Eligible Employees have the opportunity to take advantage of disability insurance and help protect their financial future. Disability insurance pays a portion of your paycheck when you become disabled and can’t work for a period of time due to a covered illness or injury.
Disability insurance can help you pay for costs, such as:
Keep in mind, disability doesn’t always mean a serious handicap. A disability is considered an illness or injury that prevents you from earning your salary.
The content in this portal is for informational purposes only and contains words and phrases that have special meanings. These words and phrases appear in the General Definitions section. The Certificate of Insurance (Certificate), provided to you once coverage has been issued, will contain the specific information on each benefit and additional information (including the eligibility rules for participation) can be found in the Insperity Welfare Benefits Plan Summary Plan Description (SPD).
Complete, sign and date the enrollment application and return to NYL GBS at the address shown on the form or via email at DSM_NYLGBSCustomerSupport@infymccservices.com.
If you have questions, please call 800.231.1193 to speak to a NYL GBS representative (Monday through Friday, 8 AM to 5 PM CST or 9 AM to 6 PM EST).
Who is Eligible for Coverage?
If you are an Eligible Employee, coverage is available to you. Coverage is not available for your Spouse/Domestic Partner or dependents.
To qualify for benefits under this plan, you must be disabled as a result of a covered injury or sickness, and you must be under the appropriate care of a U.S. licensed doctor of your choosing who is qualified to treat your disability.
Before collecting benefits, you must satisfy a 14 day waiting period following your date of disability. The waiting period is referred to as the “elimination period”.
If you are determined to be disabled, you may receive up to 60% of your weekly Covered Earnings to a weekly maximum of $2,308 during the first 24 weeks of disability payments.
After your weekly benefits stop, you may receive monthly benefits up to 60% of your monthly Covered Earnings, to a monthly maximum of $10,000.
Once you qualify for benefits under this plan, you continue to receive them until the end of the benefit period, or until you no longer qualify for benefits, whichever occurs first. (We will ask you to periodically furnish proof of your continuing disability.) Short-term disability benefits will generally be paid weekly – there may be some instances where it is paid as a lump-sum. Long-term disability benefits will be paid monthly.
Your benefit period begins on the first day after you complete your elimination period. Should you remain disabled, your benefits continue in accordance with the following maximum benefit period schedule, depending on your age at the time you become disabled.
Age at commencement
|Age 62 or younger||To age 65 or the date the 42nd monthly
benefit is payable, if later.
|63 years||36 monthly payments|
|64 years||30 monthly payments|
|65 years||24 monthly payments|
|66 years||21 monthly payments|
|67 years||18 monthly payments|
|68 years||15 monthly payments|
|69 years or older||12 monthly payments|
Benefits payable under this plan will terminate on the earliest of any date indicated below:
Monthly Cost of Insurance
Disability insurance premiums are paid for with after-tax dollars. You pay your premiums through payroll deduction unless you are on an unpaid leave of absence, in which case you will be required to pay via check. The total depends on your age and the amount of your monthly Covered Earnings. Rates are subject to change.
If you are between these ages
Your cost per $100 of monthly covered earnings
*Your age for calculating monthly cost of insurance will be updated on each January 1.
Other Benefit Features
Return-to-work incentive benefit
You may continue to receive benefits if you return to work but continue to meet the definition of disability. While weekly benefits are payable throughout the first 30 months of disability, benefits will be reduced so that the combination of this program’s benefit, work earnings and other income benefits do not exceed 100% of your pre-disability indexed Covered Earnings. After the first 30 months of disability, benefits payable under this program are reduced by 50% of your actual work earnings.
If you return to work while disability benefits are payable, but are not performing to the level of your optimum ability in that work—as determined by independent medical specialists qualified to make such an evaluation—the benefits payable under this program will be reduced by the difference between what you actually earn and what you would be earning if working to the level considered by those specialists to be your optimum ability.
Survivor income benefit
The plan also includes a family survivor benefit feature. With this feature, if you die while collecting disability benefits, we will pay a survivor benefit based on 100% of the total of your last month’s benefit, plus the amount of any disability earnings by which this benefit had been reduced for that month. This plan pays a single lump-sum, equal to 6 months of benefits.
If you are offered a rehabilitative assistance program, we will work with you during the course of your elimination period or while benefits are payable. You will be expected to cooperate with the implementation of that assistance program.
If you refuse such assistance without good cause (e.g., a medically substantiated reason), disability benefits will not be payable and coverage under this plan will end. Coverage may be reinstated, and benefits resumed, if, within 30 days of the termination date, you agree to participate in the rehabilitation efforts.
Spouse/Domestic Partner rehabilitation services
While you’re disabled, your Spouse/Domestic Partner may (at NYL GBS’s option) be eligible to participate in a rehabilitation plan. The Spouse’s/Domestic partner’s rehabilitation plan may include payment of your Spouse’s/Domestic Partner’s education expenses, reasonable job placement expenses and moving expenses. It may also include family care expenses, if necessary for your Spouse/Domestic Partner to be retrained under the rehabilitation plan.
