Page 39 - 2022_OE Benefits Guide
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Income Protection  Long-Term Disability
      The Long-Term Disability (LTD) Plan is a fully-insured plan offered through Sun Life.  Enrollment in
 Basic Short-Term Disability  the LTD plan is voluntary.  The plan is designed to provide income protection to you during times of
 The Company provides Team Members with basic short-term disability (STD) income protection   extended illness or injury over several months or even years, depending on your age at the onset
 at no cost to you.  The STD plan is an employer-funded plan designed to provide 50% base wage   of disability.  If you are receiving benefit payments under the STD plan, your claim will automatically
      transition to Sun Life’s LTD claims unit as you near 180 days of disability.  LTD benefits, once
 replacement for non-work related injury or illness with an expected duration greater than seven days   approved, begin on the 181st day of disability.
 to a maximum benefit period of 26 weeks.

      Refer to the Disability Plan Comparison chart on p. 36 for a review of both STD and LTD income
 Buy-Up Short-Term Disability  replacement plan provisions.
 Team Members may purchase an added layer of income protection to 66.67% of base wage
 replacement by electing the Buy-Up Short-Term Disability plan.  Refer to the Disability Plan   Cost of LTD Coverage
 Comparison chart below for a review of benefits available under the Basic and Buy-Up Short Term   The Company shares equally the cost of LTD coverage with you. As of 6/1/2021, the rates have
 Disability plans.  decreased to $.13/$100 of covered earnings.  Your premium cost is determined on your base rate
 COMPANY-PAID (BASIC)   BUY-UP SHORT-TERM   of pay. These premiums are withheld on an after-tax basis. When using Dayforce to review and/or
 SHORT-TERM DISABILITY  DISABILITY  LONG-TERM DISABILITY  elect coverage, your cost of coverage is automatically populated. To manually calculate your cost of
 Plan Features  coverage, you may use this formula to calculate your cost for the LTD coverage:

 Plan Pays  50% of base wages  66.67% of base wages  60% of base wages
      Example:
 Plan Benefit Limit  $2,000/week  $10,000/month  Your Base Monthly Pay / 100 = __________ # of Units x .13 = Monthly Premium
 Benefit Payment Starts  On 8th day of disability  On 181st day of disability  Then, Monthly Premium x 12 / __________  * Pay Periods = Per Paycheck
      (*26 if paid Bi-Weekly or 52 if paid Weekly)
 Maximum Benefit Period  26 weeks  To Social Security Normal Retirement
 Age, depending on age at disability
 Who Pays for Coverage  Company Paid  Employee Paid  50/50 Company/EE Paid  Maximum LTD Benefit Period
      The Maximum Benefit Period defines the maximum length of time for which benefits are payable
 Cost of Coverage  $0  $.0235 per $10  $.13 per $100
      under the plan, provided you remain continuously disabled. The Maximum Benefit Period most
 Proof of Good Health  Not required  Yes, as a late enrollee*  typically pays until you reach Social Security Normal Retirement Age (SSNRA), depending on your age
 Pre-Existing Condition Exclusion  No  Yes, for late enrollees  at onset of disability, per the schedule here.
 Note: Benefits under short-term disability plans may be reduced by benefits paid under any state short-term disability
 programs such as those in California, New Jersey, New York and Washington.   How to Report a Disability Claim  AGE AT   MAXIMUM BENEFIT
      Call Sun life at 833-812-5177 or visit www.sunlife-ams.com and   DISABILITY  PERIOD
 TO COMPARE THE AMOUNT OF YOUR STD BENEFIT UNDER BOTH PLANS, FILL IN THE BLANKS BELOW:  Register as a new user. Please have this information handy:  < 60  To SSNRA
           • Your name, address, phone number, birth date, date of hire,
 COMPANY-PAID (BASIC) STD PLAN  BUY-UP STD PLAN                  60      60 Months*
          Social Security number
 $_____________  $_____________                                  61      48 Months*
 1. Enter your weekly base pay  (If your weekly earnings exceed    (If your weekly earnings exceed      • Your employer’s name, address and phone number
 $4,000, enter $4,000 above)  $3,000, enter $3,000 above)    • Date of your claim and when you plan to return to work  62  42 Months*
 2. Percent of wages replaced by the plan  50%  66.67%           63      36 Months*
           • If you’re pregnant, give your expected delivery date
 3. Multiply amount on line 1 by the % on     • Name, address and phone number of each doctor you are seeing   64  30 Months*
 line 2 and enter total here. This is your   $______________  $______________
 weekly STD benefit amount.  for this absence                    65      24 Months*
                                                                 66      21 Months*
 Calculate Your Cost for Buy-Up Short-Term Disability
 Your premium is determined by your base rate of pay. These premiums are withheld on a pre-tax   67  18 Months*
 basis. Shown below is the formula used to populate your premium cost, as reflected when you enroll   68  15 Months*
 using Dayforce:                                                 69+     12 Months*

 Example:                                                         *or SSNRA, whichever
 Your Base Weekly Pay x 66.67%/ 10 = # of units x .0235 = Weekly Premium*   is longer
 (*Times 2 for Bi-weekly cost)







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