Disability Insurance

ATTENTION: If applying for Life or Disability as a California or New York resident please contact Hagan Benefits at 877-285-4445 or see the bottom of this page for a specified application.

Help Protect Your Most Valuable Asset: Your Ability to Earn a Living

An Injury or Sickness that results in disability could keep you from working for months. Your major medical insurance may cover much of your hospital and physician expenses, but how would you replace your income? Disability income insurance can help protect your home, your children's education and the assets for which you've worked so hard.

Are you wondering when to purchase your disability income insurance plan?

Today! Because premium and policy eligibility are based on age and health status, the best time to buy a Disability policy is when you're young and healthy. This policy includes a pre-existing condition limitation.

Benefits

Thanks to your membership in the American College of Emergency Physicians, you now have the opportunity to apply for a disability income protection plan from Hartford Life and Accident Insurance Company at reasonable group rates. Disability Income Insurance will partially replace your income for a covered Sickness or Injury up to $10,000 a month depending on your Pre-Disability Earnings! Your plan will provide you with these valuable benefits:

Two plans to choose from—up to $10,000 per monthly benefit
Occupation-specific
Affordable group rates
Partial disability benefit
Residual disability benefit
Waiver of premium during disability

Offset Provision

Benefit cannot exceed 60% of Basic Monthly Pay.

Offset Provision Example
Insured's Monthly Pre-Disability Earnings	$3,000
Long Term Disability Benefits Percentage	x 60%
Unreduced Maximum Benefit	$1,800
Less Social Security Disability Benefit Per Month	- $900
Less State Disability Income Benefit Per Month	- $300
Total Amount of Long Term Disability Benefit Per Month	$600

Plan I - Up to Age 65
Annual Rates per $100 of Monthly Benefit
Insured's Age	30-Day Waiting Period	90-Day Waiting Period	180-Day Waiting Period
Under 30	$12.22	$9.88	$8.40
30 - 34	$19.24	$15.34	$13.04
35 - 39	$26.26	$21.06	$17.90
40 - 44	$38.22	$30.68	$26.08
45 - 49	$47.06	$37.70	$32.05
50 - 54	$97.24	$75.40	$64.09
55 - 59	$114.66	$88.40	$75.14
60 - 64	$153.66	$119.60	$101.66

Rates are based on the attained age of the Insured person and increase as you enter each new age category.

Plan II - Up to 5 Years
Annual Rates per $100 of Monthly Benefit
Insured's Age	30-Day Waiting Period	90-Day Waiting Period	180-Day Waiting Period
Under 30	$13.78	$10.40	$8.84
30 - 34	$15.34	$11.96	$10.17
35 - 39	$17.16	$13.78	$11.71
40 - 44	$23.92	$17.16	$14.59
45 - 49	$34.06	$27.30	$23.21
50 - 54	$51.22	$41.08	$34.92
55 - 59	$83.46	$68.38	$58.12
60 - 64	$104.00	$71.76	$61.00

Rates are based on the attained age of the Insured person and increase as you enter each new age category.

Waiting Periods
Plan I - To Age 65 Plan: For Total Disability Beginning:
	Payment Period	Waiting Period
a. Before Age 63	To Age 65	30, 90 or 180 days 30, 90 or 180 days
b. Age 63 or over, but under 65	2 Years	30, 90 or 180 days
Plan II - 5 Year Plan: For Total Disability beginning:
a. Before Age 63	5 Years	30, 90 or 180 days
b. Age 63 or over, but under 65:	2 Years	30, 90 or 180 days

Rates are based on the attained age of the Insured person and increase as you enter each new age category.
Rates and/or benefits may be changed on a class basis

Explanation of Terms

Basic Monthly Pay or Pre-Disability Earnings means the 12 month average of your regular monthly rate of pay, not including commissions, bonuses, overtime pay or any other fringe benefit or extra compensation, with such 12 month period ending on the last day of Active employment prior to becoming Disabled.
Injury means bodily Injury that results directly and independently of all other causes from an accident within 180 days of accident.
Total Disability means a disability that prevents you from performing one or more of the duties of your usual occupation.

Exclusions:

The Policy does not cover, and We will not pay a benefit for any Disability:

unless You are under the Regular Care of a Physician;
that is caused or contributed to by war or act of war (declared or not);
caused by Your commission of or attempt to commit a felony;
caused or contributed to by Your being engaged in an illegal occupation;
caused or contributed to by an intentionally self inflicted Injury; or
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.

If You are receiving or are eligible for benefits for a Disability under a prior disability plan that:

was sponsored by the employer; and
was terminated before the Effective Date of The Policy;

No benefits will be payable for the Disability under The Policy. (GBD-1200 G01)

Pre-existing Condition Limitation:

We will not pay any benefit, or any increase in benefits, under The Policy for any Disability that results from, or is caused or contributed to by, a Pre-existing Condition, unless, at the time You become Disabled:

You have not received Medical Care for the condition for 365 consecutive day(s) while insured under The Policy; or
You have been continuously insured under The Policy for 730 consecutive day(s).

Eligibility

All Active Members of the Policyholder who are :

under age 65;
citizens or legal residents of the United States, its territories and protectorates; and
Actively-At-Work on a full-time basis at least 30 hours per week for four consecutive weeks.

Policy Age Limit:

Insured Person: Age 65

Termination:

Your coverage will end on the earliest of:

the date The Policy terminates;
the date the Policyholder withdraws its sponsorship of, or cancels, The Policy;
the Premium Due Date on or next following the date:
1. You cease to be an active member of the Policyholder; or
2. You attain The Policy Age Limit;
the date You cease to be Actively-At-Work, except due to disability covered by The Policy or leave of absence, as described herein; or the Premium Due Date any required premium contribution is not made, subject to the Individual Grace Period.

Apply now online for disability coverage or print a PDF, complete application and fax to 605-334-0556.

Attention CA and NY residents: You cannot apply online, instead please utilize the following PDF applications:
California Residents: Click Here
New York Residents: Click Here

Most people wouldn't dream of leaving their home, cars, boats or other valuables uninsured, but few think to insure their loss of income. It's too late to do anything about it once you've become disabled. That's why it's so important to safeguard your income now - while you're healthy and active.

You have 30 days from your effective date of coverage to look over the program and discuss with your family and advisors. If you are not satisfied, you may return your Certificate within 30 days for a full premium refund, less any claims paid.

Acceptance into this plan is subject to medical evidence of insurability as determined by Hartford Life and Accident Insurance Company. 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.

This website explains the general purpose of the insurance described, but in no way changes or affects the Master Policy AGP-5683 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 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.

Underwritten by:
Hartford Life and Accident Insurance Company
Simsbury, CT 06089
Form GBD-1000 ASSOC A (TX)

The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company