long term disability
SELECT TRUST PLUS Recommended for Groups of 2 to 9 Employees
Long Term Disability
Select Trust Plus Long Term Disability Recommended for Groups of 2 to 9 Employees
BENEFIT AMOUNTS Kansas City Life Insurance Company’s comprehensive Long Term Disability (LTD) program is preferred by many small group employers. The LTD product provides employees with a maxi-
The insured employee is eligible for a total benefit of 60 percent of insured monthly earnings, if his or her total disability is due to an injury (accident) or sickness (illness, pregnancy or disease); the maximum monthly benefit of $1,000 or $5,000 is elected by the employer. Benefits payable from other sources, including those listed below, reduce the initially calculated benefit: • Primary and dependent disability benefits payable under Social Security. • Worker’s compensation or any governmental disability or retirement program including primary and dependent retirement benefits from Social Security. • Employer-funded retirement benefits or pension plans or payments from any employer or self-employment. • Employee benefit plans or arrangement or group insurance providing a disability benefit. • Regardless of total income from other sources, the LTD benefit will never be less than $50 or 15 percent of gross monthly benefit, whichever is greater.
mum monthly benefit of $5,000, protecting
BENEFIT SCHEDULES
up to $100,000 of an
Two different benefit schedules are available depending on industry classification.
employee’s annual earn-
The maximum benefit period payable depends on the age of the insured employee when total disability begins, the nature of the disability and industry classification, as illustrated in the following chart.
ings. We give employers the flexibility to choose
Nature of Disability
either a 90- or 180-day
Age at Disability
elimination period. The
Prior to age 62
plan’s partial disability benefits encourage disabled employees to return to work. Additionally, no medical exams or evidence of insurability is required, except for late enrollees.
Industry I
Industry II
Injury & Sickness
Injury
Sickness
To Normal Retirement Age or for 42 months, if greater
To Normal Retirement Age or for 42 months, if greater
60 months or to Normal Retirement Age, whichever occurs first
Both Injury & Sickness
Age 62 Age 63 Age 64 Age 65 Age 66 Age 67 Age 68 Age 69 and over
42 months 36 months 30 months 24 months 21 months 18 months 15 months 12 months
Age 62 Age 63 Age 64 Age 65 Age 66 Age 67 Age 68 Age 69 and over
42 months 36 months 30 months 24 months 21 months 18 months 15 months 12 months
Normal Retirement Age means the Social Security Normal Retirement Age as stated in the 1983 revision of the United States Social Security Act.
Benefit durations provided are in compliance with age discrimination legislation.
ELIMINATION PERIODS The employer may select an elimination period of 90 or 180 days.
OTHER PROVISIONS INCLUDED • Cost of living benefit freeze — Monthly benefit will not be reduced by a cost of living benefit increase that the employee receives from any other source of income. • Partial disability benefit — A benefit is payable if a disabled employee is receiving disability benefits and returns to work part-time. • Waiver of premium benefit — Premium will be waived after the employee completes the elimination period and for as long as benefits remain payable.
ELIGIBLE EMPLOYEES To be eligible for coverage, an employee must be an active full-time employee and have completed the eligibility waiting period.
EMPLOYER-DEFINED ELIGIBILITY Employers have the option of insuring all full-time employees, one class of employees or several classes of employees. Carve-out eligibilities (plans that cover selected full-time employees) are to be defined in a nondiscriminatory manner.
PARTICIPATION REQUIREMENTS • The employer may choose to pay 100 percent of LTD premium, in which case all eligible employees must be insured. • The cost of the premium may be shared by the employer and employees; however, the employer must pay a minimum of 25 percent of the premium. When an employee is required to pay a portion of the cost, the following participation is required: Number of eligible employees
Minimum participation
2-5 6-9
100% all but one
DEFINITION OF PRE-EXISTING CONDITION A pre-existing condition is any condition for which an employee received medical advice or treatment in the 12-month period prior to coverage being effective. Any disability due to a pre-existing condition will not be covered unless the disability begins after: • The employee has gone 12 consecutive months without treatment. • The employee has been continuously insured for 24 months.
DEFINITION OF TOTAL DISABILITY Total disability is being unable to perform the essential duties of the employee’s own occupation for the elimination period and 24 months. Thereafter, it is being unable to perform the essential duties of any occupation for which the insured employee is reasonably qualified by education, training or experience.