To be eligible, you must be continuously disabled for 12 months, your Spouse’s/Domestic Partner’s earnings must be 60% or less than your earnings and NYL GBS must determine your Spouse/Domestic Partner to be a suitable candidate for rehabilitation. Your Spouse/Domestic Partner must be living with you on the date your disability begins.
Your monthly benefits will be reduced by 50% of your Spouse’s/Domestic Partner’s earnings from rehabilitative work. If your Spouse/Domestic Partner was working before the rehabilitation plan began, monthly benefits will be reduced by 50% of the increase in income that results from a Spouse’s/Domestic Partner’s participation in the program.
Recurrent disability feature
If you return to work after receiving benefits under this program, and then become disabled again from the same or a related cause, you will not have to fulfill another elimination period, unless you have worked six or more consecutive months during which you earn 80% or more of your indexed Covered Earnings. The disability would be considered a continuation of your initial claim. If the second disability recurs beyond these limits or results from a cause unrelated to the first, you must file a new claim and fulfill a new elimination period.
When Coverage Begins
If you apply within 30 days of your Benefits Eligibility Date, coverage will begin on the later of: your Benefits Eligibility Date or the date NYL GBS receives your completed online or paper insurance application.
If you apply more than 30 days after your Benefits Eligibility Date, proof of good health is required. If your application is approved, coverage will begin on the date the application approved by NYL GBS.
When Coverage Ends
This coverage will end on the earliest of any of the following dates:
If you are receiving disability benefits when the policy terminates, disability benefits will continue if you remain disabled and meet the requirements for the insurance. Any later period of disability, regardless of cause, that begins when you are eligible under another disability coverage provided by any employer, will not be covered.
Exclusions and Limitations
This plan provides only limited benefits for some conditions and excludes others from coverage, as listed below.
Pre-existing conditions (applicable to Long Term Disability only)
Pre-existing conditions are those for which you have incurred expenses, taken prescription drugs or medicines, received medical treatment, care or services (including diagnostic measures) or for which a reasonable person would have consulted a physician during the three months immediately prior to the most recent effective date of insurance.
This plan does not pay benefits for any disability resulting from a pre-existing condition, unless the disability occurs after you have been insured under this plan for 12 consecutive months. If you were insured under an employer-sponsored disability plan with a pre-existing condition limitation (immediately prior to the effective date of this plan), credit for the time you were insured may apply toward the 12 consecutive month limitation period under this plan.
This plan limits benefits for disabilities caused by or contributed to by any one or more of the following conditions:
Benefits for these conditions have a lifetime limit of 24 months for outpatient treatment. The plan also pays benefits during periods of hospital confinement for these conditions, as long as hospitalization lasts for more than 14 consecutive days and occurs before the 24-month lifetime outpatient limit is exhausted. Once the 24-month outpatient benefits are exhausted, the plan pays no further benefits for these conditions.
This plan does not pay benefits for a disability which results, directly or indirectly, from any of the following:
In addition, we will not pay disability benefits for any period of disability during which you are incarcerated in a penal or corrections institution for any reason.
Your disability insurance will continue if your Active Service ends because of a disability for which benefits under the Policy are or may become payable. Your premiums will be waived while disability benefits are payable. If you do not return to Active Service, this insurance ends when your disability ends or when benefits are no longer payable, whichever occurs first.
If your Active Service ends due to any other excused short term absence from work that is reported to the Employer timely in accordance with the Employer’s reporting requirements for such short term absence, your insurance will continue until the earlier of:
In addition, this program includes a long-term disability conversion privilege feature. Under this feature, you may be eligible to become insured under a separate disability policy if you should leave your current employment with Insperity or if your coverage ends as the result of an approved leave of absence exceeding 12 weeks (or any longer period required by applicable state or federal law).
Conversion is not available in certain situations that include:
Contact NYL GBS directly for additional information at 800.231.1193.
Understanding these words and phrases may be helpful as you read through the information about Disability insurance.
An Employee will be considered in Active Service on a day which is a scheduled workday if any of the following conditions are met:
Employees of a new Client Company who fall into one of the categories above (as of the effective date of the co-employment agreement between Employer and a Client Company) will be treated as being in Active Service for purposes of this Policy.
Affordable Care Act (ACA)
The federal health care reform legislation that was enacted in 2010, as amended.
Applicable Large Employer (ALE)
An employer that employed, on average, at least 50 full-time employees (including full-time equivalent employees), as defined by the ACA, on business days during the preceding calendar year. Contact Insperity if you have questions concerning ALE determinations and whether you are an employee subject to these rules.
The determination of an accurate and medically supported diagnosis of your disability, or ongoing medical treatment and care of your disability by a physician that conforms to generally accepted medical standards, including frequency of treatment and care.
