Eligibility
All full-time employees working 30 or more hours per week are eligible for Long Term Disability coverage on the first day of the month following the hire date.
Definition of disability
“Totally Disabled” and “Total Disability” mean, that as a result of an Injury or Sickness, during the Elimination Period (Elimination Period = period of time between the onset of disability and when benefits begin) and thereafter you cannot perform the material duties of your regular occupation;
- “Partially Disabled” and “Partial Disability” mean that as a result of an Injury or Sickness you are capable of performing the material duties of your regular occupation on a part-time basis or some of the material duties on a full-time basis. If you are Partially Disabled you will be considered Totally Disabled, except during the Elimination Period; and
- “Residual Disability” means being Partially Disabled during the Elimination Period. Residual Disability will be considered Total Disability.
Elimination period
There is an elimination period of 180 days in the event you are disabled for any reason.
Monthly benefit amount
Full time employees benefit replaces 60% of your income up to $15,000 a month after the elimination period of 180 days.
Certain benefit period
The maximum benefit period is determined by your age, as shown in the chart below:
| 180 days(no Benefits) | Monthly Benefit of 60% of Predisability Earnings Payable to Social Security Retirement Age |
| AGE | MAXIMUM BENEFIT PERIOD |
| Less than age 60 | to age 65, but not less than 60 months |
| 60 | 60 months |
| 61 | 48 months |
| 62 | 42 months |
| 63 | 36 months |
| 64 | 30 months |
| 65 | 24 months |
| 66 | 21 months |
| 67 | 18 months |
| 68 | 15 months |
| 69 and over | 12 months |
Note: This is a convenient brief summary. Always check your booklet certificate. If any discrepancies exist, the plan document prevails.
Termination of active employee benefits after 180 days
After you have been on Short Term Disability or another approved leave type for 180 days, your active employee benefits with EDENS will terminate. At that time you will be given the opportunity to enroll in COBRA to continue certain benefits including your medical, dental, and vision coverage. Here are some specifics regarding continuation of your medical insurance.
If you are approved for the company’s Long Term Disability (LTD) benefit, covered by our health plan, and employed with the company for five or more years at the time of your initial disability, the company will continue to subsidize your medical insurance premiums at the regular employer rate. The subsidy will be capped at the dollar amount of the employer rate at the time of your LTD approval. You will be responsible for sending your portion of the BCBS premium to Infinisource, our COBRA administrator. EDENS will continue paying the subsidy of the BCBS medical premium for a limited period of time based on your length of service with EDENS, as specified in the chart below, up to a maximum of 18 months, provided you remain qualified for the company’s Long Term Disability benefits.
At the end of your approved LTD leave, or the specified company-subsidized COBRA coverage period (whichever occurs first) the EDENS subsidy will terminate; however, you may qualify for unsubsidized COBRA coverage at full premium. COBRA coverage may be continued for up to 18 months for most individuals. You may qualify for an extension based on a secondary qualified event or by SSA disability qualification. Non-payment of premiums at any time may result in termination of your insurance coverage.
| Years of service at time of initial disability | Months that EDENS will subsidize |
| Less than 5 | None – employee is responsible for full premium |
| 5 to less than 10 | Up to 6 months from start of COBRA |
| 10 to less than 15 |
Up to 12 months from start of COBRA |
| 15 years or more | Up to 18 months from start of COBRA |
If you are not approved for LTD and do not return to work as scheduled after your approved leave ends, your coverage with EDENS will terminate. All family members enrolled in the medical coverage will receive information on how to continue the remaining time period on COBRA without the company subsidy. You will receive premium information and election notices within three weeks of your termination. Please read the information carefully. You have a limited time to respond.
*Employees earning $150,000 or more annually are not eligible for company-subsidized premiums while on LTD and will be responsible for the entire medical premium payment.
Contact Information:
Toll Free: (877) 786-3652
Online Booklet
Note: The simplified benefit summaries contained herein are designed to be concise, simplified highlights of each benefit plan. As such, they are not comprehensive or authoritative. For complete details, please refer to the applicable benefit plan booklet provided by the insurer or your employer. In matters of tax or legal interpretation, seek the services of a qualified professional.