Provider Choice Disability Insurance
The Intelligent Choice for Disability Income Protection
You’ve invested a lot of time and money to get where you are now. Your income makes the life you enjoy possible, paying for day-to-day expenses as well as saving for the future.
But — What if the Unexpected Happened?
If your paycheck stopped coming because you were too sick or injured to work, you might think you could rely on:
Second household income
Family or friends
Social Security Disability
What if it lasted for years? How would you get by?
Nearly 60% of the people who file for bankruptcy do so because of a health crisis — and 62% of them have health insurance.1 Being too sick or injured to work impacts finances far beyond just the medical bills.
While you can’t predict the unexpected, you can prepare. Disability insurance (DI) is income protection, helping to replace income lost during a period when you’re too sick or injured to work. You can use the monthly benefits just as you would your paycheck.
Three Key Elements
When considering disability insurance, there are three key components to look at. Disability insurance starts with a base policy. Then you choose how the policy refines a total disability as well as options that address your specific protection needs.
Non-Cancellable and Guaranteed Renewable
Look for a policy that is both non-cancellable and guaranteed renewable. It lets you "lock in" the policy’s benefits and cost when you buy it. As long as required premiums are paid, the policy can’t be cancelled, premiums increased, or coverage terms changed until the policy expiration date.
- Strong Base Policy
The base policy is the foundation on which your policy is built. Our DI coverage starts with one of the strongest base policies available in the marketplace. We built in all the benefits that are important to professionals like you and none of those that aren’t — to offer some of the best value and protection you can get.
- Option to Work in Another Occupation and Still Receive Benefits
Disabilities vary tremendously in severity and duration. A policy with flexibility built into it will give you more options to deal with being too sick or injured to work in your own occupation. Many people tell us they’d want to work even if disabled for their own sense of self-worth. So we provide options that permit you to work in another occupation and still collect total disability benefits.
- Options to Tailor to Your Unique Needs
Look for a policy with a selection of optional benefits, known as riders. They’re used to customize the policy to your specific needs. So if you’re concerned about things like the effect of a partial disability, your ability to repay student loans, or increases in the cost of living, you can add options to your policy to address those concerns.
Waiver of Premiums
You’ll be able to continue your coverage without paying the premium while disabled and for six months after your claim ends.
Exclusive! Waiver of Elimination Period
If you suffer a disability that lasts more than six months and we pay benefits, we’ll waive the elimination period, or waiting period, for any subsequent disability of 30 continuous days or more that occurs within five years – regardless of the cause.
New! Hospice Care Benefit
If you’re admitted into a qualified hospice program, we’ll consider you to be totally disabled, plus we’ll waive the policy elimination period, so there’s no waiting for benefits.
Presumptive Total Disability Benefit
If you ever lost your hearing, speech, sight in both eyes, or the entire use of both hands, feet or one hand and one foot, we would consider you to be totally disabled even if you’re still able to work. In addition, we’d waive the policy elimination period.
An endorsement is a benefit that can be added to a policy at underwriter discretion at no additional cost. Endorsements are typically added to standard issue policies.
New! Serious Illness Supplemental Benefit
If you become totally disabled from cancer, a stroke, or a heart attack, we’ll pay an additional 50% of your monthly benefit, above and beyond your regular monthly benefit, for up to 12 months, over the life of your policy. The benefit begins after you’ve satisfied the elimination period.
Occupational Rehabilitation and Modification and Access Benefit
This benefit can pay for occupational rehabilitation expenses, plus the cost of modifications to your work environment to accommodate physical limitations.
Key Policy Feature
The definition of total disability is one of the most important elements of a disability insurance policy. It’s at the core of determining your eligibility for total disability benefits.
True Own Occupation
A key advantage of a True Own Occupation Definition of Disability is that you’re able to receive your full disability benefits even if you’re gainfully employed in another occupation or capacity — with no reduction in benefits. If deemed totally disabled in your own occupation, there may be instances where you may even work in your own business or practice.
