$21.00 Safety Group Plan

Monthly Cost $21.00 per month
Percentage of
Wages Protected*
100% of wages for Catastrophic Disabilities for up to 30 months – not to exceed maximum monthly benefit
75% of wages Non-Industrial Disability
70% of wages Industrial Disability
(No reductions for Workers’ Compensation permanent disability settlements)
Maximum Benefit $6,500 per month, tax-free
Waiting Period 30 calendar days – Earlier reduced benefits may be payable based on lack of personal leave down to zero days. $700 per month Minimum Benefit after 60 days, freeze of personal leave after 60 days ($500 per month if Industrial caused). No benefits are payable if working full-time, light or modified duty.
Benefit Period Lifetime Coverage of Sickness, Accident, & Pregnancy
Sick Leave Integration Benefit After 60 days, you may use 50% sick leave and receive a 50% benefit from Plan or use 100% sick leave and receive $700 per month ($500 per month if Industrial caused).
Cost of Living Benefit (COLA) 4% compounded per year (years 2-7) thereafter, CPI increase to age 65 and then benefits continued lifetime.
Musculoskeletal & Connective Tissue Disorders Covered, no restrictions lifetime Industrial and Non-Industrial causes.
Benefits Payable During Challenged Workers’ Compensation Cases After 60 calendar days – 70% of wages or Maximum Benefit of $6,500 per month (repayable if settled in your favor).
Waiver of Payment Waiver of Payment after no-pay status
Minimum Monthly Benefit $700 per month – paid in addition to personal leave after 60 calendar days ($500 per month if Industrial caused).
Pre-Existing Medical Condition Coverage If you enroll during your initial enrollment period, all pre-existing medical conditions will be covered once you have been in the Plan for twenty-four (24) / forty-eight (48)*** months, unless you are eligible for the Prior Coverage Credit – otherwise, pre-existing medical conditions will not be covered.
Survivorship Benefit Nine (9) months additional benefits to dependent beneficiary, plus $10,000 Death Benefit (Payable and delivered usually within 24 hours of notification).
Death Benefit $10,000 Death Benefit** on- or off-duty – natural, accidental or terminally ill (Payable and delivered usually within 24 hours of notification).

 

* Forty-eight (48) months for Death Benefits and for HIV, AIDS, ARC.

* Maximum percentages reflect amount payable after completion of (a) waiting period, (b) freeze of sick leave option, or (c) sick leave integration. Offsetting Benefit/Income Amounts are applied to reduce amount from the Plan
** The Death Benefit for suicide is limited to $2,000 for the first 24 months of participation in the Plan.
*** Forty-eight months for Death Benefits and for HIV, AIDS, and ARC.

For illustration only. See the Summary Plan Description or the Plan Document provisions for a more complete description of coverage. CA Insurance Lic. #0544968.