(224) 770−5307 info@bletinsurance.com

BLET SEPTA
Voluntary Disability & Life Insurance

Income Protection Plan

– SHORT AND LONG-TERM DISABILITY

– LIFE AND AD&D INSURANCE

Enrolling in these benefits helps to ensure your paycheck is protected, but you must act to be insured on this plan. Coverages are guaranteed approved during open enrollment for actively working/full dues paying Members of the BLET.

SHORT AND LONG-TERM DISABILITY

Guaranteed approved, with 24/7 coverage

– Pre-existing conditions are covered after 12 months.
– Benefits paid are tax-free.
– Pays for on and off the job disabilities for covered injuries, surgeries or illnesses.

SHORT-TERM DISABILITY - Benefits & Costs

Pays after 14 days for up to 24 weeks (Offsets at 80% pre-disability earnings).

STD WEEKLY BENEFIT MONTHLY COST
$200 $38.00
$400 $76.00
$600 $114.00
LONG-TERM DISABILITY - Benefits & Costs

Pays after STD ends for up to 2 years. (Offsets at 70% pre-disability earnings).

LTD MONTHLY BENEFIT MONTHLY COST
$2,500 Employer Paid*

*Benefit is received by Member automatically

LIFE COVERAGE

with Accidental Death & Dismemberment (AD&D)

Member Life coverage available for $10,000.
– No medical questions or tests.
– Coverage includes an equal amount of Accidental Death and Dismemberment.
– If death is caused by an accident, the benefit doubles.
– Life coverage is convertible and portable.
Spouse coverage available when Member Life/AD&D is elected.
– Spouse can be covered at $5,000.
– Coverage is 24/7 on and off the job.

Life with AD&D - Benefits & Costs
MEMBER MONTHLY COSTS
$10,000 $5.20
SPOUSE MONTHLY COSTS
$5,000 $2.60
About Open Enrollment

The purpose of this Group Insurance Plan is to give you options to supplement your income in the event that you cannot work due to an injury, illness, surgery, or death. This group plan offers Disability Insurance and Life Insurance with Accidental Death & Dismemberment coverage.

All of the available coverages are offered separately and a Member’s participation in one or all of those coverages, and the level to which he or she elects to participate, is voluntary and strictly the individual’s choice.

All insurance under this Union Group Policy will cover you for as long as you continue to remain actively employed, pay monthly costs, and be in good standing with the union.

Attention participating Members: No action is required to maintain your current coverages. You do have the opportunity during this time to enroll in or increase Life coverage and make changes to your benefits. Please call Union One for more information at (224) 770−5307.

Official Notice To Participants – Please Read

The BLET does not make any endorsement or recommendations regarding these benefits. This program is completely voluntary and benefits can be elected on an à la carte basis. It is solely the Members decision to enroll and learn about the benefits being offered.

Eligibility Notice

You must be an actively working, full dues paying Member of the BLET union, working a minimum of 20 hours per work, in order to be eligible to enroll in and maintain coverage. If you are suspended, dismissed, retire from the railroad, or leave the BLET for any reason, you are no longer eligible for disability coverage and it is your responsibility to contact our office immediately at (847) 387−3555 so that we may stop your monthly payments. Failure to properly notify Union One within 90 days of employment and/or union status changes will result in loss of monthly payments paid.

Disabilities that occur after being removed from service are not covered. You may have the ability to suspend your disability coverage if you are not actively working. Please contact the Union One office at (847) 387−3555 for more information. Note: this also applies to any Member who has not had a formal hearing.

Actively At Work Notice

To be covered by the Group Policy you must be actively at work performing the duties of your own occupation when the policy goes into effect or when returning to work from a disability claim. Days spent not working to include, but not limited to; PLD, vacation, light duty, FMLA days, rules classes, and re-certification tests/classes do not count as actively working days. If you are not actively at work when the policy goes into effect, your coverage effective date will be deferred until your first full day of active work.

Participant and Claimant Responsibilities

It is your responsibility to notify Union One if your employment, union status, contact information, or salary changes. Failure to properly notify Union One will result in loss of monthly payments and/or insurance coverage. Notification to Union One must be made by phone at (847) 387−3555 and/or by email at admin@unionone.com.

Income Verification Notice

In the event a claim is filed, you will be required to verify your income by providing your prior year’s W-2 and/or three full months of paystubs. Benefit payments are subject to change based on the income you can verify at time of claim.

Benefits Offsets, Reductions and Overpayments

Benefits may be reduced where offsets apply. Benefit amounts illustrated on the Summary of Benefits & Rates guide do not reflect any applicable offsets. It is your responsibility as the claimant to notify Union One and the Insurance Company of any other income sources you are receiving; failure to do so may result in an overpayment that you will be required to repay. Please review the Group Policy for further information. If you have any questions regarding offsets, please call Union One at (847) 387−3555.

Railroad Retirement Board Benefits: Your Union Group Policy requires you to apply for a disability annuity through the Railroad Retirement Board if you meet the eligibility requirements. Due to the delayed Railroad Retirement Board Disability Annuity approval process and the fact that benefits are backdated once approved, an overpayment of disability benefits may occur. Union One strongly encourages you to call the Railroad Retirement Board to obtain an estimate of your monthly annuity amount and then call our office to discuss your best option.

As an individual Member of the Union, if you have voluntarily elected to participate and make monthly payments for coverage, it is your responsibility to understand the group policy and its provisions. The policy booklet can be requested by email to admin@unionone.com.

Pre-Existing Condition Limitations

Short-Term Disability – Pre-Existing Guidelines

Short-Term Disability has a Pre-Existing Condition limitation of 12 months. In order for a pre-existing condition to be covered, you must be an eligible Member of the group and have paid the Short-Term Disability monthly cost for 12 consecutive months prior to your date of disability, or you must be treatment free for the 12 months prior to your date of disability (Look Back Period) for the disabling condition.