Selecting this definition of disability for the full duration of your policy provides the strongest level of protection. With the True Own Occupation definition of disability, you’re considered totally disabled when you’re unable to perform the duties of your own occupation solely due to illness or injury. If you’re a dentist who has limited your occupation to the performance of a single dental specialty, we’ll deem that specialty to be your occupation.
Two-Year True Own Occupation
This definition of disability offers a two-year period of True Own Occupation to focus on your health and plan next steps. If you’re still disabled after two years, your coverage converts to a Modified Own Occupation definition of disability for the remainder of your benefit period. You’re eligible for benefits when, solely because of illness or injury, you’re:
Unable to perform the duties of your own occupation, and
Not gainfully employed
This definition offers the strength of True Own Occupation coverage for the first two years, along with solid protection for the remainder of the policy.
As a leading provider of DI for physicians, we understand their unique needs when it comes to income protection. That’s why we developed an Enhanced True Own Occupation Definition of Total Disability8 just for physicians and doctors of osteopathy.
It starts with our strong True Own Occupation Definition of Total Disability. It provides a physician with the flexibility to be gainfully employed, in some instances even in their own practice, with no reduction in total disability benefits.
Then, we add a straightforward, easy-to-understand formula to qualify for benefits. It’s based on the source of your earnings and provides more ways to qualify for total disability benefits. We’ll consider you totally disabled if more than 50% of your income is from:
Hands-on patient care and, solely because of injury or illness, you can no longer perform hands-on patient care; or
Performing surgical procedures and, solely because of injury or illness, you can no longer perform surgical procedures.
That’s not all.
If you don't qualify for benefits under the source-of-earnings formula above, then we’ll look at your key duties, including those you were performing in your medical specialty at the time your disability began, to assess whether or not you qualify. Because we evaluate your situation from multiple perspectives, we give you more ways to qualify for total disability benefits. This is some of the strongest, most flexible protection a physician can get.
HOW IT WORKS: See how three different physicians qualify for total disability. The first two qualify using the enhanced formula, and the third under a traditional assessment of how the disability affected his or her ability to perform occupational duties.
When a Disability Isn’t Total
Sometimes an illness or injury causes a drop in income, but doesn’t totally prevent you from working. For example, you:
Can only work reduced hours.
Aren’t able, or it takes you longer, to do some of the tasks you used to do.
Have recovered from your disability but require time to get back to your pre-disability earnings.
We offer two Partial Disability Benefit riders, or options, that provide funds to help make up for your lost earnings while you recover.
Exclusive Waiver of Premium
We’ll waive any premiums due while you’re disabled and receiving benefits. And unlike most other insurance companies, we’ll continue to waive them for six months after you recover and benefits end. We understand you need time to recover physically and financially.
This option provides benefits when, solely due to injury or illness, you suffer a loss of income of 15% or more.
For the first 12 months, the benefit is equal to the actual loss of income, up to 100% of your monthly benefit.
– Minimum benefit is 50% of your monthly benefit.
– After 12 months, benefits are paid in proportion to your income loss.
Even after you fully recover and return to work full time, we’ll continue to pay you benefits as long as you have a loss of income of at least 15% of your prior income and the loss is solely the result of the injury or illness.
The Enhanced Partial Disability Benefit Rider is particularly suited to professionals and business owners who:
Don’t have a Group Long Term Disability (LTD) or association plan.
Have fee-for-service income (derived from procedures or services).
Have highly variable earnings (from bonus, commission, or incentive compensation).
This option provides benefits when, solely due to injury or illness, you suffer a
loss of income of 20% or more and have a loss of time or duties.
Benefits are payable in proportion to your loss of income up to the policy benefit period.
– For the first six months, we’ll deem the loss of income to be at least 50% if
you meet the definition of partial disability.
Lump Sum Payment: If you receive Basic Partial Disability benefits, recover from a partial disability, and return to work within 12 months after satisfying the elimination period, a lump sum benefit equal to two times your monthly benefit is paid to you.
