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Short-Term Disability Insurance
Mar 21, 2013

I have started a new job that offers voluntary short-term disability insurance. I'm unsure if it's an insurance product that I can truly make use of (being HIV+). My benefit guide states the following: "The policy is considered guaranteed issue upon your initial enrollment period only. However, waiting periods and pre-existing condition limitations will apply." I understand that the first sentence is good news, but the second sentence makes me think this policy might not have much value to me? Any short-term disability that could be attributed to my HIV infection would probably be denied? This is an employer group sponsored plan administered by Lincoln Financial Group.

Response from Mr. Chambers

I think you will be able to benefit from it if you need it, eventually.

It sounds like you are covered under the plan, assuming the employer pays the cost of it. The fact that it is administered by an insurance company doesn't mean it is insurance; if your employer has several hundred or more it could be self-funded and simply administered by Lincoln.

You need to read the Summary Plan Description. It should contain a provision about Pre-Existing Conditions. Your plan may be slightly different but those provisions usually have two features: a "look-back" period when they define what a pre-existing condition is. It's usually defined as anything you sought treatment for in the 3 months or 6 months just before becoming insured. If you're on medication, then HIV is a pre-existing condition as well as seeing a doctor for it in the three months.

Next, they will define the "waiting period" after which pre-existing conditions are covered. Generally, this is twelve months of coverage. This would mean that they will cover a disability due to HIV as long as the disability (leaving work) starts AFTER you have been covered for twelve months, but will not cover a claim due to HIV if you leave in the first year of coverage. This is similar to such provisions in Long Term Disability plans from an employer as well.

A Summary Plan Description (SPD) is a booklet, usually 5 - 10 pages if it's for STD only, which federal law requires be given to all employees covered under an employee benefit welfare plan.

Good luck, Jacques



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