At a Glance

• Monthly benefit if you or your spouse are Disabled and unable to work
• Up to a maximum of $10,000 monthly benefit not to exceed a percentage of your Basic Monthly Pay based upon the plan selected.
• Your choice of Waiting Period; 30, 60, 90 or 180 days
• Your choice of benefit period; 2 years or to age 65

About the Disability Income Insurance Program
The program is underwritten by Hartford Life and Accident Insurance Company and Hartford Life Insurance Company and offered by AMBA. There are two insurance plans to choose from . . .

Plan I: (for members only) . . . if you are Disabled by a covered Injury or Sickness, you will receive benefits beginning on the day after your Waiting Period is satisfied and continuing up to age 65 (24 months if Disabled after age 65).

Plan II: (for members and spouses/ domestic partners) . . . if you are Totally Disabled by a covered Injury or Sickness, you will receive benefits beginning on the day after your chosen Waiting Period is satisfied and continuing for up to two full years. Spouses/domestic partners can receive benefits up to a maximum of $2,000 per month.

How Disability Income Insurance Works
Disability Income Insurance helps cover you against the risk that you will be unable to work because of an Injury or Sickness. The policy pays benefits equal to a portion of your wages when you can't work because of long-term disabling Sickness or accidental Injury that happen on or off the job.

You can select benefit amounts, how long you must be off work before benefits are paid, how long benefits will be paid, and other plan features.

Policy Form Numbers SRP-1311 AB (5636) and SRP-1311 A (HL) (5637)

Why You Would Need Disability Income Insurance

A disabling Injury or Sickness can happen in the blink of an eye. That disability could place you out of work. If you have to stop working, chances are your income will stop too. But it doesn't have to if you help protect yourself with disability insurance.

Under the Disability Income Plan, you would receive a monthly benefit that you select (up to the specified percentage of your Basic Monthly Pay). With this benefit you can better keep up with your living expenses until you get back to work.

Don't let a disability put an end to your income. Disability insurance can be a beneficial part of everyone's portfolio.

Disability Income Insurance Through Your Employer

Most employers offer some kind of disability income insurance, but you should find out exactly what your employer offers before you have to file a claim. Most allow some short-term sick leave, which might last from a few days to as much as six months. Five states and Puerto Rico have Temporary Disability Insurance (TDI) programs to provide income support to individuals who are out of work because of a non-work-related illness or injury.*

Check with your benefits department to see if you are covered and if so, how long you must wait before benefits begin and how long payments will last while you are still disabled. Also, ask if your employer's disability plan takes other disability programs into account, such as Social Security, when calculating your disability pay*.

No laws require employers to offer long-term disability (LTD) coverage, but about half of large and mid-sized employers offer it to their workers. Typical group long-term disability benefits replace about 60% of the worker’s usual salary. These benefits usually start when short-term benefits are exhausted and continue from five years to life. Usually, group long-term disability insurance is fully paid for by employers, with no contribution expected from employees*.

*Insurance Information Institute, Inc., http://www.iii.org/individuals/disability/employer, viewed on July 14, 2016.

Why Disability Income Insurance can be a Good Choice

Disability Income Insurance can be an affordable way to help assure yourself and your family of a stable income if you become Totally Disabled.

Disability Income Insurance can provide a benefit to help pay the bills after your short-term benefits are depleted. The plan provides you with up to $10,000 a month to use as you’d like. You also have the option of having your choice of coverage, so you can create the best income protection plan for yourself and your family.

Benefits of the Disability Income Insurance Program

Residual Disability Benefits (Plan I Only)
After the Waiting Period, this benefit helps ensure that a portion of your regular monthly benefit will continue to be paid as long as you are gainfully employed and your income is less than 75% of your Pre-Disability Earnings, you are under age 64 and your benefit period has not expired. This assists you with income if you are still under a doctor’s care, unable to perform all of your duties as the result of your disability.

Pre-Disability Earnings means the average monthly income received during the 12 months immediately preceding the Insured Person's Disability.

Rehabilitative Employment Benefit (Plan I Only)
If you accept Rehabilitative Employment, you will receive monthly benefits for up to 60 months while Totally or Partially Disabled. You will receive your regular monthly benefit less 50% of any income earned from Rehabilitative Employment. Your vocational rehabilitation program will include staff nurses and specially trained counselors. Each individual rehabilitation program is custom tailored to each claimant’s needs and aspirations. Our counselors use skills assessment, job and transferable skills analysis, job modification, vocational testing, job placement assistance, and retraining. The sum of your monthly benefit and total income received from the rehabilitation program may not exceed 100% of your Basic Monthly Pay.

