Attachment 3_760741-C_LTD Amend1.pdf

84 KB Posted

Attached to
Long Term & Short Term Disability Insurance, & Term Life
Solicitation number
RFP 680 26-042/DJ 2
Issued by
Palm Beach County, Florida

About this file

Written by GovTribe AI ·

This is a Group Policy Amendment to an insurance policy issued by Standard Insurance Company to the Palm Beach County Board of County Commissioners. The amendment, effective January 1, 2022, modifies the Deductible Income section of Group Policy 760741-C and clarifies what types of compensation qualify as deductible income for policy purposes.

The amendment specifically amends item 1 of the Deductible Income section to include sick pay, annual or personal leave pay, severance pay, and other salary continuation benefits paid by the employer, while explicitly excluding vacation pay and donated amounts from the definition of qualifying deductible income. This modification establishes clearer parameters for determining eligible income under the group policy's deductible provisions.

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Other files

File Type Posted
Attachment 3_760741-B_LTD Amend2.pdf PDF
Attachment 10 - Incurred and Paid 1-1-2025 through 3-31-2026_Lot 2.pdf PDF
Attachment 3_760741-B_LTD Amend3.pdf PDF
Attachment 3_760741-C_LTD Certificate.pdf PDF
Attachment 3_760741-B_LTD Certificate.pdf PDF
Attachment 5C - Incurred Paid1.1.2022 through 3.31.2026.pdf PDF
Appendix A1_Disability RFP 26-042-DJ_ Questionnaire v2.xlsx XLSX spreadsheet
Attachment 5A - Claim Run 1.1.2022 through 3.31.2026.xlsx XLSX spreadsheet
Attachment 3_760741-C_LTD Amend2.pdf PDF
Attachment 8 - Claimrun 1.1.2025 through 3.31.2026_Lot 2.xlsx XLSX spreadsheet
Attachment 4_760741_STD Certificate.pdf PDF
Attachment 4_760741_STD Amend1.pdf PDF
Attachment 9 - Claim Run Reference Sheet_Lot 2.pdf PDF
Appendix B1 - LTD Price Proposal_Disability RFP 26-042-DJ.xlsx XLSX spreadsheet
Attachment 7 -760741_Life Certificate_Lot 2.pdf PDF
Attachment 3_760741-B_LTD Amend1.pdf PDF
Attachment 6_CONVERSION Agreement - The Standard 760741_LT_B_PC-No Signature.pdf PDF
Attachment 5B - Claim Run Reference Sheet.pdf PDF
26-042-DJ.pdf PDF
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GROUP POLICY AMENDMENT NO. 1

Attached to and made a part of Group Policy 760741-C issued to Palm Beach County Board of County Commissioners as Policyholder.

Effective January 1, 2022, item 1. of the Deductible Income section is amended to read:

1. Sick pay, annual or personal leave pay, severance pay, or other salary continuation (but not vacation pay or donated amounts) paid to you by your Employer.

STANDARD INSURANCE COMPANY

By

File details come from the government source that posted it. Updated .