Benefits Continuation: When Disabled

Purpose

This document describes the Research Foundation's (RF's) policy on coverage continuation when an employee is disabled and describes life insurance continuation limits based upon an employee's age at the time of disability.

Scope

Continuation of benefit coverage is described for each of the following:

Total Disability: Workers' Compensation

When an employee is totally disabled, receiving Workers' Compensation benefits, and subsequently terminates from the RF payroll, the RF will continue coverage as shown in the following table:

Type of Benefit

Coverage Continuation

Health, dental and vision care

The RF will continue coverage in effect at the time of the disability and will extend coverage for the length of time the employee is receiving income replacement benefits (from Workers' Compensation) for the total disability or until age 65, whichever comes first.

If an employee is receiving Workers’ Compensation benefits for a total disability at age 65, he or she is eligible for retiree health insurance coverage, provided that the age and service eligibility requirements for retiree health insurance are met.

Basic life insurance

Coverage in effect at the time of the disability will continue, provided that the employee remains totally disabled and continues to submit proof of disability to the insurance carrier. Coverage for both full-time and part-time employees is subject to the rules outlined under "Life Insurance Continuation Age Limitations" in this document.

Optional life insurance

Coverage in effect at the time of the disability may be continued for the duration of the total disability or until age 65, whichever comes first, provided that the employee pays the full premium.

Retirement contributions

If an employee is a vested participant in the Research Foundation Basic Retirement Plan, the RF will continue to remit retirement contributions as long as he or she remains on the payroll. Refer below to the "Long-Term Disability: Full-Time Employees" section for more information on retirement contributions while receiving LTD benefits.

Note: Retirement contributions do not continue for totally disabled part-time employees.

New York State Disability

The RF will continue health, dental, vision care and basic life Insurance coverage in effect when the employee became disabled. Coverage will continue for the period of time during which partial income replacement is received through New York State Disability income.

An employee may continue optional life insurance coverage during New York State disability by paying the entire premium.

A disabled employee who is on New York State disability will continue to receive retirement contributions as long as he or she remains on the payroll. Contributions are based on salary payment received for RF leave accruals. Contributions cease when the employee is no longer on the RF payroll. Refer below to the "Long-Term Disability: Full-Time Employees" section for more information on retirement contribution continuation.

Long Term Disability: Full-Time Employees

An employee's coverage continuation is determined by his or her date of hire. Coverage will continue as shown in the following table:

Coverage Continuation for Employees Hired Before January 1,1986

Type of Benefit

Coverage Continuation

Health, dental and vision care coverage in effect before the employee was disabled

Coverage will continue for the length of the disability, or up to age 65, whichever comes first.

Health insurance will continue as retiree health insurance provided that the employee meets one of the following criteria:

He or she had 10 consecutive years of full-time equivalent service before the disability began and he or she continues to be disabled at age 65.

He or she is no longer receiving long-term disability benefits, is no longer disabled, and meets the age and service requirements for retiree health insurance coverage (at least age 55 and 10 consecutive years of full-time service).

Note: If the employee had five years of full-time equivalent service before he or she became disabled, the period of time during which the employee receives long-term disability benefits will be credited toward the service requirement for retiree health insurance.

Basic life and accidental death and dismemberment (AD&D) insurance coverage in effect at the time of the employee’s disability

Coverage will continue, provided that the employee remains disabled and continues to provide proof of disability to The Prudential Life Insurance Company of America (Prudential). The employee is subject to the age limitations described in the "Life Insurance Continuation Age Limitations" section.

Optional life and AD&D insurance coverage

Coverage may continue, provided that the employee

Remains disabled and continues to provide proof of disability to Prudential.

Pays the full premium.

The employee is subject to the age limitations described in the "Life Insurance Continuation Age Limitations" section.

Retirement contributions

Contributions will continue for vested employees at the same rate as before the total disability. Contributions are based on the employee’s annual salary at the time of his or her disability.

