Group Disability Income Insurance

Group Disability Income Insurance  

Overview

Apply for up to $10,000 Monthly Benefit

A total disability could stop your ability to earn an income in a split second. Make sure you have a reliable financial strategy in place that includes long term disability income protection. Members can turn to the California Pharmacists Association sponsored Group Long Term Disability Income Insurance that protects members in their specialty as a pharmacist.

Features include:

  • A 60 months Pharmacists Specialty Definition of Disability defined as the inability due to illness or injury, to work in your own specialty as a pharmacist for the first 60 months after the waiting period (a very important distinction vs. many policies with a broad “inability to do ANY job” definition).
  • For disabilities occurring prior to age 60, the policy provides benefits for total disability until your normal retirement age from either covered injury or sickness.

 

Insurance Application and Brochure

 

 

 

 

 

Underwritten by: New York Life Insurance Company
51 Madison Ave., New York NY 10010
Under Group Policy number G-30856-0 on Policy form GMR-FACE/G-30856-0

Tell Me More

Group Long Term Disability Income Insurance Underwritten by New York Life Insurance Company

 

Benefits Guide Information for California Pharmacists Association Members

"Stand alone" OR "Supplement"
This group coverage can be your sole, “stand-alone” disability insurance coverage. If you have some type of disability coverage through an employer, this policy can be an excellent supplement to it. That’s an approach some of our members take because these benefits are NOT taxable, unlike most employer insurance—and the coverage is 100% portable, provided you pay the premiums.

Eligibility
As a member, you are eligible to request coverage under this group coverage if you are:

  • Under age 60
  • At FULL-TIME work*
  • A resident of the U.S.;** except territories


* FULL-TIME work means the active performance of the regular duties of your normal occupation for pay or profit on the basis of at least 30 hours per week at the place such duties are performed.
** Not available in all states at this time. Contact the Administrator for current information

For rate information and to apply, click on the "Download Now" button.

Diagnostics: 3 Key Reasons Optometrists May Need Disability Coverage

1. Your income is substantial and your lifestyle is based on the assumption of that income stream

2. Your expenses are significant, including:

  • mortgage(s)
  • children’s college education savings to fully fund
  • retirement savings to fully fund
  • monthly living expenses
  • healthcare costs, insurance
  • student loan debt
  • office rent/maintenance


3. Your livelihood demands full use of your mind and body

Common Accidents & Medical Conditions Can Result in "Disability"

  • Motor Vehicle Accident
  • Sports Injury
  • Fall (ex: from ladder doing work around the home)
  • Arthritis
  • Neuropathic Damage
  • Degenerative Disc Disease
  • Post-Traumatic Stress Disorder+
  • Depression, Anxiety Disorder
  • Visual or Auditory Impairment
  • Stroke, Heart Attack, Aneurysm
  • Multiple Sclerosis, Parkinson’s Disease, ALS
  • Cancer


+ The policy limits benefits for Mental/Nervous disorders and Chemical Dependency.

 

Advantages—How It Works


Your benefit payments are TAX-FREE— you could collect 40% more each month
Under current tax laws, if you pay your own disability premiums, your benefits are tax-free. This means you’ll generally collect 40% higher benefit checks through this policy than you’d receive from a comparable program offered through an employer. Or, you may be able to claim part of your policy premiums as a tax deduction if you own your own practice. Consult with your tax advisor for more details.

Example: $10,000 monthly benefit taxed vs. tax-free:
(40% paid to state and federal income taxes)

Taxable Plan:  pays $6,000.00 per month vs. Tax-Free CMA/County Plan: pays $10,000.00 per month (you net 40% more)

TAX-FREE benefit payments assume you don’t choose to take your insurance premiums as a tax deduction. Of course, always consult with your tax advisor for the best advice for your individual situation.

You can collect if you cannot work within YOUR specialty as a pharmacist
As a pharmacist, your occupation is highly specialized. And if you can’t perform the duties of your occupation due to a covered Total Disability, the policy will pay your monthly income benefits for the first 60 months of a total disability.

Your coverage is portable—you can take this coverage with you anywhere you go*
Unlike hospital, healthcare systems, or other employer-paid or sponsored policies, you own your group coverage. It can go wherever you go, as long as you remain an Association member and are otherwise eligible. You don’t have to worry about losing your disability insurance because you change employers or if you strike out on your own as part of a practice or as a sole practitioner.

* Subject to policy terms and U.S. government regulations on restricted countries.



You pay group rates
This policy is only available to members. Rates have been specifically negotiated on your behalf. The policy pays monthly benefits if you are Totally Disabled.

