This disability plan long-term template has 9 pages and is a MS Word file type listed under our human resources documents.
Sample of our disability plan long-term template:
Long-Term disability plan Introduction If you are unable to work due to illness or accidental injury that lasts longer than [NUMBER] consecutive days, you may be entitled to benefits under the [YOUR COMPANY NAME] Long-Term Disability (LTD) Plan. Established [DATE], the Plan covers eligible employees of [YOUR COMPANY NAME]. In a nutshell: Qualifying employees who are totally disabled receive a benefit equal to [%] of basic monthly compensation as defined in the Plan. Benefits may continue for up to [NUMBER] months if you are certified totally disabled and are unable to perform the duties of your regular job. Benefits may continue for longer than [NUMBER] months if you continue to be certified disabled and are unable to do any work consistent with your education and training. This is a summary plan description. These regulations require that the rights, benefits, and limitations of a welfare plan be explained in ordinary, non-technical language capable of being understood by the average plan participant. This is, by its nature, a summary. If there is any conflict between this summary and the complete Plan and related trust agreement, the provisions of the Plan document and trust agreement will be controlling. Copies of the LTD Plan document are available from [Name of person who keeps the LTD policy, if this is applicable]. Definitions Active work, actively at work, active employment A Plan participant's attendance in person at his or her usual and customary place of work, acting in the full-time performance of the duties of his or her occupation for wages or profit. This includes company-authorized vacation or personal leave. Claims administrator The organization or person who is at any particular time processing claims for benefits and fulfilling other specified duties of the Claims Administrator under the Plan. Participant Any employee becoming covered under the terms and provisions of the Plan. Each active employee of [YOUR COMPANY NAME] who has completed one year of service and who is a participant in [YOUR COMPANY NAME]'s pension plan. For [YOUR COMPANY NAME], the term includes all active, regular employees who have completed one year of service and are participants in [YOUR COMPANY NAME]'s pension plan, and all full-time hourly and part-time hourly employees who have [NUMBER] years' service in [YOUR COMPANY NAME]'s pension plan. Employee Each active employee of an employer, including, in the case of [YOUR COMPANY NAME], all active full-time hourly and part-time hourly employees. Employer [YOUR COMPANY NAME]. First day of long-Term disability The first day after a [NUMBER]-consecutive-day period in which the Participant is unable to perform the material duties of his or her occupation solely because of sickness or accidental injury. First day of total disability The first day on which the Participant is unable to perform the material duties of his or her occupation solely because of sickness or accidental injury. Physician Any person (other than the Participant or his spouse, child, brother, sister, or parent, or the child, brother, sister, or parent of the Participant's spouse) who is licensed by the law of the state in which treatment is received as qualified to treat the sickness or injury for which claim is made under the Plan. Plan [YOUR COMPANY NAME]'s Long-Term Disability Plan. Plan administrator [Name of plan administrator] Qualifying period The [NUMBER]-consecutive-day period during which a participant is totally disabled, commencing on the first day on which he or she is totally disabled. To be eligible to receive Plan benefits, a participant must satisfy the entire qualifying period and be determined to be totally disabled under the terms of the Plan. Rehabilitation program A program to help any participant return to active, permanent work. Total disability An employee is considered totally disabled when he or she is unable to perform the material duties of his or her occupation solely because of sickness or accidental injury. Trust The [YOUR COMPANY NAME] Employee Benefit Trust that has been established to fund the benefits under the Plan. Trust assets The total of all assets of every kind or nature, both principal and income, at any time and from time to time held in the trust. Trustee The corporation and/or individual or individuals who from time to time is or are the duly appointed and acting trustee or trustees of the trust. Participation Eligibility Active employees of [YOUR COMPANY NAME] are eligible to participate in the Long-Term Disability Plan once they have completed one full year of service and have satisfied the requirements for participation in the [YOUR COMPANY NAME] Consolidated Pension Plan (completion of [NUMBER] hours of employment in a [NUMBER]-month period marked by anniversaries of your date of hire). In the case of [YOUR COMPANY NAME] full-time hourly and part-time hourly employees, participation in the LTD Plan is available once you complete [NUMBER] years of qualifying service. LTD benefits are not available to retirees. Commencement of participation Participation begins on the date you satisfy the eligibility requirements. If you are absent from work for any reason other than approved personal leave or vacation on the date on which you become eligible, you become a participant on the date on which you return to active work. Termination of participation Participation in the Plan ends when one of the following occurs: You are no longer an active, regular employee of a participating employer. The Plan is terminated (regardless of whether or not you are disabled). You retire under the [YOUR COMPANY NAME] Consolidated Pension Plan. Disclaimer of employment obligation Participation in the Plan does not limit [YOUR COMPANY NAME]'s right to discharge any participant from employment, nor does it give any employee the right to continued employment. Entitlement to benefits To qualify for LTD benefits, you must be totally disabled for a [NUMBER]-consecutive-day period, you must be under the regular care and treatment of a licensed physician and you must be certified disabled by [ADMINISTRATOR'S NAME], based on conclusive medical evidence. You must also have applied for Social Security disability benefits and for any benefits available to you through other disability programs, including those available through the state in which you reside. Total disability and the qualifying period You are considered totally disabled when you are unable to perform the material duties of your occupation solely due to sickness or accidental injury. To qualify for Plan benefits, you must be totally disabled for a [NUMBER]-consecutive-day period. During that time, you may qualify for benefits under [YOUR COMPANY NAME]'s salary continuation/short-term disability program. Even in cases where short-term benefits are, you could be entitled to LTD benefits if your disability is continuous for [NUMBER] consecutive days. Recurrent and successive disability during the qualifying period All days from the onset of disability on which you cannot work will be considered to be "continuous" and "consecutive" days of disability if they are from the same cause, unless you are able to return to work for a period of [NUMBER] days or more during the qualifying period. Unrelated disability If during your initial total disability qualifying period you incur an unrelated total disability while you are unable to work, you may aggregate your periods of total disability for purposes of satisfying the [NUMBER]-day qualifying period. Recurrent and successive disability after the qualifying period If you return to work following a period of long-term disability and become disabled due to the same or related problems within six months following your return to work, you will not be required to complete an additional qualifying period.
