CSEA Group SEIU Local 1000 1-Year Short Term Disability Insurance

Benefits

CSEA endorsed Group Short Term Disability Benefits

Help Replace More of Your Paycheck

The CSEA Group Insurance Plan was developed specifically for SEIU Local 1000 workers – to coordinate 100% with SDI payments. If you can't work and earn a paycheck due to a covered accident, illness or pregnancy (See definition of "disabled" in the Terms tab), you collect SDI payments up to 55% of your monthly earnings. Plus with CSEA coverage, you collect an extra 20% of your pay for the first six months of disability. Your monthly benefit, when combined with the sum of other sources of income* and benefits you receive or for which you are entitled, cannot exceed 75% of your basic monthly pay.

Collect Higher Benefits if Your Disability Lasts Longer

What if you're disabled for more than six months? The CSEA Disability Insurance Plan pays more. During months seven through 12 of your disability, you collect an extra 30% on top of your base SDI payment — increasing benefits to 85% of your basic monthly salary.

Hurt in a covered accident? Collect up to an EXTRA $5,000.00 Benefit

The CSEA Group Short Term Disability Insurance Plan includes an optional Accidental Death and Dismemberment (AD amp; D) benefit, for an additional premium, that can pay up to $5,000.00 – on top of any other disability benefit – for certain death or physical injuries caused by a covered accident. Injuries must occur within 90 days after the date of the accident. The Certificate of Insurance includes specific details.

Pay No Premiums While Collecting Benefits

Your premium payments will be waived for the entire time you receive CSEA disability benefits.

Get Peace of Mind — 2 Added Payments for Loved Ones

The CSEA Group Insurance Plan pays your family two extra monthly payments if you die while receiving benefits for a covered disability that lasted 30 days or longer. It's our way of making sure your loved ones are taken care of no matter what happens.

Exclusions and Limitations

See the "Terms" tab for which disabilities are not covered.

Work Just 20 Hours a Week

You're eligible to apply for benefits as long as you are a SEIU Local 1000 Members affiliated with the CSEA, under age 70 and actively employed on a full-time basis (working at least 20 hours a week for at least 20 consecutive service days) with the State of California or any allied organization, and you are a U.S. resident.

You're Under No Obligation.

If you decide your CSEA endorsed Group Short Term Disability Protection isn't for you, just let us know in the first 30 days. We'll promptly refund your premiums and invalidate your coverage, provided there have been no claims. No questions. No obligation.

Rates

SEIU Local 1000 1-Year Short Term Disability Rates

Benefits Paid for Up to 12 Months. Discover Affordable Coverage Here—Current 2020 Monthly Payroll-deducted Premiums!

As a CSEA member, you qualify for discounted rates for the SEIU Local 1000 1-Year Short Term Disability Plan.

SEIU Local 1000 1-Year Short Term Disability Rate Chart: View Rate Chart

FAQs

Terms

Your CSEA endorsed Group Short Term Disability benefits can begin following approval from New York Life. Your coverage will take effect on the first day of the month after your application has been approved and your first payroll deduction has been received. Once approved you will receive a Certificate of Insurance describing the terms and conditions of your coverage. If you are not working full-time on the date your insurance is scheduled to become effective, your insurance will not become effective until you return to full-time work. However, if you are not actively working due to a non-working day, you will still become insured on the scheduled effective date provided you would have been able to do your regular job on that non-working day. If you become disabled as a result of a covered accidental injury, sickness or pregnancy, benefits will be paid during the continuance of your disability. Benefits begin with the first day of a covered accident, 31st day for a sickness or pregnancy, or at the end of your sick leave, whichever is later.

Premiums are subject to change by agreement between New York Life Insurance Company and the CSEA, but not more than twice in any twelve-month period. Your rates may change only if they are changed for others in the same class of insured under this group policy. For example, a class of insured is a group of people with the same age and gender. Premium for this plan is deducted from payroll with an authorization from each individual member. Future benefits are subject to change by agreement between New York Life and the CSEA.

IMPORTANT INFORMATION

Definition of "total disability" or "totally disabled"

means that during a period of disability (including the qualifying period), a covered injury, sickness or pregnancy requires that you be under the regular care and attendance of a doctor, and prevents you from performing your usual occupation. If you voluntarily decide to work at any occupation, you would no longer be considered disabled.

