Policy_Document_-_STD_B_Amendment_2_DID_NOT_GO_INTO_EFFECT.pdf

PDF 76 KB Posted

Attached to
Short Term/Long Term Disability & Long Term Disability Only Services
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, pertaining to a Short Term/Long Term Disability and Long Term Disability Only Services contract. The amendment, designated as Amendment No. 2, was effective January 10, 2018, and modifies the "When Insurance Becomes Effective" section of Group Policy 163054-B. The amendment establishes the conditions and timelines under which disability insurance coverage becomes effective for eligible members, distinguishing between insurance subject to Evidence of Insurability and insurance not subject to such requirements. For noncontributory insurance, coverage becomes effective on the date the member becomes eligible. For contributory insurance, members must apply in writing and agree to pay premiums, with coverage becoming effective on the member's eligibility date if the application is submitted within 31 days of becoming a member.

The amendment specifies that late applications for contributory insurance submitted more than 31 days after eligibility require Evidence of Insurability approval before coverage becomes effective. The document includes a reference notation indicating a 60-day period designation related to Evidence of Insurability requirements. This policy amendment provides the framework for determining when disability insurance protections commence for County of Dane employees and members participating in the group disability insurance plan, ensuring clear guidelines for coverage activation across different insurance categories.

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Text version

GROUP POLICY AMENDMENT NO. 2

Attached to and made a part of Group Policy 163054-B issued to County of Dane as Policyholder.

Effective January 10, 2018, Part A. When 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 eligible.

[(VAR EOI_NO 60 DAY PD) ST.EF.OT.1X]

STANDARD INSURANCE COMPANY

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