A. The purpose of the Long Term Disability Program is to provide financial assistance should you lose your income due to a disabling illness or injury
A. You may apply for coverage if you are a permanent active, full-time federal employee and you are under age 62. Retirees, part-time or temporary employees are not eligible. Evidence of insurability is required.
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:
You must also be under the regular care of a physician.
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.
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.
A. Contact SAMBA as soon as you can by calling 1-800-638-6589. We will provide 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 determination on your request for benefits. Your claim must be filed within 12 months of the onset date of the disability in order for the claim to be considered for compensation.
A. No. If you are receiving disability benefits from us, we waive your disability premium following the Elimination Period for as long as benefits continue to be paid. You would however be responsible to pay the premiums for any other coverage you may have with SAMBA.
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.
A. This is the amount of coverage that you are enrolled under the plan. The Covered Salary Amount cannot exceed your Eligible Salary Amount.
A. The benefit is 65% of your Covered Salary Amount.
For example:
Covered Salary Amount – $43,000.00
Multiply by 65% – $27,950.00
Divide by 12 – $2,329.17
Your Monthly Benefit Amount (before offsets) – $2,329.17
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) As there will be a change to your premium, you need to authorize the increase.
A. You will not be required to complete a Health Statement if:
1) you apply within 90 days 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.
A. We need written documentation from you before we will cancel your coverage. If you pay your premium by payroll allotment, you need to complete Payroll Allotment Form 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
11301 Old Georgetown Rd
Rockville, MD 20852
or fax it to SAMBA at 301-816-0191.
If you are billed other than through payroll allotment, write a short note requesting that the coverage be cancelled. You can e-mail us using the Contact Us website page. We will notify you once the coverage has been cancelled.
Available only to full-time active federal employees.
You are eligible to enroll if you are under age 62, are actively at work* as a permanent full-time employee of a federal agency, and reside in the U.S. at the time of enrollment.
*If your regular place of employment is your home or other residence, you would not be considered actively at work.
The Plan will pay 65% of your monthly earnings but not more than the Maximum Monthly Benefit amount.
Your benefits begin the day after the Elimination Period of 60 days is completed.
To age 62. If your disability begins at age 61, benefits continue for 12 months.
If you die while collecting monthly benefits, a survivor benefit will be paid to your beneficiary.
Benefits continue if you return to work on a reduced schedule.
Coverage is based on your salary.
– Biweekly premium
– Monthly premium
Group Insurance coverages are issued by The Prudential Insurance Company of America, a Prudential Financial company, Newark, NJ. The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The Prudential Insurance Company of America, the Group Contract will govern. In Washington, the controlling document is the Certificate, not the Contract. Contract Series: 83500
This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York State Department of Financial Services.
THIS IS AN EXCEPTED BENEFITS POLICY. IT PROVIDES COVERAGE ONLY FOR THE LIMITED BENEFITS OR SERVICES SPECIFIED IN THE POLICY.
North Carolina Residents: THIS IS NOT A MEDICARE SUPPLEMENT PLAN. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare, which is available from the company.
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