Platinum Plus

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

Place your difficult to insure Disability Insurance cases on the Platinum Plus Plan! This plan has a five-year Benefit Period and a minimum 90-day elimination period. Reduced rates are available with 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

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

Flexible eligibility

  • Between the ages of 18 and 60
  • Earned income in excess of $30,000
  • No occupation class distinction – Broad eligibility with most occupations accepted

Core eZ-DI Benefits

  • Easy to process application
  • Simple competitive Base Rates
  • No medical exams / no blood work for amounts up to $13,000
  • Pre-existing conditions may be covered immediately if disclosed and accepted and not waivered
  • No Complicated Social Insurance Riders
 

Also included in the Platinum Plan at no additional cost:

  • Partial Disability Benefits
  • Waiver of premium in case of disability
  • Survivor benefits
  • Accidental Death & Dismemberment Benefits
  • Hospital Indemnity Benefits
 

Available in most states – Not available in: AL, AK, CO, FL*, ID, IN, KS, ME, MD, MI, MT, NH, NM, NY, ND, OR, PA, SD, UT, VT

Please contact your Broker/Agent Support Team for alternate plans in NY and FL.

 

Eligibility

Age

  • Applicants between the ages of 18 and 60

Occupation and Income

  • No occupational class distinction
  • 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 – see “Target Customers” tab for exceptions

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
  • 90-day Elimination Period
  • Other Elimination Periods: Optional 120/180/365-day Elimination Periods – Longer Elimination Periods reduce Premium Levels
  • Graded Benefits based on when disability occurs:
    • 40% of stated Monthly Benefit if disability occurs during first year of coverage
    • 75% 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 first two years!
  • Guaranteed Renewable (to age 65; Conditionally renewable to age 70)
  • Level premium at Issue Age (to age 65 – 5-year age banding)
  • Benefits paid in case of accident or sickness
  • No occupational class distinction for premium calculations
  • Partial Disability Benefits:
    • Provides up to 50% of selected monthly benefit for partial disability up to six months upon completion of the elimination period or immediately following a period of total disability. Does not include benefits for mental and nervous.
  • 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

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 Basically, what we are looking for is the hard-working, diligent person who may be uninsurable, but who is able to work fulltime 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
  • Guaranteed Renewable to age 65 – Conditional Renewable to age 70

Benefits will not be paid for Injury, Sickness, or Nervous or Mental Disorder:

  • the Insured intentionally inflicts on himself or herself while sane or insane (in Colorado or Missouri, while sane);
  • caused by riot, insurrection, war, declared or undeclared, or acts of war;
  • caused by normal pregnancy, including childbirth or elective abortion, except when loss results from Complications of Pregnancy, as defined in the Policy
  • caused by the Insured engaging in any act or occupation which is a violation of the law of the jurisprudence where the loss or cause of loss occurred. A violation of law includes both misdemeanor and felony violations.
  • caused by poison, gas, or fumes voluntary taken, absorbed or inhaled, except for the involuntary or unintentional ingestion of poison or inhalation of poisonous gasses or fumes;
  • caused by an accident that occurs while an insured has been determined to be intoxicated (a) by judicial or administrative judgment or order; (b) by evidence of an alcohol concentration in the insured’s blood, breath or urine which equals or exceeds the limits set by applicable motor vehicle laws; or (c) by other evidence demonstrating the insured was under the influence of any alcohol, narcotic, barbiturate or hallucinatory drug unless the same was administered on the advice of a physician and was taken according to the prescribed dosage; and the use of such substance was the proximate cause of the Accidental Bodily Injury

Armed forces:

  • Benefits will not be paid for Injury, Sickness, or Nervous or Mental Disorder while the insured is in the military, navel or air force of any country or international organization. Any unearned premium paid by the insured for a period not covered because of this Exclusion will be returned on a pro-rata basis if he or she notifies Us. If the insured is released from active duty within 5 years from the date he or she entered active military service, he or she may restore their coverage under the Policy by making written application and paying the required premium within 90 days of his or her release from active duty. No proof of insurability is needed. Premiums will be based on the Insured’s attained age as of the date of the new Application. The restored policy will cover only Injuries that occur after the restoration date and Sickness which makes itself known more than 10 days after the restoration date.

Worker’s Compensation:

  • Benefits are not paid for any injury, sickness, or nervous or mental disorder for which compensation is payable under any Worker’s Compensation Law, Occupational Diseases Law, the 4800 Time Benefit Plan or similar legislation.

Pre-existing conditions:

  • If a condition is listed on the Application and is accepted by Us without an exclusion rider, then this condition will be covered and is not subject to the Pre-existing Condition Limitation.
  • Pre-Existing Condition means a Sickness, Injury, Nervous or Mental Disorder, or physical condition for which an Insured has consulted a Physician or received any medical advice, treatment, medical supplies, prescription medication, or services within the 12 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. We will not pay for a Total Disability caused by or due to a Pre-existing Condition until after the Insured has been covered under the Policy Certificate 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 date the policy terminates (the certificate then becomes a contract between the insured and the company), and the premium due date when required premium is not paid. At age 65 to attainment of age 70, the policy is conditionally renewable, provided the insured pays the required premiums, subject to the grace period, and the insured continues to be actively at work. Premiums will increase each year on the anniversary date of the insured’s coverage beginning with the anniversary date following the attainment of age 65. Coverage terminates at age 70.

AD&D Benefit Exclusions:

  • Bodily infirmity or disease in any form, or medical or surgical treatment therefore
  • Bacterial infection, except infections which result from an accidental in jury or bacterial infection which results from an accidental, involuntary or unintentional ingestion of an infectious organism;
  • Travel or flight in any kind of aircraft, except on a regularly scheduled commercial flight as a fare-paying passenger, including falling or otherwise descending from or with such aircraft in flight, or while the Insured is participating in aviation training in any kind of aircraft, or is a pilot, officer or other member of the crew of such aircraft
  • Suicide, or any attempt thereat, while sane or insane (in Colorado and Missouri, while sane)

Hospital Indemnity Benefit Exclusion:

  • In addition to the Limitations and Exclusions listed in this Policy, the Hospital Indemnity Benefit excludes; confinement, treatment or care performed outside the U.S., not recommended or prescribed by a physician, or is not medically necessary