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How Group LTD Coverage Works

This section explains how Group LTD coverage works. IDI coverage is discussed under "How Individual Disability Insurance ("IDI") Works."
Group LTD coverage provides a level of income replacement should you continue to be disabled for more than 182 days. If approved by Prudential, the claims administrator, Group LTD coverage provides you with a monthly benefit of up to $20,000 based upon a percentage of your Total Annual Cash Compensation (TACC), less certain other disability benefits. TACC under the plan is limited to $400,000 if you elect the 60% option (or $480,000, if you elect the 50% option described in "If You're An Employee" with TACC $60,000 or more). If your TACC in effect for a plan year is less than $60,000, you would receive company-paid coverage if you become disabled with a replacement of 60% of TACC, to a maximum monthly benefit of $3,000.
In conjunction with disability income benefits you receive (or may be eligible to receive, even if you do not apply) from certain other sources ("other income benefits") — Group LTD coverage will provide a monthly benefit up to the percentage of TACC that you elected. The benefit will be provided when:
  • You've been disabled for the elimination period of 182 days of disability;
  • You're under the regular care of a licensed doctor during your disability, who you are not related to;
  • You have a 20% or more loss of income; and
  • Your claim has been approved by Prudential, the claims administrator.
To be considered "disabled" under the plan, you need to submit sufficient proof (as determined by Prudential) of your disability to Prudential.
You are disabled when Prudential determines that you cannot perform the material and substantial duties of your regular occupation and are not working because of an occupational or non-occupational injury or sickness. After 30 months of disability (the 182-day elimination period plus 24 months of Group LTD Plan benefits), you're eligible for continued Group LTD Plan benefits if Prudential determines that — because of an occupational or non-occupational illness or injury — you're unable to perform the duties of any gainful occupation for which you're reasonably fitted by training, education, and experience.
If your TACC is equal to or greater than $200,000, you may qualify for benefits under Group LTD coverage if you're unable to perform the duties of your regular occupation for the maximum payable duration of the disability. (Your premium will be higher in this case.)
Your long-term disability benefits may continue until you are determined not to be disabled, reach the maximum time period for benefits, or die.
Prudential may require you to be examined by a physician, other medical practitioner and/or vocational expert of Prudential's choice and will pay for this examination. Prudential can require an examination as often as is reasonable to do so, and may also require you to be interviewed by an authorized representative from Prudential. Refusal to be examined or interviewed may result in denial or termination of your claim.
Generally, you must be actively-at-work on the effective date of the coverage (including for any increase in coverage). If you are not, your coverage (including any increase) will take effect on the day you return to work.