A policy with a Basic Partial Disability Benefit Rider is most suitable for salaried
With minimal variable compensation
Whose job type is not conducive to returning part-time (often the case with
HOW IT WORKS: You have a bike accident that results in surgery and rehabilitation. As your condition improves, you return to work part time, then eventually full time.
Early Career Vulnerability
As you begin your professional career, your income is just beginning to grow, and your unpaid student loan debt is at its highest. You’re particularly vulnerable should disability strike.
Safeguard your ability to continue making your student loan payments with our optional Student Loan Protection Rider that lets you:
Obtain additional coverage — up to $2,000/month2 — above what you might otherwise qualify for based on your income
Tailor coverage to your specific debt
– Reimburses $500-$2,000 per month toward student loan payments2
Choose a rider duration — 10 or 15 years
Grow Protection with Your Income
As your income grows, you may want to obtain additional coverage. Typically, that would require evidence of good health each time you apply.
When you add a future increase rider, or option, you’ll be eligible to purchase additional coverage with no medical insurability requirement. This is a great
way to ensure that you can protect your income regardless of any changes in
Each time that you increase coverage, your eligibility is determined by your financial situation as determined by your income, employment, and other disability insurance.3
We offer two options:
Future Increase Option
This option provides the opportunity to increase benefits annually through age 55. You’re not, however, required to purchase any specific amount or at any set frequency.
Benefit Purchase Option
You have the opportunity to increase benefits every three years until age 55 with this option. At the time you purchase your policy, you must purchase at least 75% of the maximum benefit you’re financially eligible for. After that, you’re required to
Submit a short application for an increase every three years until age 55.
Purchase at least 50% of the amount of any additional coverage offered in order to keep the rider in effect.
Keep Pace with Inflation
Inflation is a fact of life, and often a forgotten economic hazard of a disability. A Cost of Living Adjustment (COLA) Rider adjusts your benefit to help keep pace with inflation during a period of disability. Each of our three riders:
Is designed to increase your monthly benefit, whether you’re totally or partially disabled.
Includes compound annual adjustments and a minimum benefit adjustment of 3%, calculated on a compounded basis.
Has no limit to the number of annual increases that can be made before the end of your policy.
After you recover, the increased benefits become part of your policy’s new base benefit — at no additional premium.4
After you’ve been disabled for 12 months, we’ll increase your monthly benefit each year according to changes in the Consumer Price Index for Urban Consumers (CPI-U). Compounded increases will be no lower than 3% compounded and no higher than 6%.
After you’ve been disabled for 12 months, we’ll increase your monthly benefit each year by 3%, compounded annually.
We’ll increase your monthly benefit each year by 3% compounded annually. Increases begin on the fourth anniversary of the date you originally became disabled.
$10,000 Monthly benefit, 90-day elimination period, to Age 65 benefit period, totally disabled from ages 45 to 65.
6% Maximum COLA assumes the CPT-U increases by 6% annually throughout the entire period of disability.
Disability Interrupts Long-Term Plans
A period of disability during prime earning years impacts your finances in two ways:
Day-to-day living expenses
Saving for future plans
Traditional disability benefits help you meet routine living expenses. However, a disability typically interrupts your ability to set aside funds for long-term goals like retirement or children’s education — and it’s difficult to catch up.
Our Lump Sum Disability Benefit Rider can help you offset these missed opportunities for savings. It can provide an extra 35% of disability benefits paid in a lump sum at age 605 —regardless of whether or not you’re still disabled. We’ve chosen to pay the Lump Sum Disability Benefit at age 60 — early enough to have an impact on some of your long-term plans and goals.
HOW IT WORKS: You’re in a serious auto accident at age 47. Your surgeries and rehabilitation take three years. You return to work part-time, and then eventually full-time. You remain healthy and working until age 65, when you retire.
You get $175,000 at age 60, over and above the $500,000 you received in disability benefits. You choose how to use the funds to regain financial footing — investing it, putting it towards education costs, buying real estate, etc. This exclusive option is not available from any other disability carrier.
