| Who can apply? |
All AAFP members under age 60, residing in the 50 United States (excluding VT) and the District of Columbia, with a satisfactory health history and engaged in Full-Time Work is eligible to apply for coverage. (AAFP members in the Uniformed Services Chapter should call AAFP Insurance Services for the disability plan designed specifically for them.)
“Full-Time Work” means the active performance for pay or profit of the regular duties of your normal occupation on a basis of at least 20 hours a week at the place such duties are normally performed.
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| When does my coverage end? |
Once approved, you can continue your coverage to age 70, as long as you pay all premium contributions when due, you remain at Full-Time Work, the group policy remains in force, and you do not enter active duty in the Armed Forces. Note: Your coverage can continue without interruption or cost penalty if you change employers or discontinue membership in the Academy.
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| What is the maximum benefit amount for which I can apply? |
You can apply for a benefit of $100 to $10,000 a month, in $100 increments, up to a maximum of 60% of your gross monthly earned income.
If you have other disability coverage, you can apply for a benefit which, when combined with all other disability insurance, does not exceed 75% of your gross monthly earned income.
Residents can apply for up to $3,500 in monthly benefits, regardless of income or other disability insurance coverage. |
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| Are there waiting periods? |
In most cases, yes. You can select a waiting period (that continuous time period between the onset of a disability and when benefit payments begin) of 60, 90 or 180 days. Your choice of waiting period has direct impact on your premium.
However, in certain situations the waiting period is waived. See the Communicable Disease, Organ Donation and Relapse provision described in the brochure. |
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| When are benefits paid? |
Benefits will be paid if you become Totally Disabled and you have completed the waiting period you have selected. You will not be required to return to work at some other occupation.
"Totally Disabled" means you are completely and continuously unable to perform the material and substantial duties of your profession or occupation for pay or profit due to accidental bodily injury or sickness, provided you are not otherwise working for pay or profit. (See liberalization of "not otherwise working" requirement under the provisions describing entrance into a rehabilitation program and return to work on a trial or part-time basis in the brochure.)
Note: You will not be considered Totally Disabled solely due to the lack of a valid occupational license or certification. |
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| Will I lose benefits if I enter a rehabilitation program? |
| No. If, while Totally Disabled, you willingly participate in an approved rehabilitation program, you can do so at no cost to you and without reduction in your disability benefits. |
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| Will I lose benefits if I return to work on a trial or part-time basis? |
No. This policy has been designed to encourage you to return to work as soon as you are able. Therefore, if you return to work after having been Totally Disabled for at least 30 consecutive days, and your income-earning capacity has been diminished by as little as 25%, you can receive what are known as residual benefits. Residual benefits end when your earnings rise to the point that they exceed 75% of your pre-disability income. (Residual benefits are a percentage of your monthly benefit equal to the percentage reduction in monthly earnings produced by your disability. See Certificate Of Insurance for additional description.)
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| What if I suffer a relapse? |
| If you suffer a recurrence of the same or related disability within three months of returning to Full-Time Work (within 12 months if the disability is due to a mental disorder, drug addiction or alcoholism), your benefits will resume without the need to satisfy a new waiting period. Your benefit period remains unchanged as well. |
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| What if I contract a communicable disease and, though otherwise fit, am prevented from working? |
The policy's Communicable Disease provision has been designed especially for medical professionals working in todays high-risk health environment. Under this provision, if you are under age 65 you will receive full disability benefits - without a waiting period - if you contract a covered Communicable Disease and, as a result, are unable to earn more than 75% of your average monthly income.
A "Communicable Disease" is defined as the following conditions, but only if public disclosure is either (a) recommended by your medical profession or (b) required by an appropriate governmental agency: Acute Viral Hepatitis of a non A type, Human Immunodeficiency Virus, Acquired Immune Deficiency Syndrome and tuberculosis. |
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| What is the Organ Donor Provision? |
| If you have been insured for at least six months and undergo a surgical procedure to donate an organ for transplant, you will be considered Totally Disabled and, therefore, eligible for total disability benefits. No waiting period will apply. |
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| Will my benefits be affected by Social Security or benefits from other coverages? |
| No. Some policies reduce benefits dollar-for-dollar when Social Security or coverage from other policies begin. However, your Academy's policy does not have such a provision. Instead, once insured, your benefits will be paid without regard to the presence of other benefits.
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| Will my benefits be taxable as income? |
That depends on whether you or someone else pays the premium. (Please consult your tax advisor for information about your specific situation.) Generally, under current tax law, when the premiums are paid by your employer or practice and taken as a tax deductible business expense, then policy proceeds which you receive will be treated as taxable income to you. However, benefits you receive under a disability policy you purchase yourself will generally be income tax-free -allowing you to keep every penny of coverage you've paid for.
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| Can I change my mind after I apply? |
| Yes. If you are not completely satisfied with your new coverage, you can return the Certificate Of Insurance within 30 days provided you did not submit a claim for benefits under this policy. Your insurance will then be invalidated and your premium contribution refunded - no questions asked.
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| Can I increase my coverage? |
Yes. Under the policy's Guaranteed Future Purchase Option, you will be offered $100 or $200 (depending on your current monthly benefit amount) of additional monthly benefits at six separate intervals. You can accept this additional coverage regardless of your health, provided you are at Full-Time Work, your total monthly benefits do not exceed the plan maximum of $10,000 a month, and you make timely premium contributions. Guaranteed purchase dates are ages 31, 34, 37, 40, 43 and 46.
This could amount to $1,200 of additional monthly benefits to help accomodate future income needs.
You also have the option to apply for additional benefits at any time prior to age 60 by providing satisfactory evidence of insurability. Your existing coverage (and your rights under the Future Purchase Option) will not be affected, even if you are declined for the additional coverage.
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