Eligibility: Subject to eligibility guidelines, all NLTA members and employees under age 60 who have permanent or term contract positions are eligible to participate in the plan. Substitute teachers, private school teachers, and retirees are not eligible for the LTD coverage. Upon enrollment, the effective date of coverage is the first day of active employment or the date the application is approved by the underwriter, whichever date is later. Replacement and term contract teachers are eligible for participation in all options of the Group Insurance Plan for the period of their teaching contract. If LTD benefits are payable, the LTD benefit is payable only until the date contract ends.

NOTE: The member must be actively at work on the effective date of coverage or coverage will not take effect until return to active employment.

Any NLTA member/employee may choose to remove him/herself from this plan by contacting the Plan Administrator, Johnson Inc., to complete an Opting Out Form. Subsequent to opting out or allowing coverage to lapse or terminate, should a teacher wish to rejoin this plan, an application for coverage with evidence of medical insurability will be required.

Long Term Disability Insurance (formerly called Salary Continuance) is intended to protect the income of an insured member in the event that a disability prevents an insured member from performing the duties of their occupation beyond the expiry of paid sick leave. LTD insurance does not automatically “kick in” when an insured member’s sick leave runs out. An application must be made and detailed medical documentation provided. To avail of the LTD benefit, a member must be totally disabled from performing their duties, and must have medical documentation, satisfying the underwriter, confirming a continual disability from the onset of sick leave. The underwriter will perform a medical adjudication as to whether benefits are, or are not, payable.

The period of benefit payment can be short term or long term depending on the medical circumstances. This plan option provides the member with the ability to insure their income, thereby protecting themselves and their family against financial disaster should the insured member become unable to earn a living due to disability.

DISABILITY INCOME BENEFIT

Application for benefit is necessary. The application requires completion of forms by the insured member, the school principal (immediate supervisor), and the attending physician (usually a medical specialist). Medical proof of continuous total disability, satisfactory to the underwriter, must be submitted. The underwriter will determine eligibility for benefit based on a medical adjudication of the medical evidence.

If approved, benefit will commence after the expiration of paid sick leave, or a qualifying period of 30 calendar days, whichever is later, provided application and proof of disability is submitted within six (6) months of this qualifying period.

Waiver of Premium

Premiums must be paid during the qualifying period. However, a member does not pay premiums while receiving LTD benefits.

Benefit Level

The amount of monthly benefit is 66 2/3% of gross monthly earnings on which the member was paying premium in effect on the date benefit payments commence up to a maximum of $8,000 per month.
The amount of benefit will be reduced so that the Long Term Disability payment plus the total income from all sources as outlined under integration of benefits does not exceed 85% of net earnings on the date of expiration of sick leave.

This benefit is not taxable since the employer does not pay any portion of the premium.

Duration of Benefit (‘own occupation’ versus ‘any occupation’)

The maximum benefit payable for an insured member who has been deemed totally disabled from performing the duties of their normal occupation is 24 months. Thereafter, benefit can be maintained until age 60 if a medical adjudication by the underwriter confirms a total disability from any occupation for which the insured is, or may become, fitted by education, training, and/or experience.

Benefit may be continued beyond 24 months if disabled from any occupation which will pay no less than 75% of the current monthly earnings for the insured’s normal occupation. The availability of such occupations, jobs, or work will not be considered in assessing the existence of an ‘any occupation’ disability.

Continuous medical treatment and documentation is required regularly throughout the time a member accesses Disability Insurance benefits. The member must be under the regular care of a physician and receiving treatment deemed appropriate by the underwriter. The member must also be prepared to attempt rehabilitative employment, or participate in a rehabilitation program considered appropriate by the underwriter. If the member’s job requires a government permit or license, he/she will not be considered totally disabled solely because such permit or license has been withdrawn or not renewed.

Integration of Benefits

The LTD plan is designed to ensure a reasonable level of income, but is not designed as a “Stand Alone Plan”. The premium structure is based on the premise that the benefit paid will be reduced by other sources of income which a member may be eligible to access. Therefore, the plan is said to be integrated with other sources of income to which the teacher may be eligible:

1. Disability benefits payable under the Canada/Quebec Pension Plan, not including CPP/QPP dependent benefits.
2. Benefits payable under any Workers’ Compensation Act.
3. Disability or retirement benefits payable under the Teachers’ Pension Act or the Pension Plan for the Support Staff of the Newfoundland and Labrador Teachers’ Association.
4. Disability or retirement benefits under an employer sponsored retirement plan.
5. Earnings recovered through a legally enforceable course of action against some other person or corporation.

The LTD benefit can be used to top up the other sources of income to 85% of net income.

In applying for the LTD benefit, the insured member will also be asked to sign an agreement to apply for TPP/CPP benefits or other employer sponsored disability benefits, if required by the insurance underwriter. If an insured member is approved for TPP/CPP or other employer sponsored disability benefits, the LTD monthly benefit will be adjusted accordingly. If the Pension benefits are received retroactively, then the LTD benefits will be recalculated retroactively, and the insured will be required by the underwriter to remit in full any overpayment that may occur due to this retroactive adjustment. Members should be aware that the LTD benefits are nontaxable, while the TPP/CPP employer sponsored benefits are taxable.

In the event that the insured member fails to apply for CPP or TPP or other employer sponsored disability benefits; or a disability decision from these plans has not been rendered within six (6) months from the application date, the underwriter reserves the right to commence deducting an estimate of CPP/TPP or other employer sponsored benefits from the LTD benefits.