Hour Bank Benefit Plan: Long Term Disability Benefit
Employees are eligible for Long Term Disability (LTD) benefits when the following conditions are met:
- you are in benefit under the Hour Bank Benefit Plan, and
- you are actively at work for a Merit employer that is participating in the Merit LTD program.
You are in benefit if you have accumulated sufficient hours in your Hour Bank account to purchase coverage for the current month.
You are considered actively at work if you were working for a Merit employer on your last scheduled shift prior to becoming disabled.
After the first 120 days of total disability, a flat benefit amount is payable for the first 24 monthly payments. The benefit level then increases and remains level while you remain totally disabled. Refer to your benefit booklet to determine the amount of your LTD coverage.
LTD benefits will be reduced by any disability benefit payable by Workers Compensation (WCB) or Workplace Safety and Insurance Board (WSIB).
There is a further reduction of the LTD benefit if the total of your income, when combined with other sources of income, exceed 85% of your pre-disability income. If it does, then your benefit is reduced by the excess amount. Other sources of income include:
- any group or association plan;
- any retirement or pension plan;
- earnings/payments from any employer, including severance payments and excluding vacation pay;
- any government plan, excluding Employment Insurance benefits;
- Canada or Quebec Pension Plans, including dependent benefits;
- any government motor vehicle automobile insurance plan or policy, unless prohibited by law;
- benefits payable under any WCB/WSIB Act or similar law.
The LTD benefit has a waiting period of 120 days from the date of disability, during which time no benefits are payable.
LTD benefits are payable while you remain totally disabled, up to age 65.
Definition of Disability
During the waiting period and next 24 months: you must, due to disease or injury, be unable to perform the essential duties of your own occupation. In addition, you must not be employed in any occupation that provides you with an income equal to, or greater than the income benefit available under this plan (with the exception of approved rehabilitation employment).
Following the waiting period and next 24 months: you must, due to disease or injury, be unable to perform the duties of any occupation for which you are qualified, or may reasonably become qualified, by training, education or experience.
Tax Status of LTD Benefits
If you pay 100% of the LTD premium, any LTD benefits received are non-taxable.
If your employer pays any portion of the LTD premium, any LTD benefits received are taxable.
Periods for Which Benefits Are Not Payable
You are not eligible to receive LTD benefits if you are:
- not receiving regular, ongoing care and treatment from a physician appropriate to the disabling condition, as determined by the insurer;
- receiving Employment Insurance Maternity or Parental benefits;
- on a lay-off during which you became disabled;
- on a leave of absence during which you became disabled, unless your employer is required to pay benefits during this period as required by legislation, regulation or case law;
- receiving benefits under an employer-sponsored salary continuance or short-term wage loss replacement plan;
- working in any occupation, except as provided under the Rehabilitation Assistance provision;
- incarcerated in a prison, correctional facility or mental institution by order of authority of a criminal court.
LTD benefits will continue during a period of approved rehabilitation employment. However, your LTD benefit will be reduced by 50% of earnings from approved rehabilitation employment. In addition, your LTD benefit may be further reduced so that your total income from all sources does not exceed 100% of pre-disability net income (if the LTD benefit is non-taxable) or 100% of your pre-disability gross income (if the LTD benefit is taxable).
Waiver of LTD Premiums
LTD premiums will be waived during any period that you are in receipt of LTD benefits.
Termination of LTD Coverage
Your LTD coverage terminates at the earliest of the following dates:
- the date you are no longer in benefit under the Hour Bank Benefit Plan;
- the date you cease to be actively at work;
- the date your employer ceases to make any required premium contributions;
- 120 days prior to your 65th birthday.
For further information on LTD features and for a list of exclusions, please refer to your benefit booklet.
Notice of an LTD claim must be provided to Great-West Life within 300 days of the date you become disabled.
Please contact Mercon Benefit Services to open an LTD claim. Mercon will provide you with claims forms which, upon completion, must be sent directly to Great-West Life.