EXCLUSIONS The plan does not cover — and no benefit will be paid — for any disability: • If the employee is not under the regular care of a physician. • Caused or contributed to by a war or act of war (declared or not). • Caused by the commission of, or attempt to commit, a felony. • Caused or contributed to by an intentionally self-inflected injury. • Covered or is eligible for coverage under the employer’s prior disability plan.
ELIGIBLE INDUSTRIES Industry I (Preferred Groups) The following industries or eligibilities have historically produced better-than-average experience. Therefore, these groups have a more liberal benefit schedule. Benefits for injury or sickness are payable to Social Security Normal Retirement Age. Specific industries are classified by 1987 Standard Industrial Classification (SIC) codes. The first two digits of the SIC code are shown. Communications SIC 48xx Depository Institutions SIC 60xx Non-depository Credit Institutions SIC 61xx Insurance Carriers SIC 63xx Holding & Other Investment Offices SIC 67xx Advertising; Mailing, Commercial Art & Stenographic Services (except 7322-7323) SIC 7311-7338
Computer Programming Services SIC 7371-7379 Educational Services SIC 82xx Engineering, Accounting, Research, Management & Related Services except Facilities Support Management Services SIC 87xx (except 8744) Public Finance, Taxation & Monetary Policy SIC 93xx
For the following types of firms, only executive, administrative, sales, supervisory and clerical employees whose duties are primarily inside-office are eligible for LTD: Apparel & Other Finished Products Mfg. SIC 23xx Furniture & Fixture Mfg. SIC 25xx Printing, Publishing & Allied Industries Mfg. SIC 27xx Rubber & Plastics Products Mfg. SIC 30xx Fabricated Metal Products Mfg. except machinery & transportation equipment SIC 34xx Industrial/Commercial Machinery & Computer Equipment Mfg. SIC 35xx
Electrical Equipment & Components Mfg. except computer equipment SIC 36xx Measuring, Analyzing & Controlling Instruments; Photographic, Medical & Optical Goods; Watches & Clocks Mfg. SIC 38xx Wholesale Trade — Durable Goods (except 5093) SIC 50xx Wholesales Trade — Non-durable Goods SIC 51xx Museums, Galleries & Zoos SIC 84xx
Industry II For following types of firms when all employees are being covered. Industry II is any industry which isn’t classified as Industry I or ineligible. Some examples would be: Special Trade Contractors SIC 17xx Apparel & Other Finished Products Mfg. SIC 23xx Furniture & Fixture Mfg. SIC 25xx Paper & Allied Products Mfg. SIC 26xx Printing, Publishing & Allied Industries Mfg. SIC 27xx Rubber & Plastics Products Mfg. SIC 30xx Leather & Leather Product Mfg. SIC 31xx Primary Metal Industries Mfg. SIC 33xx Fabricated Metal Products Mfg. except machinery & transportation equipment SIC 34xx Industrial/Commercial Machinery & Computer Equipment Mfg. SIC 35xx Electrical Equipment & Components Mfg. except Computer Equipment SIC 36xx Transportation Equipment SIC 37xx Measuring, Analyzing & Controlling Instruments; Photographic, Medical & Optical Goods, Watches & Clocks Mfg. SIC 38xx Wholesale Trade — Durable Goods SIC 50xx
Wholesale Trade — Non-durable Goods SIC 51xx Building Materials, Hardware, Garden Supply & Mobile Home Dealers SIC 52xx General Merchandise Stores SIC 53xx Food Stores SIC 54xx Apparel & Accessory Stores SIC 56xx Home Furniture, Furnishings & Equipment Stores SIC 57xx Misc. Retail (except 5912, 5983, 5984, 5989, 5999) SIC 59xx Security & Commodity Dealers SIC 62xx Insurance Agents & Brokers SIC 64xx Real Estate SIC 65xx Credit & Collection Agencies SIC 7322-7323 Services to Dwellings; Misc. Equipment Rental & Leasing SIC 7342-7359 Passenger Car Rental & Leasing SIC 7514-7515 Misc. Repair Services SIC 76xx Motion Pictures SIC 78xx Museums, Galleries & Zoos SIC 84xx