Paraplegia Benefit
This benefit equals 10 times your chosen monthly disability benefit. It will be paid if you are under age 60 and have received Total Disability benefits for 12 consecutive months because both your upper or both your lower limbs are completely and irreversibly paralyzed. The complete and irreversible paralysis must be a result of an Injury or Sickness.

Partial Disability Benefit
You can receive 50% of your chosen monthly benefit if, because of an Injury or Sickness, you are unable to perform one or more of the important duties of your regular occupation, you are not receiving Total Disability or Residual Disability benefits, and you are under the regular care of a physician. Partial Disability benefits will be paid up to your maximum benefit period under Plan I after a seven day Waiting Period. If the Partial Disability lasts for part of a month, you will receive a portion (1/60th) of your chosen monthly benefit for each day of Partial Disability. There is a seven-day Waiting Period for this benefit and it is payable for up to 180 days under Plan II.

Limitation for Mental & Nervous Disorders, Alcoholism & Drug Addictions (Plan I Only)
Benefits will be paid for Total Disabilities due to Mental or Nervous Disorders, alcoholism, or drug abuse if you are receiving psychiatric care at least twice a month for this Disability. Benefits will begin after the chosen Waiting Period and will continue for up to 24 months or to age 65, whichever occurs first. Thereafter, benefits will continue only if you are an inpatient in a hospital or institution and under a doctor’s care.

Survivor Benefit
If the insured is Totally Disabled for more than 180 days, is receiving benefits immediately prior to their death and provided the maximum payment period has not been met, a payment equal to three times their selected monthly benefit will be paid to their spouse, if living. If not, it will be paid in equal shares to their living children or, if there are none, to their estate.

Affordable Group Rates
Your alumni association gives you buying power. You can take advantage of affordable group rates.

Policy Provisions

Who May Apply?
All members under age 65, Actively-at-Work (at least 30 hours per week), and residents of the U.S. may apply for up to $10,000 per month in benefits. A spouse/domestic partner (if not legally separated or divorced from the member) who meets these same requirements may also apply for up to $2,000 under Plan II. May not be available in all states. Please refer to the product homepage for excluded states.

This example is for purposes of illustrating the effect of the benefit reductions and is not intended to reflect the situation of a particular claimant under the policy:

Offset Provision
The Offset Provision means the benefit amount payable as the result of the Insured Person’s Total Disability will be the lesser of the Monthly Benefit Amount or the Monthly Benefit Amount minus any Other Income Benefits. However, if the Insured Person’s Monthly Benefit Amount would reduce to less than $50.00 per month due to the Other Income Benefits, then the minimum Monthly Benefit Amount under this benefit will be $50.00 per month. Other Income includes any such benefits for which you are eligible or that are paid to you, or to a third party on your behalf, for: Workers’ Compensation; employer or government plan; “no-fault” automobile insurance or Social Security.

Waiver of Premium Benefit
If you become Totally Disabled prior to age 60, and receive benefits under the policy for six consecutive months, you will not have to pay any premiums for your disability income insurance coverage for as long as the disability lasts and benefits are payable. Premium payments will resume when you are no longer disabled.

Total Disability Definition
Plan I – Total Disability means Disability which, during the first 24 months during which benefits are payable, wholly and continuously prevents the Insured Person from performing the substantial and material duties of his or her usual occupation; and thereafter wholly prevents an Insured Person from engaging in any and every occupation or employment for which he is reasonably suited by training, education, or experience.

Plan II – You will be considered Totally Disabled if you cannot perform the substantial and material duties of your occupation during your chosen Waiting Period and for the first 24 months thereafter.

Pre-Existing Conditions Limitation
Plan II Only – A Pre-Existing Condition is a health problem for which you have received medical advice or treatment during the 12-month period immediately preceding the effective date of your insurance. Disabilities caused by Pre-Existing Conditions will not be covered until you have had no medical advice or treatment for that condition for 12 consecutive months or you have been insured for 24 months.

