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Reso 2001-399
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Reso 2001-399
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Last modified
6/11/2013 4:45:14 PM
Creation date
1/25/2006 1:56:58 PM
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CityClerk-Resolutions
Resolution Type
Resolution
Resolution Number
2001-399
Date (mm/dd/yyyy)
12/13/2001
Description
– Bid 01-10-01: Jefferson Pilot Life Ins&Eye Med: Emp Dental Vision etc.
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<br />PARTIAL DISABILITY MONTHLY BENEFIT <br /> <br />BENEFIT. The Company will pay a Partial Disability Monthly BenefIt to an Insured Employee, after completion of the Elimination <br />'eriod; if he or she: <br />1. is Disabled; <br />2, is engaged in Partial Disability Employment; <br />3. is earning at least 20% of Pre disability Income when Partial Disability Employment begins; <br />4. is under the regular care of a Physician; and <br />5, at his or her own expense, submits proof of continued Partial Disability, Physician's care and reduced earnings to <br />the Company upon request. <br />The Insured Employee does not have to be Totally Disabled prior to receiving Partial Disability Monthly BenefIts. The Elimination <br />Period may be satisfIed by days of Total Disability, Partial Disability or any combination thereof. <br /> <br />The Partial Disability Monthly BenefIt will cease on the earliest of: <br />1. the date the Insured Employee ceases to be Partially Disabled or dies; <br />2. the date the Maximum Benefit Period ends; <br />3. the date the Insured Employee earns more than: <br />(a) 99% of Pre disability Income, until Partial Disability Monthly BenefIts have been paid for 24 <br />months for the same period of Disability; or <br />(b) 85% of Predisability Income, after Partial Disability Monthly BenefIts have been paid for 24 <br />months for the same period of Disability; * <br />4, the date the Insured Employee is able, but chooses not to work full-time: <br />(a) in his or her regular occupation, during the Own Occupation Period; or <br />(b) in any gainful occupation, after the Own Occupation Period; <br />5. the date the Insured Employee fails to take a required medical exam, without good cause; or <br />6. the 60th day after the Company mails a request for additional proof, if not given. <br /> <br />*If the Insured Employee's earnings from Partial Disability Employment fluctuate, the Company has the option to average the most <br />recent three months' earnings and continue the claim; provided that average does not exceed the percentage of Predisability Income <br />clllowed above. A Monthly BenefIt will not be payable for any month during which earnings exceeded that percentage, however. <br /> <br />DEFINITIONS <br /> <br />"Full-Time" means the average number of hours the Insured Employee was regularly scheduled to work, at his or her regular <br />occupation, during the month just prior to: <br />1. the date the Elimination Period begins; or <br />2. the date an approved leave of absence begins, if the Elimination Period begins while the Insured Employee is <br />continuing coverage during a leave of absence. <br /> <br />"Partially Disabled" or "Partial Disability" will be defmed as follows. <br />1. During the Elimination Period and Own Occupation Period, it means that due to an Injury or Sickness the Insured <br />Employee: <br />(a) is unable to perform one or more of the main duties of his or her regular occupation, or is unable <br />to perform such duties full-time; and <br />(b) is engaged in Partial Disability Employment. <br />2. After the Own Occupation Period, it means that due to an Injury or Sickness the Insured Employee: <br />(a) is unable to perform one or more of the main duties of any gainful occupation which his or her <br />training, education or experience will reasonably allow; or is unable to perform such duties full- <br />time; and <br />(b) is engaged in Partial Disability Employment. <br /> <br />GL3001-LID-13A 98 <br /> <br />20 <br /> <br />Residual Disability, Any Occ. Disability Definition <br />01/01101 <br />
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