Disability Income Protection Plan FAQs
Q. What is the purpose of this plan?
A. The purpose of the Disability Income Protection (DIP) Program is to provide:
- Income Protection Benefit
After you have been disabled for 60 consecutive days, you can qualify for monthly benefit payments. Your Monthly Benefit Amount is 65% of
one-twelfth of your Covered Salary Amount. It may be reduced as described under the Benefits Offsets provision, but will not be reduced to less than $200 per month.
- Survivor Benefit
In the event of your death while you are receiving monthly benefit payments, your spouse or named beneficiary may receive a Survivor Benefit of
50% of your Monthly Benefit Amount that you were entitled to receive at the time of your death. The benefits are payable to the survivor for up to 10 years or the date that would have been your 65th birthday, whichever occurs first.
- Residual Benefit
If you receive monthly benefits for at least 30 days, you may qualify to receive 35% of your monthly benefit if your physician releases you to
return to work on a reduced work-week schedule.
- Hospital Confinement Benefit
Even if you are not receiving disability benefit checks, this program provides a daily benefit if you or a covered dependent is
hospital-confined. For each day you or your spouse are confined in a hospital, the program pays 70% of your daily earnings; 35% is payable each day if your dependent child is confined.
Q. Who is eligible to enroll?
A. You may apply for coverage if you are an active, full-time federal employee. Retirees, part-time or temporary employees are not eligible. Evidence of insurability is required.
Q. What kind of disabilities are covered?
A. "Disability" or "Disabled" means that because of injury, sickness, or mental and nervous disorders, you are not engaged in
any occupation or employment for wage or profit for which you are reasonably qualified by education, training, or experience, and:
- During the first 24 months of disablility, you cannot perform all of the material and substantial duties of your regular occupation; and
- After 24 months of disability, you are completely unable to perform the material and substantial duties of any occupation for which you are
reasonably fit by education, training, and experience.
You must also be under the regular care of a physician.
Q. Can I collect benefits for a work-related injury?
A. Yes, however if you receive or are eligible to receive compensation under any Workers´ Compensation Law, Occupational Disease Law, or
similar law, your SAMBA benefits will be offset by the amount you receive from the other source.
Q. What are benefit offsets?
A. Generally, any amount of money you receive from another source because of your disability will be used to offset your SAMBA disability payment.
Benefit offset examples include Workers´ Compensation, federal retirement programs, social security, or legal settlements from lawsuits
related to an injury/illness.
Q. My doctor says I will not be able to work for six months. How do I start collecting disability
benefits?
A.Contact SAMBA as soon as you can by calling 1-800-638-6589. We will furnish you with the necessary claim forms to file for compensation. You,
your physician, and your employer will need to complete the forms and return them to us so that we can review and make a decision. Your claim must
be filed within 12 months of the onset date of the disability in order for the claim to be considered eligible for compensation.
Q. If I am out on disability, do I still have to pay my plan premiums?
A. No. If you are receiving disability benefits from us, we waive your premium following the Elimination Period for as long as Disability Income
Protection benefits continue to be paid. You would however be responsible to pay the premiums for any other coverage you may have with SAMBA.
Q. What is the Elimination Period?
A. This is 60 continuous days of disability which must be satisfied before you begin to receive benefits under the Program. A new Elimination
Period is applied to each period of disability.
Q. How are my monthly disability benefits calculated?
A. The benefit is 65% of your covered salary amount, divided by 12. For example:
Covered Salary Amount - $43,000.00
Multiply by 65% - $27,950.00
Divide by 12 - $2329.17
Your Monthly Benefit Amount (before offsets) - $2329.17
Q. What is my Covered Salary Amount?
A. This is the amount of coverage that you are enrolled under the plan. The Covered Salary Amount cannot exceed your Eligible Salary Amount.
Q. My salary has increased over time, but my Covered Salary Amount has stayed the same. Why?
A. After your initial enrollment in the Program, you must notify SAMBA of any increase in your salary. There are two reasons for this:
1) SAMBA has no way of knowing when your pay increases occur or how much your pay increases are, and
2) since an increase in disability coverage means that your premium will increase, you must complete the Request for Change form and sign your
approval to have your premium changed.
Q. Do I have to fill out a Health Statement to increase my Covered Salary Amount?
A. You will not be required to complete a Health Statement if
1) you apply within 12 months of the effective date of the salary increase, and
2) your covered Salary Amount was equal to your Eligible Salary Amount immediately prior to the increase.
Q. How do I cancel this coverage?
A. We need written documentation from you before we will cancel your coverage. If you pay your premiums by payroll allotment, you need to complete
Payroll Allotment 299 and write in the name of the plan you wish to cancel at box #6. Sign and date the form and mail it to SAMBA at:
11301 Old Georgetown Rd, Rockville, MD 20852,
or fax it to SAMBA at 301-816-0191.
If you are billed quarterly or if your premium is paid by Direct Debit, write a short note requesting that the coverage be cancelled, and mail
or fax it to SAMBA using the information above. We will notify you once the coverage has been terminated.
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