Policy_Document_-_LTD_A_Amendment_2.pdf
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- Solicitation number
- 2026-RFP-065-PR
- Issued by
- Dane County, Wisconsin
About this file
This is a Group Policy Amendment document issued to the County of Dane in Wisconsin, effective January 10, 2018, modifying the terms of long-term disability (LTD) insurance coverage under Group Policy 163054-A. The amendment clarifies the effective dates for insurance coverage based on employee eligibility and application timing. For insurance subject to Evidence of Insurability, coverage becomes effective on the later of the date the employee becomes eligible or the date the insurer approves the Evidence of Insurability. For noncontributory insurance not subject to Evidence of Insurability, coverage becomes effective upon employee eligibility. For contributory insurance not subject to Evidence of Insurability, coverage becomes effective on the eligibility date if the employee applies within 31 days of becoming a member; applications submitted more than 31 days after membership begins require Evidence of Insurability approval before coverage becomes effective.
The amendment was issued by Standard Insurance Company and supersedes Group Policy Amendment No. 1, which never took effect. The document is subject to Active Work Provisions and establishes clear timelines and conditions for when employees gain access to short-term and long-term disability benefits based on their contribution status and application timing relative to their eligibility dates.
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Text version
GROUP POLICY AMENDMENT NO. 2
Attached to and made a part of Group Policy 163054-A issued to County of Dane as Policyholder.
Effective January 10, 2018, and subject to the Active Work Provisions, the Group Policy is amended as follows:
1. Group Policy Amendment No. 1 never came into effect.
2. Part A. When Your Insurance Becomes Effective of the When Your Insurance Becomes Effective section is amended to read as follows:
A. When Insurance Becomes Effective
Subject to the Active Work Provisions, your insurance becomes effective as follows:
1. Insurance Subject To Evidence Of Insurability
Insurance subject to Evidence Of Insurability becomes effective on later of:
a. The date you become eligible; and
b. The date we approve your Evidence Of Insurability
2. Insurance Not Subject To Evidence Of Insurability
The Coverage Features states whether insurance is Contributory or Noncontributory.
a. Noncontributory Insurance
Noncontributory insurance not subject to Evidence Of Insurability becomes effective on the date you become eligible.
b. Contributory Insurance
You must apply in writing for Contributory insurance and agree to pay premiums.
Contributory insurance not subject to Evidence Of Insurability becomes effective on the date you become eligible if you apply within 31 days after you become a Member.
Late application: Evidence Of Insurability is required if you apply more than 31 days after you become a Member.
[(VAR EOI) LT.EF.OT.1X]
STANDARD INSURANCE COMPANY
By
File details come from the government source that posted it. Updated .