What is the Group Insurance Plan?
The Group Insurance Plan provides AICPA member accounting firms with less than 25 eligible lives, term life coverage with Accidental Death and Dismemberment (AD&D) insurance, disability waiver of premium protection and optional dependent life insurance to firm owners, their firm members and employees. Cash refunds are paid by the Trust to participating firms from premium refunds received from Prudential. For more than 40 consecutive years, refunds have reduced the cost of coverage although they are never guaranteed.
What firms are eligible to participate?
Your firm is eligible if it has its principal office in any state of the United States (except Texas), the District of Columbia, American Samoa, Guam, Puerto Rico, or the U.S. Virgin Islands. The proprietor or at least one partner or firm member of a public accounting firm must be a member of the AICPA; or for firms other than a public accounting firm, a member or members of the AICPA must have at least 50% ownership. In addition, the firm must have at least one eligible full-time employee, other than the proprietor, partner or firm member, who is to become insured on the date participation begins for the firm.
How can I enroll my firm in the Group Life Insurance Plan?
If your firm has less than 25 eligible lives, you can enroll in the Group Insurance Plan by completing the subscription form and mailing it to: Aon Insurance Services, 1100 Virginia Drive, Suite 250, Fort Washington, PA 19034. You may also fax your form to 1-800-242-7248.
Who may be covered?
Your firm’s proprietors, partners, or firm members and full-time employees are eligible to request insurance on an immediate basis (starting date) or after completing six months of continuous service, depending on the option elected by your firm. Full-time means working in the firm for a minimum of 17 ½ hours per week and not less than five months in a calendar year. Each proprietor, partner, firm member and employee requesting insurance must provide satisfactory evidence of insurability in order to be covered. Typically, individuals requesting insurance will be accepted on the basis of their answers to questions on the request for coverage and without further medical evidence.
What are the options for waiting periods for new firm personnel?
You can select the option to make coverage available to the eligible individuals on an immediate basis (starting date) or after completing six months of continuous service. The option for waiting periods for new firm personnel is elected when the firm sets up the plan.
If dependents coverage is elected, which dependents are eligible?
Eligible dependents in most cases include the spouse and children of individuals who are insured under the Plan. Included are legally adopted children and step-children who are dependent on insured members for support and maintenance, provided in the case of the step-children, that a biological parent has given written consent for the coverage. Children must be unmarried and less than age 25. The spouse may not be on active duty in the armed forces. Firm personnel covered under the Plan cannot also be covered as dependents.
Continued Coverage for an Incapacitated Child: This applies to the Dependents Insurance you have for a child. The insurance for the child will not end on the date/the age limit in the definition of Qualified Dependent is reached if both the following conditions are true:
(1) The child is then mentally or physically incapable of earning a living. Prudential must receive proof of this within 31 days; (2) The child otherwise meets the definition of Qualified Dependent.
If these conditions are met, the age limit will not cause the child to stop being a Qualified Dependent under that Coverage. This will apply as long as the child remains incapacitated.
Does the plan include Accidental Death and Dismemberment Insurance?
Yes. The Group Insurance Plan includes Accidental Death and Dismemberment Insurance equal to the Term Life Insurance amount.
Is there a scheduled amount that the firm must choose from when applying for coverage?
Yes. Under the Group Insurance Plan, firms can choose from schedules of coverage with insurance maximums of $500,000, $400,000, $300,000, $200,000, $100,000 or $50,000. Employee coverage is based on annual earnings. For your firm's coverage basis, a choice of insurance protection from one to three times salary is available depending on the schedule of coverage elected. Coverage for employees is not to exceed your firm's schedule maximum. Proprietors and partners under the age of 65 can be covered for the schedule maximum without regard to earnings.
What happens if a covered individual becomes totally and permanently disabled under the Group Insurance Plan?
An insured individual under the age of 50 who becomes totally and permanently disabled may receive upon approval, monthly installment payments representing a portion of his or her life insurance to help out during a period of disability. Payment is at the rate of $10 per $1,000 of term life insurance in force and is paid for a period up to 10 years. As payments are made, the face amount of life insurance is reduced accordingly.
Insured individuals qualify for benefits as being totally and permanently disabled if they are less than age 50 and (1) due to sickness or injury, or both, are not able to perform for wage or profit the material and substantial duties of any job for which they are reasonably fitted by their education, training or experience for a period not less than nine months; or (2) they suffer the total and permanent loss of sight in both eyes and that condition has been met for at least nine months; or (3) the loss of both hands at or above the wrist; or (4) the loss of both feet by severance at or above the ankle; or (5) the loss of one hand and one foot by severance at or above the wrist or ankle.
What happens if a covered individual becomes totally disabled prior to age 60?
If an individual covered under either the Group Insurance Plan or the Elite Plan becomes totally disabled before the age of 60, the individual's life insurance will be extended at no cost while that individual remains totally disabled. As long as the disability remains, and proof of disability is furnished from time to time, the death benefit protection will be extended from year to year at no cost.
Insured individuals qualify to have their life insurance extended at no cost if they become totally disabled prior to age 60. Total Disability means that (1) insured individual is not working at any job for wage or profit; and (2) due to sickness or injury, or both, is not able to perform for wage or profit, the material and substantial duties of any job for which they are reasonably fitted by their education, training or experience.
When does coverage terminate or reduce?
Coverage will not terminate due to age as long as a covered individual is actively engaged in work full-time with your firm. However, coverage will reduce depending on age as follows: at age 65 (25% of the amount of insurance in force prior to the first age reduction), at age 70 (50%), at age 75 (65%) and at age 80 (75%), including any change in coverage amount due to a change in earnings or status.
The insurance for an individual will automatically terminate when he or she is no longer actively engaged in work full-time with your firm, your firm ceases to be a contributing employer, or the group policy terminates.
Important Notice: These frequently asked questions are for illustrative purposes only and is not a contract. It is intended to provide a general overview of the certificate described. Please remember that the insurance certificate governs actual terms, coverages, amounts, conditions and exclusions.
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