Policy_Document_-_STD_B_Amendment_3_When_Ins_Becomes_Eff.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 by Standard Insurance Company to the County of Dane, Wisconsin, establishing the effective dates and conditions for insurance coverage under Group Policy 163054-B. The amendment, effective January 1, 2018, specifies the terms by which employees become eligible for Short Term/Long Term Disability and Long Term Disability Only Services coverage. The policy outlines two primary categories of insurance: coverage subject to Evidence of Insurability, which becomes effective on the later of the eligibility date or approval of the evidence submission, and coverage not subject to Evidence of Insurability, which is further divided into noncontributory insurance effective upon eligibility and contributory insurance requiring written application.
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. Employees who apply more than 31 days after becoming members are required to submit Evidence of Insurability before coverage activation. The amendment supersedes Group Policy Amendment No. 2, which never took effect. All provisions are subject to Active Work requirements as defined in the original group policy.
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Text version
GROUP POLICY AMENDMENT NO. 3
Attached to and made a part of Group Policy 163054-B issued to County of Dane as Policyholder.
Effective January 1, 2018, and subject to the Active Work Provisions, the Group Policy is amended as follows:
1. Group Policy Amendment No. 2 never came into effect.
2. 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 a Member.
[(VAR EOI_NO 60 DAY PD) ST.EF.OT.1X]
STANDARD INSURANCE COMPANY
By
File details come from the government source that posted it. Updated .