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LTD Insurance Changed by My Company
Jan 12, 2006

I am Currently on LTD due to Disability in April 2001. My LTD Plan states that I will keep the same benefits I had at the time I went on LTD as long as I am considered totally disabled. It also says I can change my coverage but I have to be back at work for a least 30 days. I get a call from my company in October 2005 after being on this insurance for almost 5 years that they are going to change my Medical Insurance to a policy I now have to pay for(it has been paid for by the company up until now) and it has lot less benefits, than my current policy. So, I think this is a going against the LTD PLAN which says I will keep the same level of coverage. I also had this problem in 2001 and insurance terminated and changed to another policy. I complained and a few weeks later after compalining the Disability Claims Manager, called me to say they were changeing the insurance back to my original insurance per the LTD Plan saying I would remain at the same coverage as long as I am totally disabled. In 2001, I also received a letter form the Disability Claims Manager approving my LTD benefits which was my monthly salary at 70% and Medical at $00.00 and Dental at $00.00, it says in order to be eligable for these benefits I must be totally disabled from my occupation and would keep these benefits as long as I am totally disabled. They sent me insurance request in the mail, December 14, 2005 telling me to fill it out and choose the coverage of insurance I want and the cost I want to pay or the coverage will default to a 80/60 plan, and I now have to pay copays for office calls and prescriptions which were paid for by my current policy. Do I need to fill out the insurance request form or what can I do at this time to stop them from terminateing my current policy? I tried to discuss this with the New Disability Claims Manager and she told me I was going to have to go to a different policy because I was no longer eligable for the policy, I tried to explain this had already happened before but she just told me she would not discuss it and her decision was final.

Response from Ms. Franzoi

Based on your description of what occurred, it doesn't sound like your long term disability benefit has changed. You are still receivng the same long term disability monthly benefit. However, what has changed is the medical coverage that is being offered to you as a former employee who is on disability. Most companies that extend medical coverage to disabled employees provide them with the same benefits that are provided for active employees. Your prior employer has probably changed health plans, changed plan provisions and/or changed the cost to active employees as well as former employees who still have coverage. Much depends on what the plan documents and the written information that was provided to you at the time you became disabled. If at that time, the communication stated (in writing) that you would continue with the same coverage and it was not subject to change, you might be able to dispute this change. However, it is more likely that the information would've proivided that you have medical coverage similar to what active emplooyees have and your former employer is changing its health plan, no longer is offering the plan you had and is now offering new plans at different costs.



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