This plan was created for chiropractors like you. That’s why any Elective Chiropractic
Preventative/Maintenance
Care you receive does not subject your application to expanded underwriting, nor is it considered
a Pre-Existing Condition.
Elective Chiropractic Preventative/Maintenance Care: Elective health care that is patient initiated and
provided at regular intervals to prevent disease, prolong life, promote health and enhance the quality of life.
Care that may be initiated without symptoms in order to promote health and to prevent future problems.
Who is Eligible
As an active member of the National Business Association for Chiropractors (NBAC) and citizen or legal resident of the
U.S., you are eligible to apply for the D.C. Long Term Disability Plan, as long as you are age 65 or under and Actively
at Work (for 30 hours or more per week).
Policy highlights include:
Affordable Group Rates
Thanks to the mass buying power of NBAC, you can take advantage of affordable, group rates. They may be
less expensive than you would pay for individual coverage.
Up to $7,500 in Monthly Benefits
If an illness or Injury means you can’t earn an income, you can count on your D.C. Disability Plan to pay
you the Monthly Benefits you’ll need to help pay your expenses. Monthly Benefits of up to $7,500 are available
to help make sure you get the amount
you need.
What's more, partial disability benefits may be payable if you're Disabled and Working.
Replaces up to 60% of your Income
Like most disability insurance plans, your D.C. Disability Plan will coordinate with your other sources of income
such as Social Security and workers’ compensation to replace up to 60% of your Pre-disability
Monthly Earnings, up to $7,500 per month (less deductible sources of income). (If you have an individual disability insurance plan,
call to inquire about coordinating benefits.)
For D.C.s who are an owner, partner or shareholder, Pre-disability
Monthly Earnings means income after deducting business expenses
from gross receipts.(Find
your monthly average by using the last 2 years of income that is distributed by the corporation to you and claimed as annual income on
your individual income tax return.)
For D.C.s receiving a W-2, this means your average monthly base salary over the last 2 years, including commissions, bonuses, overtime pay, tokens,
fringe benefits or extra compensation.
The example below shows how this would work for a D.C. who, in addition to benefits from the D.C. Long Term Disability Insurance Plan,
is eligible for and receiving Social Security and state disability benefits.
| D.C.'s Pre-Disability Monthly Earnings: |
$ 3,000.00 |
| Income Replacement Percentage |
x 60% |
| |
|
| Gross Disability Payment* |
$ 1,800.00 |
| (-) Less monthly Social Security benefit |
- $ 900.00 |
| (-) Less monthly state disability benefit |
- $ 300.00 |
| |
|
| D.C. Disability Plan monthly benefit received |
$ 600.00 |
*The Monthly Benefit amount before sources of Other Income
Benefits and disability earnings are deducted.
(Please keep in mind that not all disabilities qualify for Social Security and/or state benefits. In addition, very few
states have state disability programs. The amounts shown below are simply examples of benefits one could receive; each
situation is different.)
Effective Date
Your coverage will become effective the first of the month after your application has been approved and your first
premium received.
If you are not Actively at Work on the date your coverage is to be effective, your coverage will begin the first of the
month after you have been Actively at Work for one month.
Renewability
Your D.C. Long Term Disability Plan will continue as long as: 1) The Master Policy is active; 2) NBAC sponsors the plan;
3) you are Actively-at-Work except due to a covered disability; and 4) you continue to pay your premiums.
30-Day Satisfaction Guarantee
The Hartford wants you to be absolutely satisfied with the D.C. Long Term Disability Insurance Plan. That’s why you have 30
days from your effective date to review your certificate to make sure it meets your needs. If not, return your
certificate for a full premium
refund – guaranteed.
Definition of Total Disability or Totally Disabled
Means disability which, during the Elimination Period and the first 24
months during which Total Disability Benefits are payable, wholly and continuously prevents You from performing the essential
duties of your occupation and after that, wholly and continuously prevents you from engaging in any occupation.
Pre-existing Condition Limitation
During the first two years of coverage, losses incurred for Pre-Existing Conditions
are not covered. A Pre-Existing Condition means any Injury or sickness (diagnosed
or undiagnosed) for which medical or chiropractic care
(not to include Elective Chiropractic Preventative/Maintenance Care) was received within the 12-month period immediately prior to
the effective date of your insurance or an increase of insurance benefits.
Exclusions and Limitations
Your D.C. Long Term Disability Insurance Plan does not cover any Disability or loss caused by:
intentionally self-inflicted Injury, suicide or attempted suicide, while sane or insane; or war or act of war, whether
declared or not; or any injury sustained while riding on, boarding or alighting from, any aircraft; as a pilot, crew member or
student pilot; operated by any military authority (land, sea or air) unless it is a Military Transport Aircraft used for transport and operated by the United States Military Air Mobility Command (AMC) or an AMC type service of a national
government recognized by the United States; or being used for tests, experimental purposes, stunt flying, racing or
endurance tests, or your commission or attempted commission of a felony; or sickness contracted or Injury sustained
while on full-time active duty as a member of the Armed Forces (land, water, air) of any country or international
authority.