For the following types of firms, only executive, administrative, sales, supervisory and clerical employees whose duties are primarily inside-office are eligible for LTD: General Contractors SIC 15xx Food & Kindred Mfg. SIC 20xx Tobacco Products Mfg. SIC 21xx Textile Mill Products SIC 22xx Lumber & Wood Product Mfg. SIC 24xx
Petroleum Refining & Related Industries SIC 29xx Stone, Clay, Glass & Concrete Product Mfg. SIC 32xx Misc. Mfg. SIC 39xx Electric, Gas & Sanitary Services SIC 49xx
INELIGIBLE INDUSTRIES Agricultural Production – Crops SIC 01xx, 02xx, 07xx Forestry SIC 08xx Fishing, Hunting & Trapping SIC 09xx Mining SIC 1011-1499 Heavy Constructions SIC 16xx Chemicals & Allied Products SIC 28xx Railroad Transportation SIC 40xx Local & Suburban Passenger Transportation, Ambulance Services SIC 41xx Motor Freight Transportation & Warehousing SIC 42xx US Postal Services SIC 43xx Water Transportation SIC 44xx Transportation by Air SIC 45xx Pipeline except natural gas SIC 46xx Transportation Services SIC 47xx Junk/Scrap Metals SIC 5093 Auto Dealers, Gas Services & Sanitary Services SIC 55xx Eating & Drinking Establishments SIC 58xx Liquor Stores SIC 5921 Fuel Oil Dealers SIC 5983, 5984, 5989 Misc. Retail SIC 5999 Hotel, Rooming Houses, Camps & Other Lodging Places SIC 70xx
Personal Services (laundry, barber shops) SIC 72xx Employment Agencies: Help Supply Services SIC 7361-7363 Detectives, Guard & Armored Car Services; Security Services SIC 7381-7382 Auto Repair, Services & Parking (except 7512 & 7515) SIC 75xx Amusement & Recreation Services SIC 79xx Health Services SIC 80xx Legal SIC 81xx Social Services SIC 83xx Membership Organizations SIC 86xx Facilities Support Management Services SIC 8744 Private Households SIC 88xx Services not elsewhere classified SIC 89xx Executive, Legislative & General Government, except finance SIC 91xx Justice, Public Order & Safety SIC 92xx Administration of Human Resource Programs SIC 94xx Administration of Environmental Quality & Housing Programs SIC 95xx Administration of Economic Programs SIC 96xx National Security & International Affairs SIC 97xx Non-Classified Establishments SIC 99xx
ELIGIBILITY Firms engaged in similar businesses not specifically mentioned will be considered on an individual basis. Kansas City Life should be contacted before a sale if you have a question about the eligibility of a firm. All firms are subject to Kansas City Life’s approval before acceptance. A firm is not eligible if: • Composed of 90 percent or greater blue-collar content. • Not participating in Social Security. • In business less than one year. • Any employees reside on employer’s premises.
EFFECTIVE DATE LTD coverage will be effective on the first day of the month following acceptance by Kansas City Life. This is not a certificate of insurance, but a brief description only. The group policy alone determines all rights and benefits. Kansas City Life reserves the right to withdraw this offer at any time. Products may not be available in all states. Please contact your Kansas City Life Group Benefits sales representative for more details.
LTD RATES Monthly Rates per $100 of Insured Monthly earnings Firms Insuring 2 through 9 Employees
Age
90-Day Elimination Period
180-Day Elimination Period
Industry I II
Industry
I
II
Under 40
.61
.57
.48
.43
40-44
.81
.67
.75
.57
45-49
1.18
1.01
.94
.75
50-54
1.55
1.45
1.31
1.12
55-59
1.90
2.13
1.66
1.76
60-64
2.25
2.91
1.93
2.49
65 & Older*
2.94
3.82
2.63
3.43
EMPLOYEE CENSUS/LTD PREMIUM CALCULATION Employer Group Elimination Period
days
1 Employee Name
2
Industry I or
Current Age
3 Regular Monthly Earnings* in (100s)
39
50
Industry II
4 Monthly Rate Per $100 of Regular Monthly Earnings
x
5
=
Monthly Premium
Example: John Doe
.37
$18.50
1. 2. 3. 4. 5. 6. 7. 8. 9.