Totally Disabled means an incapacity from an injury or sickness that completely and continuously prevents you from doing the material and substantial acts of your medical specialty, during the waiting period and the next 60 months of a total disability. After this period, you will be considered Totally Disabled if you are unable to perform the material duties of any gainful job for which you are reasonably fit by training, education or experience. The total disability must be a result of a covered injury or sickness. To be considered totally disabled, you must also be under the regular care of a physician, other than yourself or a member of your immediate family, and not performing the duties of any gainful job.

Maximum Benefit period for disabilities beginning:
Before age 60 – To his or her normal retirement age (NRA)+
Age 60 but before age 64- to his or her 65th birthday
Age 64 but before age 70-12 months

 


Benefits for disabilities due to mental disorders and chemical dependency/alcoholism are limited to 24 months.

 

+ The Normal Retirement Age (NRA) will gradually increase to age 67 from age 65, depending on year of birth. For example, members born in 1948 have an NRA of 66 years. Members born in 1960 or later have an NRA of 67 years.

 

You collect benefits regardless of any other coverage
This policy will pay you in addition to whatever you may collect from any other disability coverage (private, group, employer, any type) OR from any Social Security or other government benefit. Your benefit payments under this policy are never reduced because of other insurance/disability funds you may be entitled to collect. However, please note that your coverage amount, together with any other disability coverage you may have, may not exceed 60% of your AVERAGE MONTHLY INCOME.

AVERAGE MONTHLY INCOME means 1. If you’re self-employed, your wages, salaries, commissions, fees and other amounts received for personal services. If your business is incorporated, the cost of fringe benefits and your share of the monthly net profit of the corporation, whether received or not received. 2. If you’re not self-employed, your basic rate of compensation from your employer, including commission. AVERAGE MONTHLY INCOME is based on the immediately preceding period which produces the highest average: the preceding tax year; the preceding two tax years; or the entire period, if less than 12 months. It is computed before deduction of income or social insurance taxes and after deduction of the normal business expenses which are deductible for income tax purposes. It does not include bonuses, overtime pay or other compensation.

You have a broad choice of monthly benefit options to fit your needs/budget—from $500 to $10,000
If you are under age 50, you may apply for up to $10,000 in Monthly Benefits (in $500 units). If you are between the ages of 50 and 59, you may apply for up to $6,000 in Monthly Benefits. However, the option you choose, together with any other disability income insurance you may have, cannot exceed 60% of your AVERAGE MONTHLY INCOME.

Starting at age 65, your Monthly Benefit amount is reduced 5% each year through age 69. Benefits will not be reduced while you are on a claim.

You have 100% freedom and control of your benefit payments—NO restrictions on how you use the money
All benefit payments are sent to you directly, by check. The benefit is never paid to any medical provider, mortgage company, or other person unless you specifically direct it. Use the money however you choose with no limitations or requirements.

Your premiums are waived during disability—you owe $0 premiums if you become Totally Disabled
The last thing you should worry about during a disability is paying for your coverage. So, we made sure you wouldn’t owe any premiums if you become Totally Disabled. After you have been Totally Disabled for at least six months, all future premium contributions will be waived for that disability. Please see your certificate for more detailed information.

You can collect “Residual Disability” benefits—helps you supplement lost income while recovering from a Total Disability
If you go back to work after a period recovering from a Covered Total Disability, you may be eligible for a Residual Disability Benefit if you sustain a loss of at least 25% of your predisability earnings. To qualify for the Residual Disability Benefit, Refer to your Certificate of Insurance for more information on this benefit. This benefit will end if you return to work in an occupation other than your own specialty as a pharmacist.

You have a choice of waiting periods
Create custom coverage that suits your income needs and gives you the right benefit/price combination. Help replace your lost income so you can continue to pay your monthly expenses. You may select waiting periods of 90 or 180 days. If you select the two-year plan, only the 90 day waiting period is available. Coverage with a longer waiting period will be less expensive.

 

Optional Benefits

 

You can choose a “Cost-of-Living” Benefit—helps your benefit amount keep pace with inflation
This optional benefit offers disability coverage that, once benefits begin, can help keep pace with the rate of inflation. Monthly benefits will be adjusted annually beginning one year after the date the waiting period begins if you are Totally Disabled prior to age 65. Adjustments may be made to the monthly benefit paid in the second and each succeeding year up to a maximum of 10 adjustments. The adjustment amount will be based on the consumer price index for urban consumers (CPI-U) up to a maximum six percent increase per year and an overall maximum increase of one times the original benefit. Once you are no longer disabled and benefit payments stop, the monthly benefit returns to the original option amount.