Contributions continue until the disability ends (and the employee is no longer receiving long-term disability benefits), or until age 65, whichever comes first.

Note: Retirement contributions for non-vested employees do not continue during a long-term disability, unless the employee remains on the payroll.

Coverage Continuation for Employees Hired on or after January 1, 1986

Type of Benefit

Coverage Continuation

Health, dental and vision care coverage in effect before the employee was disabled

Coverage will continue for one year from the date the long-term disability benefits begin, without charge to the employee.

If the employee has 10 consecutive years of full-time equivalent service before the disability begins, the health insurance coverage the employee had at the time of the disability is continued for the length of the disability, or up to age 65, whichever comes first.

Health insurance will continue as retiree health insurance, provided that one of the following occurs:

The employee had 10 consecutive years of full-time equivalent service before the disability began, and he or she continues to be disabled at age 65.

The employee is no longer receiving long-term disability benefits, is no longer disabled, and meets the age and service requirements for retiree health insurance coverage (at least age 55 and 10 consecutive years of full-time service).

Note: If the employee had less than 10 but at least five years of full-time equivalent service before he or she became disabled, the employee will be credited with service toward eligibility for retiree health insurance while receiving long-term disability payments, provided that he or she pays the full health insurance premium (employee and employer share) until he or she reaches eligibility for retiree health insurance.

Basic life and AD&D insurance coverage in effect at the time of the employee’s disability

Coverage will continue, provided that the employee remains disabled and continues to provide proof of disability to Prudential. The employee is subject to the age limitations described in the "Life Insurance Continuation Age Limitations" section.

Optional life and AD&D insurance coverage

Coverage may continue, provided that the employee remains disabled and continues to provide proof of disability to Prudential, and pays the full premium.

The employee is subject to the age limitations described in the "Life Insurance Continuation Age Limitations" section.

Retirement contributions

Contributions will continue for vested employees at the same rate as before the total disability. Contributions are based on the employee’s annual salary at the time of his or her disability.

Contributions continue until the disability ends (and the employee is no longer receiving long-term disability benefits), or until age 65, whichever comes first.

Note: Retirement contributions for non-vested employees do not continue during a long-term disability, unless the employee remains on the payroll.

Total Disability: Part-Time Employees Receiving Social Security Disability Payments

The following table shows coverage continuation for a totally disabled part-time employee receiving Social Security disability payments:

If the employee has...

then...

for the duration of...

At least one year, but less than 10 years of full-time service, or the equivalent in part-time service (at 50 percent or more of full-time effort) at the time of disability

Health, dental and vision care coverage in effect at the time of the total disability will continue

One year beyond the time New York State Disability benefits cease, without charge to the employee.

Note: After one year, benefits for Social Security disabled employees may be continued for an additional period under COBRA, if the employee pays the required premium. Refer to COBRA Coverage Continuation.

10 or more consecutive years of full-time equivalent service at 50 percent or more of full-time effort, at the time the disability began

Health insurance coverage will continue

The total disability, while the employee continues to receive Social Security disability payments, until the employee reaches age 65. At age 65, coverage will continue as retiree health insurance.

If the employee is no longer receiving a Social Security disability benefit, health insurance coverage will continue as retiree health insurance, if the employee meets the age and service requirements outlined in the "Health Insurance Eligibility" section of Coverage Continuation After Retirement.

Note: Retirement contributions do not continue for totally disabled, part-time employees.

Life Insurance Continuation Age Limitations

The basic life and AD&D insurance coverage in effect at the time of a NYS Workers' Compensation or Long-Term Disability will continue for both full-time and part-time employees subject to the limitations shown in the following table:

If the employee became disabled...

coverage will end...

Before age 60

At age 65.

On or after age 60, but before age 65

After 4 1/2 years.

Between (and including) age 65 and 68 1/2

At age 70.

After age 68 1/2

After 1 year.

Change History

 

 

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