CALCULATION INSTRUCTION
6
Monthly Premium Charges
7
Billing Charge
$10.00**
6+7 Total Monthly Premium
A. List employer’s group name, address, elimination period and industry. B. List employees including name, age and monthly earnings in $100s, (i.e. $5,000 would be 50). *All regular monthly earnings from the participating employer (excluding overtime and bonuses), to a maximum of $8,333 a month, are to be insured for a $5,000 maximum benefit. The maximum monthly earnings for the $1,000 plan is $1,667. C. Determine appropriate monthly rate based on number of insured employees, elimination period and industry. Enter monthly rate for each insured employee in Column 4. Multiply amount in Column 3 by Column 4. Enter sum in Column 5. D. Total employees’ monthly premium to obtain monthly premium charges for all insured employees. Enter this amount in Box 6. E. The total monthly premium will be the monthly premium charges (Box 6) plus the billing charge (Box 7). ** Add this charge if firm does not already have another line of coverage with Kansas City Life through Select Trust Plus.
Send above employee census/ premium calculation, joinder agreement, enrollment card for each eligible employee and a check in the amount of one month’s premium payable to Kansas City Life Insurance Company to: KCL GROUP BENEFITS Kansas City Life Insurance Company 3520 Broadway Kansas City, Missouri 64111-2565
GROUP PRODUCTS FROM KANSAS CITY LIFE INSURANCE COMPANY Offering a variety of other employee benefit plans to meet your specific needs. ■ Term Life and Accidental Death & Dismemberment ■ Voluntary Life
Underwritten by:
■ Short Term Disability
Kansas City Life Insurance Company
■ Voluntary Short Term Disability ■ Long Term Disability
Since 1895
■ Voluntary Long Term Disability
3520 Broadway Kansas City, MO 64111-2565
■ Dental ■ Voluntary Dental
PO Box 219425 Kansas City, MO 64121-9425
■ Vision Care
Toll free: 1-877-266-6767, ext. 8200 Fax: 816-531-4648
■ Select Trust Plus - Life, STD, LTD & Dental
E-mail: [email protected] Website: www.kclgroupbenefits.com
804
4.07g
Long Term Disability
Select Trust Plus Long Term Disability Recommended for Groups of 2 to 9 Employees
BENEFIT AMOUNTS Kansas City Life Insurance Company’s comprehensive Long Term Disability (LTD) program is preferred by many small group employers. The LTD product provides employees with a maxi-
The insured employee is eligible for a total benefit of 60 percent of insured monthly earnings, if his or her total disability is due to an injury (accident) or sickness (illness, pregnancy or disease); the maximum monthly benefit of $1,000 or $5,000 is elected by the employer. Benefits payable from other sources, including those listed below, reduce the initially calculated benefit: • Primary and dependent disability benefits payable under Social Security. • Worker’s compensation or any governmental disability or retirement program including primary and dependent retirement benefits from Social Security. • Employer-funded retirement benefits or pension plans or payments from any employer or self-employment. • Employee benefit plans or arrangement or group insurance providing a disability benefit. • Regardless of total income from other sources, the LTD benefit will never be less than $50 or 15 percent of gross monthly benefit, whichever is greater.
mum monthly benefit of $5,000, protecting
BENEFIT SCHEDULES
up to $100,000 of an
Two different benefit schedules are available depending on industry classification.
employee’s annual earn-
The maximum benefit period payable depends on the age of the insured employee when total disability begins, the nature of the disability and industry classification, as illustrated in the following chart.
ings. We give employers the flexibility to choose
Nature of Disability
either a 90- or 180-day
Age at Disability
elimination period. The
Prior to age 62
plan’s partial disability benefits encourage disabled employees to return to work. Additionally, no medical exams or evidence of insurability is required, except for late enrollees.
Industry I
Industry II
Injury & Sickness
Injury
Sickness
To Normal Retirement Age or for 42 months, if greater
To Normal Retirement Age or for 42 months, if greater
60 months or to Normal Retirement Age, whichever occurs first
Both Injury & Sickness
Age 62 Age 63 Age 64 Age 65 Age 66 Age 67 Age 68 Age 69 and over
42 months 36 months 30 months 24 months 21 months 18 months 15 months 12 months
Age 62 Age 63 Age 64 Age 65 Age 66 Age 67 Age 68 Age 69 and over
42 months 36 months 30 months 24 months 21 months 18 months 15 months 12 months
Normal Retirement Age means the Social Security Normal Retirement Age as stated in the 1983 revision of the United States Social Security Act.