Keep Retirement Savings on Track
This option, or rider, helps replace the contributions you’d have made to a defined contribution plan while you are totally disabled and not gainfully employed. A monthly benefit insuring up to 100% of your retirement contributions, including any employer match, will be paid into a trust established by you. You direct how benefits are invested and can begin accessing them at age 65.
See the difference between how retirement contributions would fare with and without an interruption of contributions.
Retirement Protection Plus is not a pension plan or a substitute for one.
Exclusive Stronger Protection
Many disability insurance carriers offer a catastrophic benefit. However, we’re the only one with an Enhanced CAT rider that includes an automatic 3% compound cost-of-living increase.
Funds for Added Flexibility
A devastating illness or accident can leave you needing extra assistance. The Catastrophic Disability Benefit (CAT) provides extra funds so you’ll have the flexibility to do things such as hire help and pay for items not covered by your health insurance. The CAT option can provide up to 100% income replacement when combined with the base policy benefit and other disability coverage.
Choose from two strong options:
Enhanced – Provides extra funds in the event of a sever disability plus an automatic 3% cost of living adjustment.
Basic – Provides extra funds in the event of a severe disability.
Graded Lifetime Indemnity for Total Disability Rider
This option provides a lifetime benefit for continuous total disabilities, beyond the policy’s expiration. The monthly benefit amount is based on your age at the time the continuous total disability began. For disabilities that began prior to age 46, the benefit is equal to 100% of your policy’s monthly benefit. For those that began after age 45, the benefit is reduced by 5% for each year over 45 that the disability began. Benefits are payable so long as you remain disabled.
Social Insurance Substitute Rider
This monthly benefit coordinates with payments received under Social Security and some other government programs6. This option is often purchased to reduce the overall cost of your policy.
Unemployment Waiver of Premium Rider
Should you ever find yourself unemployed and receiving unemployment benefits, this option helps by waiving your premiums for 12 months. It helps you maintain your coverage during a period of unemployment.
Automatic Benefit Enhancement Rider
This convenient, no-cost rider helps keep your disability benefit aligned with normal, annual income increases you might experience when healthy. It’s applied automatically at the time of underwriting to eligible policies and provides an annual 4% benefit increase each year for six years, with no proof of income required. Each increase will include an additional premium based on your then-current age.
Help Secure Your Path to the Future
You’ve invested so much in your career that it only makes sense to protect that investment’s earning power. The promise for the years ahead relies on a strong financial foundation: your income.
Our commitment to protecting that foundation shapes the way we operate every day. Berkshire Life is a wholly owned stock subsidiary of Guardian. We share Guardian’s timeless values of doing the right thing and holding ourselves to high standards.
We have a rich heritage of integrity and trust. We’ve weathered some of the most prosperous as well as most turbulent of times, reflecting our philosophy of taking the long view. Berkshire Life has these exemplary financial ratings7:
Highest of 15 ratings
AA+ Very strong
2nd highest of 21 ratings
Standard & Poor’s
AA+ Very strong
2nd highest of 22 ratings
Finding the Best Policy
One size doesn’t fit all – particularly when it comes to income protection. The best policy isn’t necessarily the one loaded with every feature available. It’s the one tailored to your life. You and your insurance representative can work together to configure the best policy for you.
Look for a policy with:
Strong base policy with built-in benefits.
Options to tailor coverage to your life.
Flexibility to align with your present and future needs.
Evaluate an insurance company with an eye toward:
Experience and expertise in disability insurance.
Coverage that fits your needs and wallet.
A track record of financial strength.
Heritage of doing the right thing for customers.
Now that you’ve had a chance to learn more, what are the next steps?
1. Consider your protection needs and priorities.
2. Ask your insurance advisor for a proposal.
3. Learn about the two options for paying for your DI policy.
Level Premium is a fixed premium that never increases.
Graded Premium lets you pay a lower premium initially, with increases according to a pre-determined, guaranteed schedule.
You have the option to convert to a level premium through age 50.