Definition of "MONTHLY INCOME"

The monthly rate of pay from the employer. Overtime pay, commissions, bonuses and other pay (not considered as basic wages or salary) are not included.

Definition of "Other Income":

(1.)50% of any salary, wages, partnership or proprietorship draw, commissions, or similar pay from Rehabilitative Employment (2.) any salary or other compensation you receive for work performed while disabled and the amount of any income payment under a salary continuance or sick leave plan; (3.) income payments, other than unearned income, from a professional corporation, partnership or other group practice arrangement. Income payments include the cost of your fringe benefits and the share of the total contributions to corporate surplus; (4.) income payments under a retirement plan, other than a government pension plan, which starts on or after the date of disablement for which Covered Disability benefits become payable; (5.) income payments under a government pension plan which starts on or after the date of disablement for which Covered Disability benefits become payable. Any increase in such payments that occurs after the waiting period is excluded from the determination of such benefits; (6.) benefits for loss of time from employment which is provided for a disability under: (a) any plan arranged by any employer, union or association; (b) any fund or other arrangement pursuant to any compulsory disability benefit act or law; or (c) an individual disability income policy; (7.) benefits in the form of periodic cash payments for a disability, excluding any benefits for a disability starting before the effective date, which is provided: (a) under any group life insurance plan; (b) by any federal, state, provincial, municipal or other governmental agency, or pursuant to the Federal Railroad Retirement Act; or (c) under the Federal Social Security Act, Canada Pension Plan or Quebec Pension Plan on the basis of your record of wages and self-employment income and payable to your spouse or child, without regard to any deductions from such benefits which can be made: (1) on account of work; (2) because of your refusal to accept rehabilitation; or (3) because your spouse or child has elected to be paid benefits under the Federal Social Security Act, Canada Pension Plan or Quebec Pension Plan on the basis of the spouse's or child's own record of wages and self-employment income. In determining the amount of such benefits, however, there will be excluded the amount of any increase therein which occurs after the waiting period; and/or (8.) benefits under any work loss provision in the mandatory part of any "no-fault" auto insurance policy.

MONTHLY INCOME

Means a person's basic monthly pay from the State of California or any allied organization determined on his or her initial INSURANCE DATE and thereafter on each October 1. MONTHLY INCOME for hourly employees will be based on the hourly rate of pay, but not on more than 40 hours per week.

Pre-Existing Conditions

Any injury, sickness, mental, emotional or nervous disorder or related illness for which a person consulted a doctor, received any medical services or supplies or took any medication during the 12 months immediately before becoming covered under this plan and which was not disclosed on the person's request for coverage. A condition which was fully disclosed on the application for insurance is not considered a Pre-Existing Condition. Benefits will not be paid for disabilities due to non-disclosed pre-existing conditions, as defined above until the end of the earlier of (a) 12 consecutive months after the effective date of coverage during which the covered person has had no treatment or medical advice for that condition or (b) 24 consecutive months during which the person has been insured under the policy.

What is not covered under this disability plan (Exclusions and Limitations)

This plan does not pay benefits for a disability and/or confinement that began before a person becomes an insured member; a disability, confinement and/or injury that: occurs during or is due or related to incarceration for or participation in (except as victim) the commission of a felony, an illegal occupation or activity, an insurrection, terrorist activity or a riot; any disability, confinement or injury caused by war or any act of war or an armed conflict which involves the armed forces of one or more countries, whether declared or not; intentionally self-inflicted injury, while sane or insane; A disability, confinement or injury that occurs or is due or related to duty in the military, naval or air service of any country; a disability that is due to a Preexisting condition, as defined above; a disability that no longer requires the regular care and attendance of a doctor or any period of disability for which insured member is not under regular care and attendance of a doctor; an injury that is due or related to or occurs during the course of any occupation for pay or profit; or a sickness that entitles the insured member to benefits under a Worker's Compensation Act or similar Act. (AD&D coverage: No benefits are payable for losses due or related to: serving as a pilot, crew, or training instructor of an aircraft; disease or bodily infirmity, or medical or surgical treatment thereof; bacterial infections due to an accidental cut of wound; illegal use of drugs; use of alcohol, and; accidental ingestion of contaminated material. All other exclusions noted above also apply except those for: Preexisting Condition, and; regular doctor care.)