Benefit durations provided are in compliance with age discrimination legislation.
ELIMINATION PERIODS The employer may select an elimination period of 90 or 180 days.
OTHER PROVISIONS INCLUDED • Cost of living benefit freeze — Monthly benefit will not be reduced by a cost of living benefit increase that the employee receives from any other source of income. • Partial disability benefit — A benefit is payable if a disabled employee is receiving disability benefits and returns to work part-time. • Waiver of premium benefit — Premium will be waived after the employee completes the elimination period and for as long as benefits remain payable.
ELIGIBLE EMPLOYEES To be eligible for coverage, an employee must be an active full-time employee and have completed the eligibility waiting period.
EMPLOYER-DEFINED ELIGIBILITY Employers have the option of insuring all full-time employees, one class of employees or several classes of employees. Carve-out eligibilities (plans that cover selected full-time employees) are to be defined in a nondiscriminatory manner.
PARTICIPATION REQUIREMENTS • The employer may choose to pay 100 percent of LTD premium, in which case all eligible employees must be insured. • The cost of the premium may be shared by the employer and employees; however, the employer must pay a minimum of 25 percent of the premium. When an employee is required to pay a portion of the cost, the following participation is required: Number of eligible employees
Minimum participation
2-5 6-9
100% all but one
DEFINITION OF PRE-EXISTING CONDITION A pre-existing condition is any condition for which an employee received medical advice or treatment in the 12-month period prior to coverage being effective. Any disability due to a pre-existing condition will not be covered unless the disability begins after: • The employee has gone 12 consecutive months without treatment. • The employee has been continuously insured for 24 months.
DEFINITION OF TOTAL DISABILITY Total disability is being unable to perform the essential duties of the employee’s own occupation for the elimination period and 24 months. Thereafter, it is being unable to perform the essential duties of any occupation for which the insured employee is reasonably qualified by education, training or experience.
EXCLUSIONS The plan does not cover — and no benefit will be paid — for any disability: • If the employee is not under the regular care of a physician. • Caused or contributed to by a war or act of war (declared or not). • Caused by the commission of, or attempt to commit, a felony. • Caused or contributed to by an intentionally self-inflected injury. • Covered or is eligible for coverage under the employer’s prior disability plan.
ELIGIBLE INDUSTRIES Industry I (Preferred Groups) The following industries or eligibilities have historically produced better-than-average experience. Therefore, these groups have a more liberal benefit schedule. Benefits for injury or sickness are payable to Social Security Normal Retirement Age. Specific industries are classified by 1987 Standard Industrial Classification (SIC) codes. The first two digits of the SIC code are shown. Communications SIC 48xx Depository Institutions SIC 60xx Non-depository Credit Institutions SIC 61xx Insurance Carriers SIC 63xx Holding & Other Investment Offices SIC 67xx Advertising; Mailing, Commercial Art & Stenographic Services (except 7322-7323) SIC 7311-7338
Computer Programming Services SIC 7371-7379 Educational Services SIC 82xx Engineering, Accounting, Research, Management & Related Services except Facilities Support Management Services SIC 87xx (except 8744) Public Finance, Taxation & Monetary Policy SIC 93xx
For the following types of firms, only executive, administrative, sales, supervisory and clerical employees whose duties are primarily inside-office are eligible for LTD: Apparel & Other Finished Products Mfg. SIC 23xx Furniture & Fixture Mfg. SIC 25xx Printing, Publishing & Allied Industries Mfg. SIC 27xx Rubber & Plastics Products Mfg. SIC 30xx Fabricated Metal Products Mfg. except machinery & transportation equipment SIC 34xx Industrial/Commercial Machinery & Computer Equipment Mfg. SIC 35xx
Electrical Equipment & Components Mfg. except computer equipment SIC 36xx Measuring, Analyzing & Controlling Instruments; Photographic, Medical & Optical Goods; Watches & Clocks Mfg. SIC 38xx Wholesale Trade — Durable Goods (except 5093) SIC 50xx Wholesales Trade — Non-durable Goods SIC 51xx Museums, Galleries & Zoos SIC 84xx
