2004 V1
AVAILABLE IN MASSACHUSETTS

Group Short-Term Disability Insurance

Eligibility - An employee must be actively at work for a minimum of 20 hours per
week to be eligible for coverage

Benefit - Standard pays 70% of basic weekly income up to $750 per week

Elimination Period - 15th Day Accident/15th Day Sickness

Maximum Benefit Duration - 26, or 52 weeks

Pre-existing Conditions - Benefits amounts are subject to 12/12 pre-existing
exclusion

Participation – Voluntary Enrollment

Availability – Stand alone.

Termination - Benefits terminate at retirement or end of employment

Limitations - Short-Term Disability benefits are limited to non-occupational
disabilities.

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