Repeat Claims
Repeat disability claims due to different causes will be treated as separate disabilities, with a new Waiting Period and full benefit period. Repeat claims from the same cause will be treated as separate disabilities, with a new Waiting Period and full benefit period, if there are at least 90 days during which you are Actively-at-Work between disabilities. Otherwise, the benefits remaining under the original claim will be paid.

Concurrent Disabilities
Benefits during any Period of Disability as the result of: more than one sickness; or more than one Injury; or both Sickness and Injury; will be considered the same as if the disability resulted from only one cause.

Exclusions and Limitations
This Policy does not cover intentionally self inflicted Injury, suicide or attempted suicide, while sane or insane (in Missouri while sane); pregnancy or childbirth, except Complications of Pregnancy; war or act of war, whether declared or not; the commission or attempted commission of a felony by you; Sickness contracted or Injury sustained while on full-time active duty as a member of the Armed Forces (land, water, air) of any country or international authority.

Continuing Coverage
Coverage can continue until you retire, are no longer Actively-at-Work, except due to disability, covered by the Policy, or reach age 70, as long as the association remains a member of the Trust, you remain a member of the association or spouse/domestic partner of a member, pay premiums, and the Master Policy is in force.

Basic Monthly Pay means your regular monthly rate of pay, not counting commissions, bonuses, overtime pay or any other fringe benefit or extra compensation, in effect on the last day of Active employment prior to becoming Disabled. See your Certificate of Insurance for information if you are self-employed.

The Waiting Period is a specified amount of time (for example, 30 days), beginning with the onset of the disability, during which benefits are not payable. You select a Waiting Period when you apply for your disability insurance coverage.

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.

Important Notes:

This website explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by the Hartford Life and Accident Insurance Company and Hartford Life 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.

Important Notice

NOTICE OF INSURANCE INFORMATION PRACTICES

To properly underwrite and administer your application for insurance coverage, we must collect certain information concerning your insurability. You are our most important source of information, but we may also contact other sources such as medical professionals and institutions, employers and other insurance companies. While all information regarding your insurability will be treated as confidential, in some situations, and in compliance with applicable law, we may disclose necessary items of information to third parties without your specific authorization.

INVESTIGATIVE CONSUMER REPORTS – NOT APPLICABLE TO RESIDENTS OF NEW YORK
As part of our procedure for processing your application, an investigative consumer report may be prepared by an outside insurance reporting organization. Personal information may be collected from others regarding your general reputation and lifestyle. If an interview is conducted with someone other than you, we will inform you of your right to be interviewed in connection with the preparation of the investigative consumer report. You have the right to send a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.

PERSONAL HISTORY INTERVIEW
To provide you, our client, with the best possible service, we may also conduct what we call a personal history interview. This is a phone call placed from our underwriting office. Its purpose is to make sure that the application information is complete. Our interviewers are trained to conduct their calls in a friendly, professional manner. The nature of the information discussed is always treated as personal and confidential and will only be used to assess your eligibility for insurance.

MEDICAL INFORMATION BUREAU (MIB) PRE-NOTICE
Information regarding your insurability will be treated as confidential. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the MIB, Inc., formerly known as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, MIB, upon request, will supply such company, with the information about you in its file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at (866) 692-6901 (TTY (866) 346-3642). If you question the accuracy of the information in MIB's file, you may contact MIB and seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of MIB's information office is 50 Braintree Hill Park, Suite 400, Braintree, Massachusetts 02184-8734. Hartford Life Insurance Company, Hartford Life and Accident Insurance Company, or their reinsurers, may also release information from their files to other insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Information for consumers about MIB may be obtained on its website at www.mib.com.

ACCESS, CORRECTION AND DISCLOSURE
You can obtain access to personal information about you contained in our policy files by sending us a written request. You may also request any necessary corrections, amendments or deletion of any information in our files which you believe to be inaccurate or irrelevant. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may release information in their files to other life insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Also, please be advised that personal and confidential information collected by us may, in certain circumstances, be disclosed to third parties without authorization. A notice providing further description of the circumstances under which information about you may be disclosed and the types of persons and organizations to whom it may be disclosed will be sent to you upon your written request. If you desire further information or access to your personal information, please send your written request to: Hartford Life Insurance Company or Hartford Life and Accident Insurance Company, One Hartford Plaza, Hartford, CT 06155.

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