Industry II For following types of firms when all employees are being covered. Industry II is any industry which isn’t classified as Industry I or ineligible. Some examples would be: Special Trade Contractors SIC 17xx Apparel & Other Finished Products Mfg. SIC 23xx Furniture & Fixture Mfg. SIC 25xx Paper & Allied Products Mfg. SIC 26xx Printing, Publishing & Allied Industries Mfg. SIC 27xx Rubber & Plastics Products Mfg. SIC 30xx Leather & Leather Product Mfg. SIC 31xx Primary Metal Industries Mfg. SIC 33xx Fabricated Metal Products Mfg. except machinery & transportation equipment SIC 34xx Industrial/Commercial Machinery & Computer Equipment Mfg. SIC 35xx Electrical Equipment & Components Mfg. except Computer Equipment SIC 36xx Transportation Equipment SIC 37xx Measuring, Analyzing & Controlling Instruments; Photographic, Medical & Optical Goods, Watches & Clocks Mfg. SIC 38xx Wholesale Trade — Durable Goods SIC 50xx
Wholesale Trade — Non-durable Goods SIC 51xx Building Materials, Hardware, Garden Supply & Mobile Home Dealers SIC 52xx General Merchandise Stores SIC 53xx Food Stores SIC 54xx Apparel & Accessory Stores SIC 56xx Home Furniture, Furnishings & Equipment Stores SIC 57xx Misc. Retail (except 5912, 5983, 5984, 5989, 5999) SIC 59xx Security & Commodity Dealers SIC 62xx Insurance Agents & Brokers SIC 64xx Real Estate SIC 65xx Credit & Collection Agencies SIC 7322-7323 Services to Dwellings; Misc. Equipment Rental & Leasing SIC 7342-7359 Passenger Car Rental & Leasing SIC 7514-7515 Misc. Repair Services SIC 76xx Motion Pictures SIC 78xx Museums, Galleries & Zoos SIC 84xx
For the following types of firms, only executive, administrative, sales, supervisory and clerical employees whose duties are primarily inside-office are eligible for LTD: General Contractors SIC 15xx Food & Kindred Mfg. SIC 20xx Tobacco Products Mfg. SIC 21xx Textile Mill Products SIC 22xx Lumber & Wood Product Mfg. SIC 24xx
Petroleum Refining & Related Industries SIC 29xx Stone, Clay, Glass & Concrete Product Mfg. SIC 32xx Misc. Mfg. SIC 39xx Electric, Gas & Sanitary Services SIC 49xx
INELIGIBLE INDUSTRIES Agricultural Production – Crops SIC 01xx, 02xx, 07xx Forestry SIC 08xx Fishing, Hunting & Trapping SIC 09xx Mining SIC 1011-1499 Heavy Constructions SIC 16xx Chemicals & Allied Products SIC 28xx Railroad Transportation SIC 40xx Local & Suburban Passenger Transportation, Ambulance Services SIC 41xx Motor Freight Transportation & Warehousing SIC 42xx US Postal Services SIC 43xx Water Transportation SIC 44xx Transportation by Air SIC 45xx Pipeline except natural gas SIC 46xx Transportation Services SIC 47xx Junk/Scrap Metals SIC 5093 Auto Dealers, Gas Services & Sanitary Services SIC 55xx Eating & Drinking Establishments SIC 58xx Liquor Stores SIC 5921 Fuel Oil Dealers SIC 5983, 5984, 5989 Misc. Retail SIC 5999 Hotel, Rooming Houses, Camps & Other Lodging Places SIC 70xx
Personal Services (laundry, barber shops) SIC 72xx Employment Agencies: Help Supply Services SIC 7361-7363 Detectives, Guard & Armored Car Services; Security Services SIC 7381-7382 Auto Repair, Services & Parking (except 7512 & 7515) SIC 75xx Amusement & Recreation Services SIC 79xx Health Services SIC 80xx Legal SIC 81xx Social Services SIC 83xx Membership Organizations SIC 86xx Facilities Support Management Services SIC 8744 Private Households SIC 88xx Services not elsewhere classified SIC 89xx Executive, Legislative & General Government, except finance SIC 91xx Justice, Public Order & Safety SIC 92xx Administration of Human Resource Programs SIC 94xx Administration of Environmental Quality & Housing Programs SIC 95xx Administration of Economic Programs SIC 96xx National Security & International Affairs SIC 97xx Non-Classified Establishments SIC 99xx
ELIGIBILITY Firms engaged in similar businesses not specifically mentioned will be considered on an individual basis. Kansas City Life should be contacted before a sale if you have a question about the eligibility of a firm. All firms are subject to Kansas City Life’s approval before acceptance. A firm is not eligible if: • Composed of 90 percent or greater blue-collar content. • Not participating in Social Security. • In business less than one year. • Any employees reside on employer’s premises.
