Summary

This is a Group Policy Amendment document issued by Standard Insurance Company to the County of Dane, Wisconsin, regarding Long-Term Disability (LTD) insurance coverage under Group Policy 163054-A. The amendment, effective January 10, 2018, modifies the provisions governing when insurance becomes effective for eligible members. The document outlines the process for insurance activation based on two primary categories: insurance subject to Evidence of Insurability, which becomes effective on the later of the member's eligibility date or the company's approval of submitted evidence, and insurance not subject to Evidence of Insurability, which includes both noncontributory coverage (effective upon eligibility) and contributory coverage (effective upon eligibility if applied for within 31 days, or subject to Evidence of Insurability if applied for after 31 days).

The amendment establishes clear procedural requirements for members seeking coverage under the disability insurance plan administered for Dane County employees. The document specifies that noncontributory insurance requires no member action and becomes effective automatically upon eligibility, while contributory insurance requires written application and premium payment agreements. The 31-day application window for contributory coverage without Evidence of Insurability creates a defined enrollment period, with late applications triggering additional underwriting requirements. This policy framework governs the activation timeline and eligibility conditions for short-term and long-term disability benefits provided to county employees.