Recovery Benefit
You can receive a lump sum recovery benefit upon your return to FULL-TIME WORK following a Covered Total Disability for which you received a Total Monthly Benefit. The benefit payable will be ¼ of the Total Monthly Benefit amount received for each full month of Total Disability to a maximum of three times the last Total Monthly Benefit. For more information, please refer to your Certificate of Insurance.

You can never be singled out for a rate increase
This is a group policy exclusively for CPhA members, which means you can never be singled out for a premium increase, even if there is a change in your health or where you reside. However, your rates may change only if they are changed for all others in the same class of insureds.

When Coverage Starts (Effective Date)
You will become insured on the date approved by New York Life Insurance Company provided the first premium contribution is paid when due, satisfactory evidence of insurability has been submitted and you are at FULL-TIME WORK on that date.

If you are not at FULL-TIME WORK as required, coverage will not become effective until the day you are at FULL-TIME WORK provided such date is within six months of the date insurance would have been effective and you are still eligible for insurance.

Payment of a premium contribution for insurance does not mean there is any coverage in force before the effective date approved by New York Life Insurance Company.

When Coverage Ends
Once coverage is validly in force, until you reach age 70. Coverage will end earlier if: you cease FULL-TIME WORK other than for reasons of total disability, cease to be an Association member, fail to pay premium contributions when due, enter full-time active duty in the armed forces (coverage may be restored upon termination of active duty status, subject to policy guidelines), group policy is terminated or modified to exclude coverage for the group of individuals to which you belong or the association sponsors a similar policy of disability income insurance for members.

Exclusions & Limitations
The policy does not provide benefits for any disability that occurs during or is due or related to: intentionally self-inflicted injury while sane or insane (Missouri Residents: This exclusion is not applicable to injury caused by an intentionally self-inflicted injury while insane.), declared or undeclared war or any act thereof, or incarceration or participation in (except as a victim) an illegal occupation/activity or the commission of a crime, flying in any aircraft, except as a fare-paying passenger on a licensed commercial carrier: PREEXISTING CONDITION (except as noted below) or any impairment or disease specifically excluded from your coverage.

No benefits are payable for any disability for which you are not under the regular care of a licensed physician or surgeon other than yourself, your business associate, or member of your immediate family or household.

The policy limits benefits for disabilities due to mental disorders to 24 months. Benefits for disabilities due to chemical dependency are limited to 24 months.

A PREEXISTING CONDITION is an injury or illness for which you consulted a physician, took medication, or received medical services or supplies during the immediate 12-month period prior to becoming insured under this plan. Benefits are not payable for a disability due to a PREEXISTING CONDITION until the end of the earlier of: 12 consecutive months during which you have not consulted a physician, taken medication, or received medical services or supplies; or 24 months.

New York Life reserves the right to request medical information needed to determine an applicant’s eligibility for coverage. Based upon the age of the person proposed for insurance and the amount of coverage requested, a physical exam, EKG, blood test or other medical information may be required.

Not all applicants will have to supply additional information. However, if required, we will arrange for an independent professional paramedic to contact you to perform these simple tests at your convenience. The exam and blood test will be paid for by the policy.

Request for insurance will be processed promptly and coverage will be issued for members whose evidence of insurability has been found to be satisfactory.

Important Notice:

How New York Life Obtains Information and Underwrites Your Request For Group Disability Income Insurance

In this notice, references to “you” and “your” include any person proposed for insurance. Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualify for insurance, we will rely on the medical information you provide, and on the information you AUTHORIZE us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, LLC. (“MIB”). MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. If you apply for life or health insurance coverage, a claim for benefits is submitted to an MIB member company, medical or non-medical information may be given to MIB, and such information may then be furnished by MIB, upon request, to a member company.

Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application for insurance, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying New York Life in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.

MIB and other insurance companies may also furnish New York Life, its subsidiaries or the Plan Administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other applications for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.

New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing, however, this will not be done in connection with test results concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but we will not disclose our underwriting decision

New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a "need to know" basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.

If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB's information office is: MIB, LLC., 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 866-692-6901. For Canadian residents, the address is: MIB Information Office, 330 University Avenue, Suite 501, Toronto, Ontario, Canada M5G 1R7, telephone 416-597-0590. Information for consumers about MIB may be obtained on its website at www.mib.com.

 

For NM Residents: PROTECTED PERSONS1 have a right of access to certain CONFIDENTIAL ABUSE INFORMATION2 we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.

1PROTECTED PERSON means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured person or prospective insured person.

2CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.

 

100066                                                                                                                          New York Life Insurance Company

                                                                                                                                       8/12 ed.

