Page 14 - Great Circle 2022 Benefits Guide
P. 14
Coverage Continuation Long Term Disability (LTD)
In the event you do not return to work from leave or The company ofers voluntary long term disability
you terminate employment: insurance to provide inancial security if you are
unable to work for an extended period of time. You
z You may continue your medical, dental, and may purchase voluntary LTD at a competitive group
vision coverages and possibly access to your rate. The plan covers 60% of your monthly salary up to
lexible spending account through COBRA. COBRA
coverage will be ofered to you 7–10 business $5,000 per month. Review your enrollment materials on
days after your separation from Great Circle. the myCircle intranet under Beneits for more details.
z You may be able to continue your basic life and/or
voluntary life insurance through certain provisions Your estimated per pay period premium is determined
under our policy with The Hartford (subject to by multiplying your monthly salary (up to $8,333) by
their approval). In addition, your dependents may your age-range premium rate. If your monthly salary
be eligible to port or convert their life insurance exceeds $8,333, multiply $8,333 by your premium rate.
coverage. Please see the certiicates and forms
located on the intranet, and for additional details, $________________ × _________________ = $________________
you can contact The Hartford at: 877.320.0484. Monthly Salary Premium Rate Per Pay Period
Please note, application for portability or Premium
conversion must be made within 31 days after
separation from Great Circle. Age Range Premium Rate
z If you previously elected voluntary STD and/or 0–24 0.00095
voluntary LTD coverage, you may be able to port 25–29 0.00095
0.00160
30–34
your coverage. Please see the certiicates and 35–39 0.00260
forms located on the intranet, and for additional 40–44 0.00405
details you can contact Lincoln Financial at: 45–49 0.00560
800.423.2765. Please note, application for 50–54 0.00725
portability must be made within 31 days after 55–59 0.00920
separation from Great Circle. 60–64 0.00775
z If you previously elected voluntary critical illness 65–69 0.00610
or voluntary accident coverage, you may be able 70–74 0.00530
to port your coverage. Please see the certiicates 75–99 0.00530
and forms located on the intranet, and for Short Term Disability (STD)
additional details, you can contact The Hartford
at: 866.547.4205. Please note application for The company ofers voluntary short term disability
portability must be made within 31 days after insurance to help provide inancial security until you
separation from Great Circle.
get back on your feet and return to work. You may
purchase voluntary STD at a competitive group rate.
The plan covers 60% of weekly salary up to $1,000 per
week for up to 12 weeks. STD begins on the 8th day
from the accident or 8th day from an illness. There is
a pre-existing condition clause to this plan. See plan
for details. The premium is calculated based on age
and your cost will be calculated for you if you elect
during the online enrollment. Review your enrollment
materials on the myCircle intranet under Beneits for
14 more details.
In the event you do not return to work from leave or The company ofers voluntary long term disability
you terminate employment: insurance to provide inancial security if you are
unable to work for an extended period of time. You
z You may continue your medical, dental, and may purchase voluntary LTD at a competitive group
vision coverages and possibly access to your rate. The plan covers 60% of your monthly salary up to
lexible spending account through COBRA. COBRA
coverage will be ofered to you 7–10 business $5,000 per month. Review your enrollment materials on
days after your separation from Great Circle. the myCircle intranet under Beneits for more details.
z You may be able to continue your basic life and/or
voluntary life insurance through certain provisions Your estimated per pay period premium is determined
under our policy with The Hartford (subject to by multiplying your monthly salary (up to $8,333) by
their approval). In addition, your dependents may your age-range premium rate. If your monthly salary
be eligible to port or convert their life insurance exceeds $8,333, multiply $8,333 by your premium rate.
coverage. Please see the certiicates and forms
located on the intranet, and for additional details, $________________ × _________________ = $________________
you can contact The Hartford at: 877.320.0484. Monthly Salary Premium Rate Per Pay Period
Please note, application for portability or Premium
conversion must be made within 31 days after
separation from Great Circle. Age Range Premium Rate
z If you previously elected voluntary STD and/or 0–24 0.00095
voluntary LTD coverage, you may be able to port 25–29 0.00095
0.00160
30–34
your coverage. Please see the certiicates and 35–39 0.00260
forms located on the intranet, and for additional 40–44 0.00405
details you can contact Lincoln Financial at: 45–49 0.00560
800.423.2765. Please note, application for 50–54 0.00725
portability must be made within 31 days after 55–59 0.00920
separation from Great Circle. 60–64 0.00775
z If you previously elected voluntary critical illness 65–69 0.00610
or voluntary accident coverage, you may be able 70–74 0.00530
to port your coverage. Please see the certiicates 75–99 0.00530
and forms located on the intranet, and for Short Term Disability (STD)
additional details, you can contact The Hartford
at: 866.547.4205. Please note application for The company ofers voluntary short term disability
portability must be made within 31 days after insurance to help provide inancial security until you
separation from Great Circle.
get back on your feet and return to work. You may
purchase voluntary STD at a competitive group rate.
The plan covers 60% of weekly salary up to $1,000 per
week for up to 12 weeks. STD begins on the 8th day
from the accident or 8th day from an illness. There is
a pre-existing condition clause to this plan. See plan
for details. The premium is calculated based on age
and your cost will be calculated for you if you elect
during the online enrollment. Review your enrollment
materials on the myCircle intranet under Beneits for
14 more details.