For Full-time Employees, Covered Earnings means an Employee's base annual salary, plus actual earnings for the previous 12 months derived from (i) commissions, (ii) piece work, (iii) fee-based work, and (iv) for ordained, commissioned, or licensed ministers only, any housing allowance paid by the Employer, as reported by the Employer to New York Life on the eligibility file. Amounts attributable to actual earnings will be annualized if the Employee has been employed by the Employer for less than 12 months. In no event will Covered Earnings include bonuses, overtime pay, special pay or any other form of extra compensation.
For part-time Employees, Covered Earnings means actual earnings for the previous 12 months derived from (i) salary (including hourly wages), (ii) commissions, (iii) piece work, (iv) fee-based work, and (v) for ordained commissioned or licensed ministers only, any housing allowance paid by the Employer, as reported by the Employer to New York Life on the eligibility file. Any such amount will be annualized if the Employee has been employed by the Employer for less than 12 months. In no event will Covered Earnings include bonuses, overtime pay, special pay or any other form of extra compensation.
For Employees on a Leave of Absence (whether paid or unpaid), Covered Earnings will be the amount in effect (as calculated above) immediately prior to going on an approved Leave of Absence. The Covered Earnings amount will remain frozen until the Employee returns to work.
Domestic Partner means any of the following:
All references in the policy to “Spouse” shall be changed to read “Spouse and Domestic Partner" except as follows:
Important Note: In order to file a claim for benefits, proof of the domestic partnership as indicated above must be furnished the same as proof of a marriage.
If, solely because of a covered injury or sickness, you are unable to perform the material duties of your regular occupation and you are unable to earn 80% or more of your indexed earnings from working in your regular occupation. After benefits have been payable for 30 months, you are considered disabled if solely due to your injury or sickness, you are unable to perform the material duties of any occupation for which you are (or may reasonably become) qualified by education, training or experience, and you are unable to earn 80% or more of your indexed earnings. We will require proof of earnings and continued disability.
The Plan administers two sets of eligibility rules – one for employees of a non-ALE company and one for employees of an ALE company, as described below and in the SPD.
Employees of a Non-ALE Company
You are an Eligible Employee if your benefits package from Insperity includes coverage under the Plan and you are:
Employees of an ALE Client Company
You are an Eligible Employee if your benefits package from Insperity includes coverage under the Plan and if you are:
Eligibility for employees of an ALE Client Company will be determined based on hours worked during the employee’s Measurement Period. Once the employee is determined by Insperity to be eligible for benefits, eligibility will be retained during the Stability Period associated with that Measurement Period (regardless of any changes in hours worked during the Stability Period).
Certain exclusions may apply. Please see the Certificate for more information.
Indexed earnings are the same as Covered Earnings for the first 12 months of benefit payments. After the 12th month of benefit payments, we apply an increase to your Covered Earnings amount, and refer to this as “indexed earnings,” in order to calculate the maximum benefit payable under this plan when combined with other income benefits you may be eligible to receive. The amount of the increase we apply is the lesser of either 10% or the rate specified in the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPIW) for the preceding calendar year. We do not reduce indexed earnings if the CPIW drops. If the CPIW is ever discontinued, we will use a comparable national index to calculate indexed earnings.
Any accidental loss or bodily harm that results directly and independently of all other causes from an accident.
The occupation you routinely perform at the time your disability begins. In evaluating your disability, NYL GBS will consider the duties of your occupation as it is normally performed in the general labor market in the national economy, and not work tasks performed for a specific employer or at a specific location.
Any physical or mental illness.
Apply Today - Important Tips for Applying for Coverage Online
You can apply For Disability Insurance Online by using the "Apply Now" button to the right. Or, you can Complete An Application and submit to NYL GBS.
Important Tips For Applying For Coverage With NYL GBS Trusted Advisor
How do I report a claim?
You can report your claim by phone, fax, web or mail. However, when you report your claim via the phone, this allows our intake specialists to obtain relevant information in a single phone call, get verbal authorization to obtain your medical information, which allows for quicker access to medical information from your treating physician—this helps to speed up the claim decision process.
To file a disability claim by phone please call 800.362.4462.
How can I check the status of my claim?
You may check the status of your claim by logging into www.myNYLGBS.com. If you do not have a registration ID and password, you will need to register for one before accessing your claim information. Please wait 48 hours from the time you file your claim before checking the status of your claim.
You can check the status of your disability claim by phone at 800.362.4462
Are there resources available to help me return to work?
Yes. If you are able to return-to-work after a disabling injury or accident, NYL GBS has a team of dedicated vocational rehabilitation counselors who will support your to return-to-work efforts and they will develop a personalized plan for you and recommend assistive equipment as needed.
What if I cannot return to work, are there any resources to help guide me through the Social Security Disability Insurance process?
Yes. Our expert resources help qualified individuals apply and be approved for Social Security Disability Insurance and also represent them at Social Security hearings.
Are there any other programs I should know about?
Yes. Our Disability insurance plan includes many value-added programs, offered at no additional cost, to help you and your family maintain your health, well-being and sense of security throughout your lifetime. To see which programs are available to you select Value-Added Programs from the menu above.