AGE & HEALTH
The cost of disability insurance increases with age, so typically:
When you buy young, you “lock in” a lower cost for the life of your policy.
Health problems may increase with age, and affect pricing as well as the ability to get coverage with the most favorable terms.
Professionals who have invested a great deal of time and money in career preparation usually want:
Protection for specialized skills.
– For physicians and dentists, protection in their specialty.
The ability to decide whether or not you’d want to work in another occupation, if disabled, without a reduction in disability benefits.
The option to take their DI coverage with you each time you change employers. (Group and association plans are typically not portable.)
Your earnings and their composition play a key role in:
How much coverage you would need and qualify for;
– Even dual career households generally depend on both incomes to get by.
What is and isn’t protected.
– Bonus, commission, and incentive income can be covered under individual DI, but not usually with DI plans through work or an association.
Your savings and debt will influence choices around:
How long to wait for benefits (your policy’s elimination period).
Whether or not student loan payments, retirement contributions, etc. need protection.
EXISTING DISABILITY INSURANCE, IF ANY
If you have any disability insurance already, it’s important to understand:
What it does and doesn’t cover.
How disability is defined (true own occupation, modified own occupation, etc.).
Whether or not its benefits would be taxable. Typically, benefits are tax-free if you pay the premiums with after-tax dollars.
All new policies issued in CA will have a Mental and/or Substance-Related Disorder (MSRD) limitation, whereas those issued in VT will not. Policies issued to anesthesiologists/anesthetists, emergency room physicians, pain management physicians, and nurse anesthetists will have an MSRD limitation. Discounts are applied when there is an MSRD limitation of 6 or 24 months. MSRD limitations do not apply to policies issued as the result of a future increase or future purchase option when exercised from a policy that did not have such a limitation.
In New York: These policies provide disability insurance only. They do not provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. For policy form 18ID, the expected benefit ratio is 50%. For policy forms 18UD, and 18UD-F, the expected benefit ratio is 60%. The expected benefit ratio is the portion of future premiums that the company expects to return as benefits, when averaged over all people with these policy forms.
This brochure is provided for informational purposes only and should not be considered tax or legal advice. You should consult your tax, legal, or accounting professional regarding your individual situation.
1. NerdWallet Health Bankruptcy Report 2014, nerdwallet.com
2. Reimburses $500 - $1,000 per month toward student loan debt incurred from a degree-granting institution; $500 - $2,000 if pursuing or holding an advanced degree.
This rider provides coverage for a period of 10 or 15 years from the policy date. When a qualifying total disability occurs, benefits are only payable during the remaining portion of the 10- or 15-year term that has not elapsed when the disability begins.
3. All other disability insurance that you own, have applied for, or for which you are eligible with any insurer.
4. Provided the increase is $300 or more.
This benefit is not necessarily protection against increases in the cost of living.
5. Policy must still be in force at age 60 to qualify for benefits.
This example is provided for informational purposes only and should not be considered tax or legal advice Contact your tax or legal advisor regarding the tax treatment of the policy and policy benefits. You should consult with your own independent tax and legal advisors regarding your particular set of facts and circumstances. The information provided is not intended or written to be used, and cannot be relied upon, to avoid penalties imposed under the Internal Revenue Code or state and local tax law provisions.
6. If legislated benefits are paid in excess of the Social Insurance Substitute Rider benefit amount, no Social Insurance benefit will be paid. In New York and New Jersey only, the Social Insurance Substitute Indemnity is payable only if you are not receiving any legislated benefits.
7. Ratings are as of 4/1/2016 and are subject to change.
Individual disability income products underwritten and issued by Berkshire Life Insurance Company of America (BLICOA), Pittsfield, MA. BLICOA is a wholly owned stock subsidiary of and administrator for The Guardian Life Insurance Company of America (Guardian), New York, NY. Product provisions and availability may vary by state.
8. Not available for policies with a Graded Lifetime Rider or that do not include a partial disability rider.
2016-22158 (Exp. 06/18)