Enhanced Individual Plan (EIP) – Cal Fire
|Cost||$24.50 per month – monthly bank draft, credit card or annual billing||$34.00 per month|
|80% of wages Non-Industrial causes.
66 2/3% of wages Industrial causes.
100% of wages for Catastrophic – not to exceed maximum monthly benefit.
No Cal Pers pension advances
(No reductions for Workers’ Compensation permanent disability settlements.)
|66 2/3% of covered earnings reported on previous year’s W-2 to a maximum of $10,000 monthly benefits for Non-Industrial and Industrial Disabilities.
(No reductions for Workers’ Compensation Permanent Disability settlements)
Maximum Benefit $10,000 per month.
|Waiting Period||30 calendar days – Earlier reduced benefits may be payable based on lack of sick/personal leave down to zero days. $750 Minimum Benefit (see Minimum Benefits below) after 60 days, freeze of sick/personal leave after 60 days. No benefits are payable if working full-time, light or modified duty.||90 consecutive days of total disability
No benefits are payable if working full-time, light or modified duty.
|Benefit Period||Lifetime Coverage of Sickness and Accident
Industrial & Non-Industrial Disabilities – 2 years own occupation definition.
|To Age 65 for Sickness, Accident, and Pregnancy
|Freeze of Sick Leave Options||After 60 calendar days||None|
|Sick Leave Integration Benefit||After 60 days, you may use 50% sick/personal leave and receive a 50% benefit from the Plan.||None|
|Cost of Living Benefit (COLA)||4% compounded per year (years 2-7) thereafter, CPI increase to age 65 and then benefits continued lifetime.||None|
|Stress & Psychological||Four (4) months per occurrence. Sixteen (16) months lifetime benefit (4 occurrences per lifetime). A member must return to work for one (1) year between claims.”||Twelve (12) months..|
|Musculoskeletal & Connective Tissue Disorders||Fully covered. Lifetime coverage – 2 years own occupation definitions, restrictions apply.||24 months, lifetime limitation on back and its surrounding soft tissue, sprains, strains of joint or muscles, and connective tissue disorders. Numerous conditions are limited to 24 months.|
|Benefits Payable During Challenged
|After 60 calendar days – 66 2/3% of wages or Maximum Benefit of $10,000 per month (repayable only if settled in your favor).||After 90 days – 66 2/3% of wages or maximum benefit of $10,000 (Repayable only if determined to be Industrial).|
|Waiver of Payment||After no-pay status||After 90 consecutive days of total disability|
|$750 per month – paid in addition to sick/personal leave after 60 calendar days ($500 per month if job related).||10% of covered earnings per month or $100 per month whichever is greater|
|Pre-Existing Medical Condition Coverage||All pre-existing medical conditions will be covered once you have been in the Plan for sixty (60) months.||Subject to 12/12/24 pre-existing medical condition limitations. Also, proof of evidence of insurability may be required and coverage may be declined at the discretion of the insurance company.|
|Survivorship Benefit||Nine (9) months additional benefits to dependent beneficiary.||Three (3) months additional benefits to dependent beneficiary if continuous disability of 6 months.|
|Death Benefit||$15,000 Death Benefit** on- or off-duty natural, accidental or terminal illness (Payable and delivered usually within 24 hours of notification).***||None|
|Ownership of Plan||Managed, operated and funded by members||Insured by Reliance Standard Insurance Co. (a fore-profit stockholder-owned company).|
* 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
To Apply: Please download the enrollment application above
and mail to CAPF, PO Box 31, Martell, CA 95654.
Please do not discontinue any other coverage until you have been notified that
your CAPF LTD Plan has gone into effect.