BASIC & ADDITIONAL LONG-TERM DISABILITY
Summary of Coverage
|Benefit Plan||Who Pays for Coverage||Coverage Amount||Waiting Period|
|Basic Long Term Disability||Texas Health||50% of your base pay. The minimum benefit is $100 per month and the maximum is $15,000 per month||180 days|
|Additional Long Term Disability||You||10% of your annual base pay in addition to Basic LTD — for a total of 60% of your annual base pay, up to a combined maximum benefit of $15,000 per month||180 days|
If you are a physician employed by THPG, you are not eligible for the Texas Health LTD plan.
How it Works
The Long Term Disability (LTD) plan through Prudential (Sedgwick) pays benefits for an eligible disability that lasts more than 180 days. Under the LTD plan, disability means you are receiving appropriate, regular care for your condition from a licensed physician who is not you or a member of your family and:
- For the first 24 months, you are unable to perform the essential duties of your own occupation
- After 24 months, you are unable to perform the essential duties of any occupation for which you are reasonably qualified by education, training, or experience.
LTD benefits are reduced by other sources of income during disability such as Workers’ Compensation, Social Security, and other benefits.
You must have active disability coverage on the date you become disabled to receive benefits. If you are absent from work due to illness or injury during the date your STD or LTD coverage would otherwise become effective, coverage becomes effective after you are actively at work for one full day. The requirement to be actively at work also applies to increases in coverage. Any changes to STD or LTD coverage would take effect upon your return to work.
Getting LTD payments started
If you have Short Term Disability, you will automatically be transferred to LTD if you are still unable to work. If not, you will need to contact Prudential when you have been out for more than 180 continuous days. They will walk you through the process.
Pre-Existing Conditions under LTD
If you were diagnosed or received treatment, services, or medications for a condition during the 12 months before your LTD coverage became effective, the LTD plan will not pay benefits for a disability caused by that condition that begins in the first 12 months of your LTD coverage.
Who do I contact with questions?
- Call IDM at 1-877-MyTHRLink (1-877-698-4754) prompt 6, then 1
- Email IDM at THRIDM@texashealth.org
- Contact Prudential at 1-844-223-4398 (telephone) or 1-855-800-5116 (fax)