Mental Illness, Alcoholism, Substance Abuse Limitation
If you are Totally Disabled due to Mental Illness, alcoholism or Substance Abuse, the Maximum
Payment Period will be reduced to 2 years during your lifetime unless you are confined in a hospital or other institution
licensed to provide care and treatment for that disability.
NOTICE OF INSURANCE INFORMATION PRACTICES
To properly underwrite and administer your application for insurance coverage, we must collect certain information concerning
your insurability. You are our most important source of information, but we may also contact other sources such as medical
professionals and institutions, employers and other insurance companies. While all information regarding your insurability
will be treated as confidential, in some situations, and in compliance with applicable law, we may disclose necessary items
of information to third parties without your specific authorization.
INVESTIGATIVE CONSUMER REPORTS – NOT APPLICABLE TO RESIDENTS OF NEW YORK
As part of our procedure for processing your application, an investigative consumer report may be prepared by an outside
insurance reporting organization. Personal information may be collected from others regarding your general reputation and
lifestyle. If an interview is conducted with someone other than you, we will inform you of your right to be interviewed in
connection with the preparation of the investigative consumer report. You have the right to send a written request within
a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.
PERSONAL HISTORY INTERVIEW
To provide you, our client, with the best possible service, we may also conduct what we call a personal history interview.
This is a phone call placed from our underwriting office. Its purpose is to make sure that the application information is
complete. Our interviewers are trained to conduct their calls in a friendly, professional manner. The nature of the information
discussed is always treated as personal and confidential and will only be used to assess your eligibility for insurance.
MEDICAL INFORMATION BUREAU (MIB) PRE-NOTICE
Information regarding your insurability will be treated as confidential. Hartford Life Insurance Company or Hartford Life
and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the MIB, Inc., formerly known
as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information
exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim
for benefits is submitted to such a company, MIB, upon request, will supply such company, with the information about you in its
file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at
(866) 692-6901 (TTY (866) 346-3642). If you question the accuracy of the information in MIB's file, you may contact MIB and
seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of MIB's
information office is 50 Braintree Hill Park, Suite 400, Braintree, Massachusetts 02184-8734. Hartford Life Insurance Company,
Hartford Life and Accident Insurance Company, or their reinsurers, may also release information from their files to other
insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted.
Information for consumers about MIB may be obtained on its website at www.mib.com.
ACCESS, CORRECTION AND DISCLOSURE
You can obtain access to personal information about you contained in our policy files by sending us a written request.
You may also request any necessary corrections, amendments or deletion of any information in our files which you believe
to be inaccurate or irrelevant. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its
reinsurer(s) may release information in their files to other life insurance companies to whom you may apply for life or
health insurance, or to whom a claim for benefits may be submitted. Also, please be advised that personal and confidential
information collected by us may, in certain circumstances, be disclosed to third parties without authorization. A notice
providing further description of the circumstances under which information about you may be disclosed and the types of
persons and organizations to whom it may be disclosed will be sent to you upon your written request. If you desire further
information or access to your personal information, please send your written request to: Hartford Life Insurance Company or
Hartford Life and Accident Insurance Company, 200 Hopmeadow St., Simsbury, CT 06089.
PA-9369
STATE NOTICE
Any person who includes any false or misleading information on an application or filing a claim for an insurance policy is subject
to criminal and civil penalties. It is unlawful to knowingly provide false, incomplete or misleading facts or information to an
insurance company for the purpose of defrauding or attempting to defraud the company. In certain states, penalties may include
imprisonment, fines, denial of insurance, and civil damages.
Any insurance company or agent of an insurance company who knowingly provides false, incomplete or misleading facts or information
to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to
a settlement or award payable from insurance proceeds shall be reported to the State Insurance Regulatory Agency and/or Division
of Insurance. If while in the state of Florida, a person knowingly and with intent to injure, defraud, or deceive any insurer,
files a statement of claim or an application containing any false, incomplete or misleading information, the person is guilty of
a felony in the third degree. Any person who knowingly and with intent to defraud any insurance company or other person, files
an application for insurance or statement of claim containing any materially false, misleading or deceptive information, or
conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act,
which is a crime and shall be subject to substantial civil and/or criminal penalty where and to the extent allowed by state law.
Acceptance into this plan is subject to medical evidence of insurability as determined by The
Hartford. Depending on your age, the amount of coverage you request, and your answers on the application, a medical
examination, medical test(s) or other evidence of good health may be required. Any exams/tests requested by the
company will be conducted at no expense to you.
This website explains the general purpose of the insurance described, but in no way changes
or affects the policy AGP-5673/5675 as actually issued. In the event of a discrepancy between this website and the policy,
the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten
by Hartford Life and Accident Insurance Company detail exclusions, limitations, reductions of benefits and terms under
which policies may be continued in force or discontinued. Complete details are in the Certificate of Insurance issued
to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be
available to residents of all states.
NCMIC Insurance Services is the Plan Administrator and Insurance Broker that administers the D.C. Long Term Disability
Insurance Plan on behalf of The Hartford for the benefit of the Group Policyholder, NBAC. NCMIC Insurance Services is
compensated for the placement of insurance and for the services it provides to customers on behalf of The Hartford.
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