EFFECTIVE DATE LTD coverage will be effective on the first day of the month following acceptance by Kansas City Life. This is not a certificate of insurance, but a brief description only. The group policy alone determines all rights and benefits. Kansas City Life reserves the right to withdraw this offer at any time. Products may not be available in all states. Please contact your Kansas City Life Group Benefits sales representative for more details.
LTD RATES Monthly Rates per $100 of Insured Monthly earnings Firms Insuring 2 through 9 Employees
Age
90-Day Elimination Period
180-Day Elimination Period
Industry I II
Industry
I
II
Under 40
.61
.57
.48
.43
40-44
.81
.67
.75
.57
45-49
1.18
1.01
.94
.75
50-54
1.55
1.45
1.31
1.12
55-59
1.90
2.13
1.66
1.76
60-64
2.25
2.91
1.93
2.49
65 & Older*
2.94
3.82
2.63
3.43
EMPLOYEE CENSUS/LTD PREMIUM CALCULATION Employer Group Elimination Period
days
1 Employee Name
2
Industry I or
Current Age
3 Regular Monthly Earnings* in (100s)
39
50
Industry II
4 Monthly Rate Per $100 of Regular Monthly Earnings
x
5
=
Monthly Premium
Example: John Doe
.37
$18.50
1. 2. 3. 4. 5. 6. 7. 8. 9.
CALCULATION INSTRUCTION
6
Monthly Premium Charges
7
Billing Charge
$10.00**
6+7 Total Monthly Premium
A. List employer’s group name, address, elimination period and industry. B. List employees including name, age and monthly earnings in $100s, (i.e. $5,000 would be 50). *All regular monthly earnings from the participating employer (excluding overtime and bonuses), to a maximum of $8,333 a month, are to be insured for a $5,000 maximum benefit. The maximum monthly earnings for the $1,000 plan is $1,667. C. Determine appropriate monthly rate based on number of insured employees, elimination period and industry. Enter monthly rate for each insured employee in Column 4. Multiply amount in Column 3 by Column 4. Enter sum in Column 5. D. Total employees’ monthly premium to obtain monthly premium charges for all insured employees. Enter this amount in Box 6. E. The total monthly premium will be the monthly premium charges (Box 6) plus the billing charge (Box 7). ** Add this charge if firm does not already have another line of coverage with Kansas City Life through Select Trust Plus.
Send above employee census/ premium calculation, joinder agreement, enrollment card for each eligible employee and a check in the amount of one month’s premium payable to Kansas City Life Insurance Company to: KCL GROUP BENEFITS Kansas City Life Insurance Company 3520 Broadway Kansas City, Missouri 64111-2565
GROUP PRODUCTS FROM KANSAS CITY LIFE INSURANCE COMPANY Offering a variety of other employee benefit plans to meet your specific needs. ■ Term Life and Accidental Death & Dismemberment ■ Voluntary Life
Underwritten by:
■ Short Term Disability
Kansas City Life Insurance Company
■ Voluntary Short Term Disability ■ Long Term Disability
Since 1895
■ Voluntary Long Term Disability
3520 Broadway Kansas City, MO 64111-2565
■ Dental ■ Voluntary Dental
PO Box 219425 Kansas City, MO 64121-9425
■ Vision Care
Toll free: 1-877-266-6767, ext. 8200 Fax: 816-531-4648
■ Select Trust Plus - Life, STD, LTD & Dental
E-mail: [email protected] Website: www.kclgroupbenefits.com
804
4.07g
