Policy_Document_-_LTD_A_Amendment_4_member_def.pdf
PDF 92 KB Posted
- Solicitation number
- 2026-RFP-065-PR
- Issued by
- Dane County, Wisconsin
About this file
This is a Group Policy Amendment document issued by Standard Insurance Company to the County of Dane, Wisconsin, establishing eligibility criteria for short-term and long-term disability insurance coverage. Amendment No. 4, effective May 1, 2017, modifies the definition of "Member" to clarify who qualifies for insurance coverage under Group Policy No. 163054-A. The amendment specifies that Members must be full-time, elected county officials or regular employees working at least 20 hours per week, with Active Work status including regularly scheduled days off, holidays, and vacation days. Additionally, Members must be residents or citizens of the United States or Canada. The policy explicitly excludes temporary or seasonal employees, full-time members of the armed forces of any country, leased employees, and independent contractors from coverage eligibility.
To become insured under the policy, individuals must satisfy Member status requirements, complete an Eligibility Waiting Period as specified in the Coverage Features section, and meet Active Work Provisions and insurance effective date requirements. The amendment clarifies that Active Work status is maintained during regularly scheduled absences provided the individual is capable of returning to work on those days. No information regarding pricing, renewal terms, contract duration, or other financial considerations is provided in this amendment document.
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Group Policy No. 163054-A Page 1 of 1 of Amendment No. 4
GROUP POLICY AMENDMENT NO. 4
Attached to and made a part of Group Policy 163054-A issued to County of Dane as Policyholder.
Effective May 1, 2017, and subject to the Active Work Provisions, the Group Policy is amended as follows:
1. The General Policy Information portion of the Coverage Features is amended to provide the following definition of Member:
Member means:
1. A full-time, elected county official or regular employee of the Employer;
2. Actively At Work at least 20 hours per week (for purposes of the Member definition, Actively At Work will include regularly scheduled days off, holidays, or vacation days, so long as the person is capable of Active Work on those days); and
3. A resident or citizen of the United States or Canada.
Member does not include a temporary or seasonal employee, a full-time member of the armed forces of any country, a leased employee, or an independent contractor.
2. The Becoming Insured section is amended to read as follows:
BECOMING INSURED
To become insured you must be a Member, complete your Eligibility Waiting Period, and meet the requirements in Active Work Provisions and When Your Insurance Becomes Effective.
You are a Member if you are:
1. A full-time, elected county official or regular employee of the Employer;
2. Actively At Work at least 20 hours per week (for purposes of the Member definition, Actively At Work will include regularly scheduled days off, holidays, or vacation days, so long as the person is capable of Active Work on those days); and
3. A resident or citizen of the United States or Canada.
You are not a Member if you are a temporary or seasonal employee, a full-time member of the armed forces of any country, a leased employee, or an independent contractor.
Eligibility Waiting Period means the period you must be a Member before you become eligible for insurance. Your Eligibility Waiting Period is shown in the Coverage Features.
LT2.BI.01
STANDARD INSURANCE COMPANY
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