or greater, your full
Disability Benefit will be paid.)
- Your Residual Benefit for this month: $4,000
Back to Top
What Happens If I Suffer the
Same Disability More Than Once?
Two periods of total disability are considered to be related
unless:
- You return to work full-time for at least 6 months between
disabilities, or;
- The cause(s) of the latter disability is not related to that
of the earlier one.
Back to Top
What If I Die While I'm
Disabled?
We will pay a benefit amount equal to 3 times your last monthly
benefit payment (not including wages earned while in
rehabilitative employment) if your disability leads to death while
you're collecting benefits and your disability lasted at least 180
consecutive days immediately proceeding the day of death.
Back to Top
Can My Coverage Be Cancelled
For Any Reason?
Your coverage can end if you are no longer a member of AIA, fail
to pay your premiums in a timely manner, enter active full-time or
temporary duty that lasts longer than 30 days in the military, are
no longer a resident of the U.S., reach age 65, retire or are no
longer actively at work at least 20 hours per week or, in the
unlikely event, the entire Master Policy is terminated by the
Group Policyholder or New York Life.
Back to Top
If I'm Disabled Will My
Premiums Be Waived?
Yes. Your premium payments are waived if you become disabled prior
to age 60, and remain totally disabled for at least six
consecutive months. Your coverage will remain in full force and
you'll pay nothing. You won't owe a cent as long as you remain
eligible for total disability benefits.
Back to Top
How Are Benefits Paid To an
AIA Member?
All benefits are paid directly to you.
Back to Top
What if I have questions
about my Plan?
Just call the TOLL-FREE AIA Trust Hot Line at 1-800-255-8215.
Experienced customer service representatives are on staff to
answer your questions.
Don't hesitate to give us a call when you need
assistance. Or you can write:
The AIA Trust Insurance Plans
300 South Wacker Drive, 7th Floor
Chicago, Illinois 60606
We'll help however we can.
Back to Top
Important Notice
How New York Life Underwrites Your Request for AIA coverage.
Information regarding insurability will be
treated as confidential. In considering whether the persons in
your request for insurance qualify for coverage, we will rely on
the medical information you provide, and on the information you
authorize us to obtain from your doctor, other medical
practitioners and facilities, and other insurance companies to
which you have applied for insurance and MIB, Inc. (Medical
Information Bureau). New York Life will not disclose such
information to anyone except those you authorize or where required
by law. We may make a brief report to MIB, however, we will not
disclose our underwriting decision. Information in our files may
be seen by New York Life and Plan Administrator employees, but
only on a "need to know" basis in considering your request. Upon
receipt of all requested information we will make a determination
as to whether your request for insurance can be approved.
MIB is a nonprofit membership organization of
life insurance companies which operates an information exchange on
behalf of its members. When you apply for insurance or submit a
claim for benefits to a MIB member company, medical or non medical
information may be given to the Bureau, which may then be
furnished to member companies. Upon written request, MIB will
arrange disclosure of any information it may have about you in its
file. MIB's information office is P.O. Box 105, Essex Station,
Boston, MA 02112, telephone 617-426-3660.
If we cannot provide the coverage you request,
we will tell you why. In all cases medical records information
will be given to a medical professional designated by you (except
for certain types of medical record information in specified
jurisdictions you may choose to receive such information
directly). If you feel our information is inaccurate, you will be
given a chance to correct or complete the information in our
files. For New Mexico residents, in addition, protected persons*
have a right of access to certain confidential abuse information**
we maintain in our files and they may choose to receive such
information directly. You have the right to register as a
protected person by sending a signed request to the Administrator
at the address listed on the application. Please include your full
name, date of birth, and current address. For U.S. residents, your
request is handled in accordance with the Fair Credit Reporting
Act procedures. If we can provide the coverage you requested, we
will inform you as to when such coverage will be effective. Under
no circumstances will coverage be effective prior to this date.
Payment of a premium contribution with your application does not
mean there is any insurance in force before the effective date
determined by New York Life.
*"Protected person" means a victim of
domestic abuse who has notified us that he or she is or has been a
victim of domestic abuse and who is an insured or prospective
insured.
**"Confidential abuse information" means
information about acts of domestic abuse of abuse status, the work
or home address or telephone number of a victim of domestic abuse
or the status of an applicant or insured as family member,
employer or associate of a victim of domestic abuse or a person
with whom an applicant or insured is known to have a direct, close
personal, family or abuse-related counseling relationship.
Back to Top
Administered by
Affinity Insurance Services, Inc.
300 South Wacker Drive, 7th Floor
Chicago, Illinois 60606
1-800-255-8215
Back to Top
Residents of Florida
Bob Bartee is a licensed Florida Agent for service of Florida
residents.
Back to Top
Underwritten by
New York Life Insurance Company
51 Madison Avenue
New York, NY 10010
(NAIC #: 66915)
Back to Top
Please Note:
This brochure contains a brief description of the principal
provisions and features of these plans. Insured members will
receive a Certificate of Insurance providing details of the
coverage.
Back to Top
|
