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Key Plan Definitions

Benefit Offsets include all benefits under: (1) Workers’ Compensation or similar law; (2) any state disability income benefit law or similar law; (3) any other group disability coverage; (4) the Federal Employees’ Retirement System (FERS), the Civil Service Retirement System (CSRS), Social Security or any similar pension or retirement plan; (5) disability benefits through the Veteran’s Administration; (6) “no fault” auto laws or insurance policy providing for loss of wages payments; (7) any amount received by compromise, settlement, or other method resulting from a claim; (8) any sick pay or other salary continuance payable after receiving monthly benefits for 12 months; and (9) any pay received as a result of administrative leave, excused absence, or any other official release from duties without loss of pay (including a leave bank, or leave share program) and without charge to annual or sick leave.

Confined/Confinement is any confinement which has been ordered by a physician and for which the covered person is charged by a hospital for a full day’s room and board. (A hospital is defined as providing full-time medical care and treatment under the direction of licensed physicians and registered nurses, but does not mean nursing homes, rest homes, convalescent homes, homes for the aged, drug and alcohol rehabilitation centers, or facilities primarily providing custodial, educational, or rehabilitative care.)

Covered Salary Amount is the amount of coverage applied for and approved by SAMBA; cannot exceed your Eligible Salary Amount.

Eligible Salary Amount is your gross income, rounded up to the next highest $1,000. It includes locality pay, availability pay, or administratively uncontrolled overtime, but does not include bonuses, regular overtime, differential pay allowances, or any other compensation.

Disability or Disabled means that because of injury, sickness, or mental or nervous disorders you are not engaged in any occupation or employment for wage or profit, and (1) during the first 24 months of Disability, you cannot perform all of the material and substantial duties of your regular occupation; and (2) 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, or experience. You must be under the regular care of a physician.

Full-Time means working for your employer at least 32 hours per week.

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.