Platinum

A graded 5 year benefit plan for applicants with sub-standard medical conditions.

Place your difficult to insure Disability Insurance cases on the Platinum Plan! This plan has a five-year Benefit Period and a minimum 60-day elimination period. Discounted options are available with 90/120/180/365-day elimination periods. Choose a Benefit Amount between $500 and $15,000 per month with no blood work or medical exams.

Overview

  • Benefit Amount up to $15,000 Monthly
  • 5-Year Benefit Period
  • Graded plan
  • Own Occupation definition of Total Disability for the first two years!

Flexible eligibility

  • Between the ages of 18 and 63
  • Earned income in excess of $30,000
  • No occupation class distinction – Broad eligibility with most occupations accepted
  • No Tobacco / Gender based rates

Core eZ-DI Benefits

  • Easy to process application
  • Simple competitive Base Rates
  • Non-Medical Underwriting: No medical exams / no blood work up to $15,000
  • Pre-existing conditions may be covered immediately
  • No Complicated Social Insurance Riders

 Included in the Plan at no Additional Cost

  • Waiver of premium in case of disability
  • Survivor benefits
  • Accidental Death & Dismemberment Benefit
  • Hospital Indemnity Benefits
 
Available in most states, except the following states: AL, AK, CO, CT, FL, ID, KS, ME, MT, NH, NM, NY, NC, OK, PA, SD and UT
Please contact your Broker/Agent Support Team for alternate plans in NY and FL.

Eligibility

Age

  • Applicants between the ages of 18 and 63

Occupation and Income

  • Earned annual income of $30,000 or more
  • Actively working a minimum of 30 hours per week at their regular occupations for the past year
  • Majority of occupations accepted

Medical

  • Pre-existing conditions may be covered immediately when listed on the application, approved by the company and coverage is issued!

Benefits

If disability occurs, Monthly Benefits paid are those shown in the Policy schedule and correspond to the level of premium the insured pays on an annual/semi-annual/quarterly or monthly basis. Monthly Benefits are paid for a maximum of 5 years.

Benefits paid in case of disability

  • Benefit Amount: $500 to $15,000 per month – up to 60% of gross monthly earned income
  • Benefit Period: maximum of five years
  • 60-day Elimination Period
  • Other Elimination Periods: Optional 90/120/180/365-day Elimination Periods- Longer Elimination Periods reduce Premium Levels
  • Graded Benefits based on when disability occurs:
    • 33% of stated Monthly Benefit if disability occurs during first year of coverage
    • 66% of stated Monthly Benefit if disability occurs during the second year of coverage
    • 100% of stated Monthly Benefit if disability occurs after second year of coverage

Other Benefits included in the plan

  • Premiums are waived during disability (After elimination period and prior to age 65)
  • Own occupation definition of Total Disability for the full two years!
  • Survivor Benefits:
    • Two times the amount of the last monthly benefit paid to the insured is provided to the surviving spouse. The insured must have been disabled for 180 days and receiving benefits.
  • Hospital Indemnity Benefits:
    • $30 per day for up to 90 days after the elimination period if the insured was hospital confined for the entire elimination period.
  • Accidental Death & Dismemberment Benefits:
    • Up to $5,000 benefit paid should death or dismemberment occur within 90 days of covered accidental injury.

Options

Options are available for an additional charge only at the time of application

Partial Disability Rider:

  • Provides up to 50% of selected monthly benefit for partial disability up to 6 months upon completion of elimination period or immediately following a period of total disability

Hospital Indemnity Rider:

  • Provides benefits should insured be hospital-confined. From $25 to $100 per day up to 365 days.

Home Health Care Benefit Rider:

  • Pays $50 to $100 per day for home health care services for up to two years after insured has been hospital-confined for three or more days.

Own Occupation Extension Rider:

  • Amends the definition of total disability to increase the time period insured is covered at own occupation from two to five years. Otherwise total disability is defined as when an insured, because of injury, sickness or nervous or mental disorder, during the first 24 months of disability, cannot perform the material and substantial duties of his or her regular occupation. After 24 months, the insured must be completely unable to perform the material and substantial duties of any occupation for which he or she is reasonably fitted by education and training.

Target Customers

General applicant profile: Applicants are to be actively working for a minimum of 30 hours. What we are looking for is the hard-working, diligent person who may be uninsurable, but who is able to work full-time without losing time from his/her profession or job and is not chronically ill. Do not solicit applications from any applicant who is currently disabled, unemployed due to health reasons, hospitalized, or whom you have reason to believe is suffering from chronic or terminal illness.

Target Customers

  • Working Professionals
  • Executives
  • Individuals in Small Businesses with medical conditions

 

Limitations

Some provisions, benefits, exclusions or limitations listed herein may vary depending on your state of residence. Please refer to the Policy or Certificate for full details of limitations and exclusions contained in this coverage.


General:

  • Optional benefits terminate with the disability coverage
  • Benefit period reduces by 50% at age 65 and terminates at age 70
  • Conditional renewable

Benefits are not paid for any injury, sickness, or nervous or mental disorder caused:

  • By war, declared or undeclared.
  • By normal pregnancy, including childbirth or elective abortion.
  • By intentional infliction while sane or insane (in Colorado or Missouri, while sane).
  • By an illegal act, or resisting or fleeing arrest.
  • By voluntary taking of poison or inhaling of gas.
  • From any accident where blood alcohol content exceeds legal state limit.
  • While under the influence of any narcotic, barbiturate or hallucinatory drug, unless under advice of a physician.
  • While in the military, naval or air force of any country.

Worker’s Compensation:

  • Benefits are not paid for any injury, sickness, or nervous or mental disorder which is payable under Worker’s Compensation, Occupational law or similar legislation.

Pre-existing conditions:

  • A condition listed on the application and not excluded by a rider is covered.
  • A pre existing condition means a sickness or injury for which the insured has consulted a physician or received any medical advice, treatment, medical supplies, prescription medication or services within12 months immediately before the effective date of insurance, or for which symptoms of a condition have occurred that would have led a prudent person to seek diagnosis, care or treatment during the 12 months immediately before the effective date of insurance, or until the insured has been covered for 24 months.

Nervous or mental disorder benefit:

  • Nervous or mental disorder benefit is one-half the maximum monthly benefit to a maximum benefit period of six months.

Other Disability Income coverage:

  • If the insured has other disability income coverage in effect at the time of total disability, the benefit will be reduced so the total benefit does not exceed 100% of the insured’s gross monthly income.

Termination of coverage:

  • The insured’s coverage terminates on the earliest of: the premium due date when required premium is not paid, the premium date after the insured retires or ceases to actively perform the material and substantial duties of regular occupation, the premium due date following attainment of age 70, the next premium due date upon request for cancellation, or the premium due date after the insured has a change in employment to an ineligible occupation.

AD&D Benefit Exclusions:

  • Bodily infirmity or disease in any form, or medical or surgical treatment
  • Bacterial infection, except infections from an accidental injury or unintentional ingestion of an infectious organism.
  • Participating in a riot or insurrection.
  • Travel or flight in any kind of aircraft, except on a regularly scheduled commercial flight as a fare-paying passenger.
  • Suicide, or any attempt, while sane or insane (in Colorado or Missouri, while sane)

Hospital Indemnity Benefit Exclusion:

  • Confinement, treatment or care performed outside the U.S., not recommended or prescribed by a physician, or is not medically necessary.

Home Health Care Benefit Exclusion:

  • Benefits are not payable for custodial care, for services provided by a person resides in the insured’s home or who is a member of the immediate family, or for services provided to an insured who is eligible for Medicare.