Policy_Document_-_STD_B_Amendment_5_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 for disability insurance services issued by Standard Insurance Company to the County of Dane, Wisconsin, in connection with a Short Term/Long Term Disability and Long Term Disability Only Services contract opportunity. The amendment, effective May 1, 2017, modifies the definition of "Member" under Group Policy No. 163054-B to establish eligibility criteria for coverage. To qualify as a Member eligible for insurance benefits, an individual must be a full-time elected county official or regular employee of the County who has elected both short term and long term disability coverage, be actively at work at least 20 hours per week (including regularly scheduled days off and vacation days when capable of working), and be a resident or citizen of the United States or Canada. The amendment explicitly excludes temporary or seasonal employees, full-time members of the armed forces of any country, leased employees, and independent contractors from Member status.
The amendment further specifies the process for becoming insured, requiring completion of an Eligibility Waiting Period as outlined in the Coverage Features section of the policy. The document establishes that individuals must meet the Member definition criteria and satisfy Active Work Provisions before insurance becomes effective. No specific pricing terms, renewal options, contract term dates, or funding amounts are detailed in this amendment document, which serves primarily to clarify membership eligibility requirements for the County of Dane's disability insurance program.
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Text version
Group Policy No. 163054-B Page 1 of 1 of Amendment No. 5
GROUP POLICY AMENDMENT NO. 5
Attached to and made a part of Group Policy 163054-B 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 who elected both short term disability and long term disability;
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 who elected both short term disability and long term disability;
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.
ST2.BI.01
STANDARD INSURANCE COMPANY
By
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