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Cigna Long Term Disability Effects of Other
Income Benefits
Prepare for the Unexpected with Long Term The disability benefit provided
Disability (LTD) Insurance by this plan is a total benefit;
Eligible employees are able to purchase voluntary LTD insurance (100% which is, it will be reduced by
any disability benefits payable on
employee paid) which provides beneits should you become disabled behalf of you or your dependents,
because of a non-occupational illness or injury and cannot work in your or a qualified third party on
own job, you would qualify for LTD. This beneit would begin paying on behalf of you or your dependents,
the 91st day of the illness or injury, but may continue until retirement. You whether or not you are actually
would receive 60% of your monthly earnings to a maximum of $10,000 per receiving them . Examples of
month. other income sources which may
reduce your benefits include, but
are not limited to Social Security
Pre-existing conditions will not be covered if the employee incurred disability or retirement benefits,
expenses, received medical treatment, care or services including diagnostic Railroad Retirement Act, company
measures, took prescribed medications, or for which a reasonable person sponsored sick leave, and workers’
would have consulted a physician within three months before effective date compensation .
of insurance. Pre-existing conditions clause will be satisied after 12 months
of continuous enrollment.
Employee LTD Calculation
To calculate your LTD bi-weekly payroll deduction, use the formula
indicated below. Round all numbers to the nearest whole number.
Employee—Calculate Your LTD Bi-Weekly Payroll Deduction
Enter your annual salary* $
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 by 12 (monthly income); $
average monthly income cannot exceed $16,666
Multiply the amount on line 2 by 0 .60 $
Divide the amount on line 3 by 100 and enter the amount $
on line 4 to get your 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 (EOI) form is required for approval if you
did not choose this beneit when irst eligible. The EOI must be approved
before coverage begins.
American Oncology Network 13
Income Benefits
Prepare for the Unexpected with Long Term The disability benefit provided
Disability (LTD) Insurance by this plan is a total benefit;
Eligible employees are able to purchase voluntary LTD insurance (100% which is, it will be reduced by
any disability benefits payable on
employee paid) which provides beneits should you become disabled behalf of you or your dependents,
because of a non-occupational illness or injury and cannot work in your or a qualified third party on
own job, you would qualify for LTD. This beneit would begin paying on behalf of you or your dependents,
the 91st day of the illness or injury, but may continue until retirement. You whether or not you are actually
would receive 60% of your monthly earnings to a maximum of $10,000 per receiving them . Examples of
month. other income sources which may
reduce your benefits include, but
are not limited to Social Security
Pre-existing conditions will not be covered if the employee incurred disability or retirement benefits,
expenses, received medical treatment, care or services including diagnostic Railroad Retirement Act, company
measures, took prescribed medications, or for which a reasonable person sponsored sick leave, and workers’
would have consulted a physician within three months before effective date compensation .
of insurance. Pre-existing conditions clause will be satisied after 12 months
of continuous enrollment.
Employee LTD Calculation
To calculate your LTD bi-weekly payroll deduction, use the formula
indicated below. Round all numbers to the nearest whole number.
Employee—Calculate Your LTD Bi-Weekly Payroll Deduction
Enter your annual salary* $
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 by 12 (monthly income); $
average monthly income cannot exceed $16,666
Multiply the amount on line 2 by 0 .60 $
Divide the amount on line 3 by 100 and enter the amount $
on line 4 to get your 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 (EOI) form is required for approval if you
did not choose this beneit when irst eligible. The EOI must be approved
before coverage begins.
American Oncology Network 13