Successive Periods of Covered Total Disability

Successive periods of Covered Total Disability will be considered one period of Covered Total Disability, if such disabilities are due to: (a) the same or related causes, and which are separated by less than three months of return to continuous FULL-TIME work during which the INSURED MEMBER is not totally disabled; or (b) different or unrelated causes, and are not separated by return to FULL-TIME work.

Rehabilitative Employment

If you are disabled from your regular job but accept rehabilitative employment within 31 days after a period of disability for which a monthly benefit is payable, 50% of any salary, wages or similar pay received from rehabilitative employment will be considered along with your other sources of income and benefits when determining the monthly benefit payable.

When Coverage Ends

Your coverage under the policy will end upon the earliest of the following occurrences:

(1) the insured member retires or ceases active fulltime work of at least 20 hours per week (other than for reason of disability); (2) membership in the California State Employees Association ends; (3) active duty in the armed forces (except for training purposes of 2 months or less) begins; (4) premium contributions are not paid when due; (5) the Group Policy is terminated by the policyholder or New York Life; (6) the member is no longer a permanent resident of the United States, District of Columbia, Puerto Rico or Canada.

(Please read and retain for your records)

IMPORTANT NOTICE:

How New York Life Obtains Information and Underwrites Your Request For Group Disability Income Insurance

In this notice, references to "you" and "your" include any person proposed for insurance. Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualify for insurance , we will rely on the medical information you provide, and on the information you AUTHORIZE us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, Inc. ("MIB"). MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. If you apply for life or health insurance coverage, a claim for benefits is submitted to an MIB member company, medical or non-medical information may be given to MIB, and such information may then be furnished by MIB, upon request, to a member company.

Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application for insurance, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying New York Life in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.

MIB and other insurance companies may also furnish New York Life, its subsidiaries or the Plan Administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other applications for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.

New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing, however, this will not be done in connection with test results concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but we will not disclose our underwriting decision.

New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a "need to know" basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.

If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB's information office is: MIB, Inc., 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 866-692-6901 (TTY 866 346-3642). For Canadian residents, the address is: MIB Information Office, 330 University Avenue, Suite 501, Toronto, Ontario, Canada M5G 1R7, telephone +1-416-597-0590. Information for consumers about MIB may be obtained on its website at www.mib.com.

For NM Residents: Protected persons¹ have a right of access to certain Confidential abuse information² we maintain in our files and they may choose to receive such information directly. You have the right to register as a Protected person by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.

¹Protected person means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured person or prospective insured person.

²Confidential abuse information means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.

NEW YORK LIFE INSURANCE COMPANY 6.15 ED.

Endorsed by: California State Employees Association

CSEA incurs certain administrative expenses in connection with this sponsored program. To provide and maintain this valuable membership benefit it is reimbursed for such expenses.

California State Employees Association
Administered by A.G.I.A., Inc.
PO Box 9997 Phoenix, AZ 85068-0997

A.G.I.A, Inc. is licensed and authorized to transact business in all 50 United States and the District of Columbia. Their state of domicile is California. J. Christopher Burke CA Insurance License #0F709407. J. Christopher Burke AR Insurance License #8876308.

This Group Whole Life Insurance Plan is underwritten by:
New York Life Insurance Company
51 Madison Avenue
New York, NY 10010

Under Group Policy G-29115-1 on policy form GMR-FACE G-29115-1.

New York Life is licensed/authorized to transact business in all of the 50 United States, District of Columbia, Puerto Rico and Canada. However, not all group plans it underwrites are available in all jurisdictions. Please check the plan details for current availability.

New York Life Insurance Company's state of domicile is New York and their NAIC ID# is 55915.

This is not a policy or Certificate of Insurance. It merely summarizes the benefits available and is for informational purposes only. The complete terms and provisions of coverage and conditions under which it may be kept in force are contained in the Group Master Policy issued by New York Life Insurance to the California State Employees Association.