More Pre-Existing Limitation Information

  • Pre-Existing Conditions are reviewed by the insurance carrier at time of claim, which will require disclosure of all medical records, doctors’ notes and prescription drug history.
  • Failing to receive treatment does not preclude you from the Pre-Existing Condition Look Back Period.

Please review the Group Policy for further information. If you have any questions regarding Pre-Existing Condition limitations, please call (847) 387−3555.

Group Life Insurance Notice

This is a Voluntary Group Term Life Insurance plan offered through your Union. As such, this plan should not serve as your primary source of Life Insurance as the Union or insurance company may terminate, cancel or change this policy at renewal. This Life Insurance Plan is designed to give you and your family a guaranteed approved option for additional Supplemental Life Insurance while working as an active Member of your Union. Please review all the provisions of this Life Insurance Policy. It is highly recommended that this policy not be used to replace any existing Life Insurance coverage you may have.

When Life Insurance Coverage Ends

If suspended or disabled you may keep your Life Insurance coverage for up to 12 months provided monthly costs continue to be paid during that period. Beyond 12 months, your coverage will terminate unless you convert or port your Life Insurance coverage.

If you leave the Union or retire, you may convert your Group Term Life Insurance to a Permanent Individual Life Insurance Policy or you may port your coverage. You must elect to convert or port your coverage within 31 days from the date of you are no longer eligible to be covered on the group plan (i.e. date of retirement or termination). Please contact the Union One office at (847) 387−3564 for questions about rates associated with converting or porting your Life Insurance coverage.

If you are enrolled in Child Life coverage and your child is disabled, you can retain your child’s coverage beyond age 26 by completing an application. You will have only 31 days from your child’s 26th birthday to submit this application.

Note: Typically converting your Group Term Life Insurance to an Individual Permanent Life Insurance Policy is very expensive and only recommended for people who cannot qualify for Life Insurance elsewhere.

Monthly Cost Payments, Calculations and Adjustments

Renewal Notice

This is a Group Insurance Plan offered through your Union. As such, your rates and benefits may change at renewal or non-renew based on the overall claims experience of the group and/or if participation requirements are not being met. Further, any substantial change to the makeup of the group, such as a change in the Member demographics, that impacts the underwriting risk of the plan may immediately result in a change to the plan.

At renewal, if you do not call Union One to make changes to or discontinue coverage, you herby authorize and give permission to Union One to auto-enroll you in the renewal plan benefits that most resemble your currently elected benefits. Auto-enrollment could result in a potential increase in your monthly or bimonthly payment drafts. Please understand, this is intended to ensure no Member loses coverage for failing or forgetting to take the time to renew or re-enroll. Given that all benefits are “Voluntary,” you can cancel or lower your coverage at any time.

Loss of Monthly Cost Notice

If you do not contact our office within 90 days of your date of dismissal (the date in which the railroad removes you from service), date of retirement, date in which you left the BLET or furloughed, there will be no refund for any monthly cost paid. It is the sole responsibility of the Member to contact Union One at (847) 387−3555 or by email at info@bletinsurance.com within the 90 day allotted time.

Failure to Make a Payment

Participating Members for whatever reason may miss a monthly payment from time to time. The current plan allows for a 60 day grace period to make up any missed monthly payments.

Administrative & Transaction Costs

All administrative and transaction fees (fees) are included in your monthly payment. These fees cover the costs associated with, but not limited to, monthly cost processing, monthly cost returns, postage, policy correspondence, claims advocacy and other ancillary expenses associated with the administration of your elections. These monthly fees are applied to all coverages shown on the Summary of Benefits & Rates. Below is the structure of all applicable fees:

Included in monthly costs shown on Summary of Rates: Short-Term Disability 2.00, Member Life/AD&D Coverage 1.00, Spouse Life/AD&D Coverage 0.50, Child Coverage 0.00

Included when monthly total is collected: Payment Transaction Fee 1.00 per transaction.

Important Information

This program is voluntary and it is solely the Members’ decision to enroll. Members are responsible for paying their own costs. All non-banking administrative and transaction fees are included in the enclosed costs. This is a basic summary of benefits and makes no guarantee or warranty on the processing of claims. Other limitations may apply. It is recommended that each enrolled Member obtain a copy and read the entire policy booklet. A copy of the policy booklet may be requested by email to admin@unionone.com.

Coverages are underwritten by Prudential. Like most insurance polices, insurance polices offered by Prudential and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations, and terms for keeping them in force. AD&D insurance does not include payment for certain losses as described in more detail in your certificate. Specific information pertaining to your insurance can be obtained by contacting your plan administrator. Please contact Prudential or your plan administrator for complete details.

IMPORTANT: If you leave the union or retire, it is your responsibility to contact our office immediately at (224) 770-5307. Failure to do so within 90 days will forfeit your ability to keep coverage and receive any refunds.

OFFSET EXPLANATION

Short-Term Disability (STD) can be stacked with other group benefits (including Railroad Retirement Board and contract benefits), not to exceed 80% of your pre-disability earnings. Long-Term Disability (LTD) Option A can be stacked with other group benefits (including Railroad Retirement Board benefits), not to exceed 70% of your pre-disability earnings. Long-Term Disability (LTD) Option B is directly offset by other eligible benefits (including Railroad Retirement Board benefits).

RRB: If you’re unsure about how many years of retirement you have, you can contact the Railroad Retirement Board (RRB) by calling an RRB office toll-free at (877) 772-5772.

For more detailed information, call (224) 770−5307 or email info@bletinsurance.com.