- Forms & Docs
Dear Brothers and Sisters:
Nearly 13 years ago, Sheet Metal Workers' Local 73 initially offered a member paid supplemental Short Term and Long Term Disability Insurance Plan. Since then, our brothers and sisters have received over $1.9 Million Dollars in benefits. I am pleased to announce, that for the first time since 2001, Sheet Metal Workers' Local 73 has secured a new open enrollment period for all members who are currently not enrolled.
Disability income insurance allows you to protect your earnings in the event that a non-work related illness, injury, or pregnancy prevents you from performing your job. These new benefits are being offered at an affordable rate and should be considered by anyone who would suffer financially should their salary stop due to their inability to work.
Here is how the plan works:
Short Term Plan - The plan provides an additional $250 per week, tax-free, for a total of 24 weeks. It is payable after you have been off of work for a total of 15 days, for a non-work related injury, sickness, or pregnancy.
Long Term Plan - Should your ability to return to work last beyond 180 days, this plan provides 60% of your income up to $4,500/month tax-free, for up to 2 years or until you are no longer considered disabled based on the plan definition.
The enrollment period begins immediately and will continue through December 31, 2017. Upon enrollment, your coverage will begin on January 1, 2018.
This initial enrollment period will be your only opportunity to freely enroll in the plan without having to answer ANY medical questions. If you choose not to apply during this open enrollment period, your application will be subject to approval by the insurance company and could be denied based on your past medical history. Detailed information about the program can be found at www.groupba.com, and then select "Union Members".
We are pleased to offer you these new disability benefits and we believe they will be of tremendous value to the brothers and sisters of Sheet Metal Workers' Local 73.
If you have additional questions please contact Group Benefit Associates at 800-450-1271 or go to www.groupba.com, and then select "Union Members". Please do not contact the union office with your questions as they do not have access to the information and will direct you to Group Benefit Associates.
This disability plan is specifically designed for Sheet Metal Workers' Local 73 members to help them protect their income and assets in the event of a disability or illness.
Some Questions to Think About
- Could you afford to take a six-month vacation? If you can’t, do you think you could afford living through a six-month illness or injury?
- How would you and your family pay your bills without your income?
- How long would your savings last if you were unable to work because of an illness or accident and your income stopped?
- If you were sick or injured in an accident today, would your family’s standard of living be affected?
- What impact would a long-term illness or injury have on your ability to save for retirement?
- This plan is specifically designed to benefit the members of Sheet Metal Workers' Local 73. As a current member, you are eligible to enroll in this group coverage.
- You must be actively at work to be eligible to enroll and maintain coverage.
As a plan participant, you must notify Group Benefit Associates:
- Within 30 days of any layoff or work stoppage and again within 30 days of your return to work
- Immediately when your bank account or credit card information changes for the purpose of premium collection
- Immediately when your wage rate changes
- Within 30 days of any disability and 30 days of your return to work
- Within 30 days if you withdraw from the Union
- Within 30 days of your retirement
Failure to notify Group Benefit Associates in a timely manner of any of the above listed changes can affect your participation in the plan or the benefits that you are eligible to receive under the plan.
Group Benefit Associates has teamed together with Guardian to bring you this program. Guardian is the insurance carrier for the policy and processes all claims and Group Benefit Associates is the third-party administrator responsible for premium collection and remittance.
Short Term Disability (STD)
- Benefit Begins: 15th day non-occupational accidental injury, 15th day non-occupational sickness or pregnancy.
- Benefit Amount: $250 per week
- Benefit Period: 24 weeks
During the first 12 months of coverage, no STD benefits will be paid for a disability that is due to a pre-existing condition. A pre-existing condition is an injury or sickness for which you received medical treatment, consultation, diagnostic measures, prescribed drugs or medicines, or for which you followed treatment recommendations during the three months prior to your effective date of coverage. This provision also applies if you did not consult a physician when an ordinarily prudent person would have. Exclusions may vary by state.
Long Term Disability (LTD)
- Benefit Begins: 180 days following non-occupational accidental injury, sickness or pregnancy
- Benefit Amount: 60% of monthly covered earnings
- Maximum Benefit: $4,500 per month less deductible sources of income and disability earnings.
- Minimum Benefit: $100 per month
- Benefit Period: Up to 2 years or to age 70 (whichever comes first)
- Limited Pay Periods:Disabilities due to mental illness and disabilities primarily based on self-reported symptoms are limited to 24 months of benefits during your lifetime.
- Survivor Benefits: In the event of your death, three times your net disability payment is payable to your spouse or children under age 20 or under age 26 if a full-time student at an accredited school.
Short-Term Disability (STD)
- For STD benefit of $250 per week, the monthly premium is $38.00.
Long-Term Disability (LTD)
Long Term Disability premiums are based on your age and wage rate. To calculate your LTD premium follow the steps below:
Calculating your monthly long-term disability (LTD) cost:
Enter your hourly wage rate
Multiply by 2000
Divide by 12
*If your monthly earnings exceed $7,500 (maximum monthly covered earnings) then use $7,500 as your monthly earnings to calculate your premium.
Multiply your monthly earnings by the rate for your age x your rate= $_______._____
Age as of Jan. 1st of this year
Rate per $100 of pre-disability earnings
Divide by 100 for your cost: ($/100)= $_______._____ LTD Cost
Add the short-term disability premium to determine your total monthly premium +$38.00 = $_______._____ Total Premium
**Please note that if you fall into a new age bracket as indicated above, your premium will increase. You will also experience a premium change if you have experienced a change in your pay rate.
Cancellation Requests: Cancellation requests must be received in writing by mail, fax, or e-mail. Cancellations will become effective on the last day of the month in which they are received.
Premium Waived if Disabled: Premium will not need to be paid if you are receiving benefits. Please contact us within 30 days of your disability so that we may waive your premium while you are not working.
Premium Payments: Your initial premium due will be collected within 5 business days of your enrollment. Subsequent premiums will be collected automatically from a Visa, MasterCard or direct debit from a checking account on the 15th of each month. If the 15th falls on a weekend or holiday, the charge will occur on the next business day.
The following PDF documents are provided for your reference:
Disability Claim Forms:
The disability income insurance claim form is composed of three separate sections that need to be completed by you, your physician and your employer.
- Employee Section: Please be sure to complete this part clearly and sign where indicated.
- Physician Section: Please have the physician that disabled you complete this part. If you have seen additional physicians, please also include their names, addresses, phone numbers and fax numbers on a separate sheet of paper.
- Employer Section: Even though your policy is purchased through the union, your benefit is based on the income you receive from your particular employer. Your employer assumes no liability or responsibility for your claim by completing this form for you.
Failure to provide proper information and documentation will delay your claim so it is very important the claim form is complete and clear. Once complete, forward the form to our office by mail or fax.
How Your Claim Will Be Handled:
Once received by Group Benefit Associates, we will begin waiving your premium as of the date of your disability. The processing of your claim will be handled by Guardian Life Insurance Company and therefore you may inquire with them regarding the status of your claim. Please note that Group Benefit Associates does not have access to information regarding claims determination or benefit payments. Guardian can be reached Monday through Friday from 8am to 5pm Eastern Standard Time at:
Short-Term Claims Department (for claims payable during first 6 months of disability)
800-268-2525 phone/ 610-807-8270 fax
Long-Term Claims Department (for claims payable after 6 months of disability)
800-538-4583 phone/ 610-807-9221 fax
Premium billing questions are handled by Group Benefit Associates at 800-450-1271.