ShelterPoint Life Insurance – Formerly First Rehab Life 1972 Located at
1225 Franklin Avenue, Ste. 475, Garden City, NY.
Phone: 516-82908100
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Long-Term Disability

1. What income sources are used to determine the benefit amount when I file a claim?

We consider the following income sources: Your prior year’s Form W-2, Schedule K-1, Schedule C or S Corporation Federal income tax return, excluding commissions, bonuses, overtime pay and any other extra compensation.

2a. The LTD benefit may be offset by certain other benefit income. What does that include?

Primary and Dependent Social Security Disability or retirement benefits, Workers’ Compensation benefits, other group disability benefits (regardless of who pays the premium), and salary continuance.

2b. Will my group LTD benefits be affected by my individual disability income policy?

  • If your individual disability income policy (DI) was in place before the LTD coverage and you pay the premium on your individual policy, the group LTD benefits will not be offset by your individual policy’s benefits.
  • If your individual DI was effective before your LTD coverage and your employer pays the individual disability insurance premium for you, the group LTD benefits will be offset by the individual benefits you receive.
  • If you apply for your individual DI after LTD, it does not affect your LTD coverage, but your individual DI carrier may issue a lower benefit.

3. Are my LTD benefits taxable?

If your coverage is noncontributory (i.e. your employer pays the entire premium), your LTD benefits are taxable. With contributory coverage (i.e. your employer shares the cost of the premium with you), the portion of your benefits that is equivalent to your contribution percentage is nontaxable.

4. Am I eligible for benefits as a "1099-employee"?

No, as a 1099er you are an independent contractor, and this does not satisfy the definition of an employer/employee relationship.

5. Will the premium be waived for an employee collecting LTD?

Yes, premium payments for this individual are waived during any period for which LTD benefits are payable.

6a. What is the return-to-work benefit?

During the first 12 months that you return to work on a part-time basis, we may pay benefits to provide you with up to 100% of your predisability income.

6b. How is the return-to-work benefit calculated?

Here are three examples (based on monthly figures):
John Dough Jane Doe Jon Doe
Step 1a Take your predisability income and multiply it by the benefit percentage in your policy (e.g.60%). $12,000
x60% 		$12,000
x60% 		$3,000
x60%
$7,200 $7,200 $1,800
Step 1b Take your predisability income and subtract any current income. $12,000
-$2,000 		$12,000
-$8,000 		$3,000
-$1,000
$10,000 $4,000 $2,000
Step 1c Compare the amount in 1a/b to the maximum benefit of $6,000. $6,000 $6,000 $6,000
Step 2 The smallest amount in 1a/b/c is your monthly benefit $6,000 $4,000 $1,800
Result: Together with your current earnings in 1b, your total monthly income would be... $8,000 $12,000 $2,800

6c. What happens after the first year if I'm still working on a part-time basis?

After the first 12 months, you receive a partial disability benefit. This benefit continues until you either earn more than 80% of your predisability earnings or return to your own job on a full-time basis. To remain eligible for this benefit, you must continue to be treated by a physician and receive periodic medical updates to determine if you continue to be eligible for benefits as defined by the definition of disability in your policy.

6d. How is the partial benefit calculated after the first 12 months?

John Dough Jane Doe Jon Doe
Step 1a Take your predisability income and multiply it by the benefit percentage in your policy $12,000
x60% 		$12,000
x60% 		$3,000
x60%
$7,200 $7,200 $1,800
Step 1b Compare the amount in 1a to the maximum benefit of $6,000.
Step 2 The smaller of 1a or 1b is your gross monthly benefit $6,000 $6,000 $1,800
Step 3 a. Subtract 100%of other income benefits.
b. Subtract 50%of current earnings (see 1b in question 7b) 		-$ 0
-$1,000 		-$ 0
-$4,000 		-$ 0
-$500
Step 4 Your monthly LTD benefit would be... $5,000 $2,000 $13,00
Result: Together with your current earnings (see 1b in question 7b). Your total monthly income would be... $7,000 $10,000 $2,300

7a. What does the "own occupation" definition mean?

For the first 24 months of disability, you are considered disabled if you are unable to perform all of the essential functions of your regular occupation. Thereafter, you will be considered disabled if you cannot perform all the essential duties of any gainful occupation.

7b. How is a disability from any gainful occupation determined?

The inability to work in any occupation for which you are or may be reasonably qualified by training, education or experience.

8. Do I have to be totally disabled during the elimination period to be eligible for benefits?

No, the elimination period can be satisfied with a mix of days of partial and total disability.

9. Does the group LTD policy offer a conversion privilege?

No, upon termination of employment the LTD coverage ceases.

10. How do I submit a claim?

  • E-mail: claimforms@shelterpoint.com
  • Fax: 516.829.8213
  • Mail: Claims • ShelterPoint Life • 1225 Franklin Avenue, Ste. 475, Garden City, NY 11530