Page 12 - AONNH19
P. 12
Effects of Other Cigna Short Term
Income Benefits
The disability benefit provided by Disability
this plan is a total benefit which
means it will be reduced by any Prepare for the Unexpected with Short Term
disability benefits payable on Disability (STD) Insurance
behalf of you or your dependents,
or a qualified third party on Eligible employees are able to purchase voluntary STD insurance (100%
behalf of you or your dependents, employee paid) which provides beneits should you become disabled
whether or not you are actually because of a non-occupational illness or injury and cannot work in your
receiving them . Examples of own job. This beneit would begin paying on the 8th day for accident and
other income sources which may for illness with a beneit of up to 60% of your basic weekly earnings with
reduce your benefits include, but
are not limited to Social Security a maximum beneit of $1,000 per week.
disability or retirement benefits,
Railroad Retirement Act, company Pre-existing conditions will not be covered if the employee incurred
sponsored sick leave, and expenses, received medical treatment, care or services including diagnostic
workers’ compensation . measures, took prescribed medications, or for which a reasonable person
would have consulted a physician within 3 months before effective
date of insurance. Pre-existing conditions clause will be satisied after 6
months of continuous enrollment.
To calculate your STD bi-weekly payroll deduction, use the formula
indicated below. Round all numbers to the nearest whole number.
Calculate Your STD Weekly Payroll Deduction
Enter your annual salary*, not to exceed $86,667 $
If you work part-time, to calculate your annual salary:
Hourly rate × # scheduled hours per week = weekly
salary
Weekly salary × 52 = annual salary
Divide your annual earnings (line 1) by 52 $
Multiply the amount on line 2 by 0 .60 $
Multiply the amount on line 3 by 0 .061 to get the $
monthly cost
Multiply the amount on line 4 by 12 to get your annual $
cost
Divide the annual cost by 26 to get your bi-weekly cost $
* To determine your annual salary, multiply your hourly rate by 2,080 hours .
An evidence of insurability form is required if the beneit was not chosen
when you irst became eligible. The EOI must be approved before
coverage begins.
12 2019 Benefits Enrollment
Income Benefits
The disability benefit provided by Disability
this plan is a total benefit which
means it will be reduced by any Prepare for the Unexpected with Short Term
disability benefits payable on Disability (STD) Insurance
behalf of you or your dependents,
or a qualified third party on Eligible employees are able to purchase voluntary STD insurance (100%
behalf of you or your dependents, employee paid) which provides beneits should you become disabled
whether or not you are actually because of a non-occupational illness or injury and cannot work in your
receiving them . Examples of own job. This beneit would begin paying on the 8th day for accident and
other income sources which may for illness with a beneit of up to 60% of your basic weekly earnings with
reduce your benefits include, but
are not limited to Social Security a maximum beneit of $1,000 per week.
disability or retirement benefits,
Railroad Retirement Act, company Pre-existing conditions will not be covered if the employee incurred
sponsored sick leave, and expenses, received medical treatment, care or services including diagnostic
workers’ compensation . measures, took prescribed medications, or for which a reasonable person
would have consulted a physician within 3 months before effective
date of insurance. Pre-existing conditions clause will be satisied after 6
months of continuous enrollment.
To calculate your STD bi-weekly payroll deduction, use the formula
indicated below. Round all numbers to the nearest whole number.
Calculate Your STD Weekly Payroll Deduction
Enter your annual salary*, not to exceed $86,667 $
If you work part-time, to calculate your annual salary:
Hourly rate × # scheduled hours per week = weekly
salary
Weekly salary × 52 = annual salary
Divide your annual earnings (line 1) by 52 $
Multiply the amount on line 2 by 0 .60 $
Multiply the amount on line 3 by 0 .061 to get the $
monthly cost
Multiply the amount on line 4 by 12 to get your annual $
cost
Divide the annual cost by 26 to get your bi-weekly cost $
* To determine your annual salary, multiply your hourly rate by 2,080 hours .
An evidence of insurability form is required if the beneit was not chosen
when you irst became eligible. The EOI must be approved before
coverage begins.
12 2019 Benefits Enrollment