Contacts

We're here to help! Please contact us in whatever manner is most convenient for you.

 

 Address
AMBA
4050 114th Street
Urbandale, Iowa 50322
 Phone
1-888-926-CPhA
 Hours
 M-F 8a-5p PST
 Email
[email protected]

FAQS

Answers about this coverage including eligibility, options, enrollment, customer service and more.
  • Who is the underwriter?

    Underwritten by New York Life Insurance Company, 51 Madison Avenue, New York, NY 10010, under Group Policy No. G-30856-0, on Policy Form G-30856-0/GMR-FACE.

     

    About New York Life Insurance Company.

     

    IMPORTANT NOTICE

     

    For information on ratings for AMBA:

    Rating Agencies Disclaimer

  • How much insurance should I consider?

    This depends on a number of factors including: the disability benefits that you may receive from your employer, the amount of private disability income insurance you may have in force, plus the household income that will continue during your disability.
  • Who is eligible for this insurance?

    Members under age 60 who are at FULL-TIME WORK (as defined in the brochure) are eligible to request coverage.

     

    This coverage is available to residents of the United States (except LA, MT, NH, OR, SD, VT, WA and territories) and Puerto Rico.

  • Can you explain the two options?

    Two-Year Plan
    Provides benefits for total disability due to a covered injury or sickness for up to two years.

     

    Long-Term Plan
    Provides benefits for total disability due to a covered injury or sickness up to: Normal Retirement Age if total disability begins prior to age 60; to age 65 if total disability begins on or after age 60 but prior to age 64; or 12 months if total disability begins on or after age 64 but prior to age 70.

  • What is the waiting period?

    You have a choice of two waiting periods. Choose eiher a 90 or 180 day. A waiting period is the number of consecutive days you must be Totally Disabled before benefit payments begin. You should choose one that will provide benefits when your employer-provided salary continuation plan runs out. Coverage with a longer waiting period is less expensive.
  • How much insurance can I apply for?

    If you are under age 50 on the effective date of coverage, you may apply for benefits up to $10,000 per month. If you are at least age 50, but under age 60 on the effective date of coverage, you may apply for up to $6,000 per month. The amount you choose cannot exceed 60% of your AVERAGE MONTHLY INCOME. At age 65, the benefit amount is reduced by 50% of the amount in effect on the day before you attained age 65.
  • How is Total Disability defined?

    "Totally Disabled" means you are prevented by illness or injury from performing the material and substantial duties of your usual occupation, provided you are not otherwise working for pay or profit.
  • Will I meet with a sales person?

    Issuance of this coverage is handled over the Internet and the mail. You can review the materials in the privacy of your home and purchase your coverage directly through the mail without meeting with a salesman. You can, of course, talk to a licensed representative if you'd like. Please view the Contact Us section for the Programs Administrator's toll-free number.
  • When is the coverage effective?

    You will become insured on the date approved by New York Life Insurance Company provided the first premium contribution has been paid, satisfactory evidence of insurability has been submitted, and you are actively performing the normal activities of a person in good health of like age on that date. If you are not performing your normal activities as required, coverage will not become effective until the day you are performing such normal activities provided such date is within three months of the date insurance would have been effective and you are still eligible for insurance.

     

    Note: For Residents of NC: Any references to the performance of normal activities by a person in good health of like age are replaced by the requirement that your health status remains the same as stated on your application.

     

    Payment of a premium contribution for insurance does not mean there is any coverage in force before the effective date specified by New York Life Insurance Company.

  • When does the coverage end?

    Once coverage is validly in force, it may be continued to the premium due date on or immediately after you reach age 70, unless: the maximum benefit period has been reached, you cease FULL-TIME WORK (as defined in the brochure) other than for reasons of disability, you cease to be a member, ceases to be a participating organization, you fail to pay premium contributions when due, you enter full-time active duty in the armed forces (coverage may be restored upon termination of active duty status, subject to policy guidelines) or the group policy is modified or terminated by the policyholder or New York Life Insurance Company to end insurance on the group of insureds to which you belong.
  • Are there any exclusions?

    Yes. Please refer to the Brochure for more information.
  • What if I have second thoughts after I apply?

    When you become insured, you will be sent a Certificate of Insurance summarizing your benefits. If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will be sent a full refund—no questions asked!

     

    The information on this site describes benefits available through this insurance program and is intended to provide a brief overview of the coverage. In the event of any conflict or inconsistency between the information on this site and the information contained in the underlying plan documents, the plan documents will in all respect control and govern. If any provision is not explained or only partially explained, your rights will always be determined under the provisions of the underlying plan documents.