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17

Voluntary Short Term Disability (STD)

For employees who wish to purchase Short Term Disability coverage, ACP offers eligible employees a voluntary

Short Term Disability benefit. This coverage is offered through Cigna. STD provides short-term income protection in

the event of a non-occupational illness or disability. STD provides partial income replacement during your period

of disability to help provide you and your family with financial security. STD begins after a 14 day waiting period.

Benefits begin on the 15th day of your approved disability and will continue for the duration of your disability up to a

maximum of 11 weeks. STD benefits are 60% of your pre-disability earnings to a maximum of $2,300 per week.

Guarantee Issue for STD Insurance:

An employee who applies within 31 days after becoming eligible will not have

to complete Evidence of Insurability for approval. If enrollment is received more than 31 days after first eligible,

Evidence of Insurability must be satisfied and approved before coverage is effective.

Short-term Disability Pre-existing Condition Limitation:

Pre-existing condition limitation is 3/12 - This means you have

not been treated for or incurred expenses for this medical condition within 3 months of the STD coverage effective

date. This limit will not apply after you have been covered under the plan for 12 months.

NOTE: Rates may be slightly different due to rounding issues.

The Voluntary STD premium is per $10 of covered weekly benefit. The premiums are as follows:

Employer Paid Long Term Disability (LTD) Insurance

ACP provides active, full-time employees working aminimumof 27 hours per week with employer paid LTD. LTD provides

long-term income protection in the event of an unexpected non-occupational disability. LTD provides partial income

replacement during your period of disability to help provide you and your family with financial security.

This benefit

is effective on date of hire.

LTD benefits begin after you have been disabled for 90 days due to a non-occupational

injury or sickness. LTD benefits are 60% of pre-disability earnings to a maximum of $5,000 per month (except for Nurse

Practitioners, Physician Assistants and Physicians). The LTD benefit for Physicians, Nurse Practitioners and Physician

Assistants is 50% of annual earnings to a maximum of $10,000 per month and includes a “gross-up” feature. The LTD

benefit will continue until you are no longer disabled or until you reach Social Security Normal Retirement Age (SSNRA).

Voluntary STD - Coverage Amounts and Semi-Monthly Costs

Amounts

$10,000

$0.10

$30,000

$0.30

$50,000

$0.50

$70,000

$0.70

$100,000

$1.00

$130,000

$1.30

$150,000

$1.50

$200,000

$2.00

$250,000

$2.50

$300,000

$3.00

$350,000

$3.50

$400,000

$4.00

$450,000

$4.50

$500,000

$5.00

Sample Coverage

Amounts

Spouse Cost

$5,000

$0.08

$10,000

$0.15

$25,000

$0.38

$35,000

$0.53

$50,000

$0.75

$75,000

$1.13

$100,000

$1.50

$150,000

$2.25

$200,000

$3.00

$250,000

$3.75

Sample Coverage

Amounts

Dependent Child(ren)

Cost

$2,000

$0.03

$4,000

$0.06

$6,000

$0.09

$8,000

$0.12

$10,000

$0.15

Sample Annual

Salary

Estimated Weekly

Benefit Amount for

Covered Disability

Under Age 55

55-59

60-64

65+

$20,000

$231

$6.32

$7.02

$8.18

$8.98

$30,000

$346

$9.48

$10.52

$12.27

$13.46

$40,000

$462

$12.65

$14.03

$16.36

$17.95

$80,000

$923

$25.29

$28.06

$32.72

$35.91

$120,000

$1,385

$37.94

$42.09

$49.08

$53.86

$160,000

$1,846

$50.58

$56.12

$65.45

$71.82

$200,000

$2,300

$63.02

$69.92

$81.54

$89.47

$240,000

$2,300

$63.02

$69.92

$81.54

$89.47

$250,000

$2,300

$63.02

$69.92

$81.54

$89.47

Coverage

Low Option

High Option

Employee Monthly

Cost

Employee C st

Per Check

Employee Monthly

Cost

Employee Cost

Per Check

Employee Only

$26.34

$13.17

$35.50

$17.75

Employee + 1

$54.40

$27.20

$73.31

$36.66

Family

$84.24

$42.12

$113.53

$56.77

Coverage

Employee Monthly Cost

Employee Cost Per Check

Employee Only

$7.53

$3.77

Employee + 1

$14.27

$7.14

Family

$20.91

$10.46

Coverage

Employee Monthly Cost

Employee Cost Per Check

Employee Only

$13.34

$6.67

Employee + 1

$22.66

$11.33

Family

$31.75

$15.88

Age

Premium

<20

$0.5480

20-24

$0.5480

25-29

$0.5480

30-34

$0.5480

35-39

$0.5480

40-44

$0.5480

45-49

$0.5480

50-54

$0.5480

55-59

$0.6080

60-64

$0.7090

Age 65 or older

$0.7780