AOCDS/FOP Individual LTD Plan
| Features/Benefits | FOP #18 CLEA (Enhanced Individual Plan) | AOCDS Plan (Group UNUM Ins. Plan) |
| Monthly Cost |
$32.00 per month, level cost Voluntary individual participation Convenient AOCDS payroll deduction |
$56.00 per month Voluntary group participation Convenient AOCDS payroll deduction |
|
Percentage Of Wages Protected*
|
85% of wages Non-Industrial Disability 70% of wages Industrial Disability (100% of wages for Catastrophic Disabilities for up to 30 months – not to exceed maximum monthly benefit) (No Workers’ Comp. Permanent Disability offsets) Maximum Benefit of $10,000 per month, tax-free (90% of wages for Non-Industrial Disability if continuously insured by and benefits are payable under the AOCDS Group UNUM Plan during the first calendar year of disability) |
66.67% of wages Industrial and Non-Industrial Disability (No permanent disability offsets) Benefits payable in addition to Annual Leave Balance Maximum Benefit $5,500 per month, tax-free |
| Waiting Period | 30 Calendar days – If less than 60 days of personal leave, you may receive 70% of wages after 30 days. Otherwise, 60 calendar days. |
30 calendar days |
| Benefit Period | Lifetime: Sickness, Accident and Pregnancy (Industrial Disability and Non-Industrial Disabilities) |
Maximum three (3) years coverage for Sickness, Accident, and Pregnancy for both Industrial and Non-Industrial Disabilities |
| Cost of Living Benefit (COLA) | 3% compounded per year (years 3-8) thereafter, CPI increase to age 65 and then continued lifetime benefits | None |
| Drug and Alcohol Abuse |
Six (6) months lifetime coverage (3 months per occurrence) |
Twenty-four (24) months coverage after 30 days |
| Stress & Psychological Conditions |
3 months per occurrence, 18 month maximum aggregate lifetime benefit. Must return to work for 1 year between each occurrence. Additional benefits may be payable if hospitalized. |
Twenty-four (24) months coverage after 30 days |
| Waiver of Payment | Waiver of Payment after no-pay status | After 30 days and receiving benefits |
| Benefits Payable During Challenged Workers’ Compensation Cases | After 60 calendar days – 70% of wages to a Maximum Benefit of $10,000 per month (Repayable only if settled in your favor) |
66.67% of wages after 30 days – Maximum Benefit $5,500 per month (Repayable if determined to be Industrial) |
| Minimum Monthly Benefit |
$1,000 per mo. – paid in addition to personal leave after 60 calendar days. ($100 per mo. for Disputed Workers’ Compensation claims.) |
None |
| Pre-Existing Medical Condition Coverage | All pre-existing medical conditions will be covered once you have been in the Plan for sixty (60) months, unless you are eligible for the Prior Coverage Credit – otherwise, pre-existing medical conditions will not be covered. | You may apply during open enrollment without having to complete “health screen” unless you have been previously declined by UNUM. In all cases, pre-existing conditions will apply. Claims for pre-existing conditions will be covered after 12 months after effective date of coverage. |
| Death Benefit |
$65,000 Death Benefit on- or off-duty natural, accidental or terminal illness *** $10,000 for suicide ($2,000 first 2 Years in Plan)** (Benefits may be payable within 24 hours of notification) |
None |
| Survivorship Benefit | Six (6) months addition benefits to dependent beneficiary | Three (3) months disability benefits |
| Ownership of Plan | Owned, operated and managed by its Participants through a representative Board of Directors (non-profit California Corporation since 1985) | Owned, operated and managed by the UNUM Ins. |
Special Provision: Participants not covered by Penal Code 830.1 and 830.2(a) will have limited benefits (36 months Maximum Benefit at 70% of wages and one (1) year Own Occupation Disability Plan Provision) if they suffer a disability that would normally be covered by Labor Code 3212 and its subchapters, and the disability is not determined to be job-related.
* Maximum percentages reflect amount payable after completion of (a) waiting period, (b) freeze of personal leave option, or (c) personal 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.
The California Law Enforcement Association (Safety Personnel) Long Term Disability Plan was established pursuant to the California Department of Insurance, Insurance Code Sections 11400 – 11407 (Peace Officers Benefit and Relief Association) by CLEA, a police officers benefit and relief association. CLEA is a non-profit corporation exempt from tax under Internal Revenue Code Section 501(c)(9). The Plan, CLEA and the Trust, are annually audited by independent certified public accountants in conformity with generally accepted accounting principles.
4-18 This is a highlight page only – certain exceptions & limitations apply. See the complete Plan Document provisions for a more complete description of coverage. CA Insurance Lic. #0544968