Plan Information

Whether you currently have some disability income protection and wish to increase your coverage, or you're purchasing a policy for the first time, ATLA Catastrophic Disability insurance offers a highly flexible, affordable income replacement plan.

Who Is Eligible?

Catastrophic Disability insurance is available to ATLA members or a participating state trial lawyer association members age 55 and under in good standing. Individuals must be actively employed, working a minimum of 20 hours a week, and earning a minimum of $12,000 a year. Spouses of members are eligible to apply under the member's policy for the Extended Disability Benefit only.

Please Note: This Plan is currently available to residents of the following states: AK, AL, AR, CA, CO, DC, GA, HI, IL, IN, KS, KY, LA, MA, ME, MI, MN, MO, MT, NE, NM, NV, OH, OK, PA, RI, TX, UT, VA, WY. The list changes periodically as new states are added. Call 1-800-482-ATLA (2852) to learn more.

HOW THE PLAN WORKS

Protect up to 100% of Your Income

Catastrophic Disability insurance provides up to 100% income replacement — with a maximum of $10,000 per month — when an illness or injury leads to cognitive impairment, or the loss of two or more ADLs (Activities of Daily Living: bathing, dressing, eating, toileting, continence, and transferring).

Benefits are provided regardless of Social Security or Workers' Compensation. The policy also offers return-to-work incentives where appropriate, such as rehabilitation, worksite modification, and continuing benefits if you are still disabled, as defined by the plan.

Waiting Period Options

Choose from four waiting period options: 60 days, 90 days, 180 days, 360 days.

Benefit Period Options

Choose between three benefit period options, with benefits payable as follows:

To Age 65 Benefit Period: Benefits are payable to the later of:

• the certificate renewal date immediately after age 65, or
• a 12 month minimum benefit

5-Year Benefit Period: Benefits are payable for 60 months but not beyond the later of:

• the certificate renewal date immediately after age 65 or,
• a 12 month minimum benefit

10-Year Benefit Period: Benefits are payable for 120 months but not beyond the later of:

• the certificate renewal date immediately after age 65 or,
• a 12 month minimum benefit

IMPORTANT FEATURES OF THE PLAN

Extended Disability Benefit

The optional Extended Disability benefit rider offers an additional lump sum benefit of $10,000 to $100,000, payable after you have been ADL disabled or cognitively impaired for 180 days.

Survivor Benefit

A three month lump sum benefit is payable to your eligible survivor or your estate, if you die after 180 days of continuous disability during which you received or were entitled to receive benefits under the plan.

Continuous Coverage

If you are materially and substantially disabled from your regular occupation for at least the length of your waiting period, premiums will be waived for a period up to 24 months.

Rehabilitation Assistance

Through the policy, you gain access to Unum Provident's rehabilitation services that will assist you in returning to work

Catastrophic Disability Rates

Use the following example to calculate your quarterly premium. Divide the monthly benefit by 100 and multiply by the base rate (listed in the tables).

Example: Applicant, Age 42, requesting the 5 Year Plan with 90 Day Waiting Period and $5,000 Monthly Benefit.

$5,000 divided by 100 = 50 X .47 = $23.50 quarterly

ADDITIONAL PLAN PROVISIONS

Pre-Existing Condition Provision

The Catastrophic Disability policy will not cover any sickness or injury caused by, contributed to, or resulting from a pre-existing condition that begins in the first 24 months after your coverage is effective, unless you have been treatment-free for 12 consecutive months after the effective date of coverage.

A pre-existing condition is defined as a sickness or injury for which you received medical treatment, consultation, care, or services, including diagnostic measures, or for which you had taken prescribed medications in the 6 months prior to the effective date of coverage. It also means any condition that produced symptoms within 6 months prior to the effective date of coverage.

When Does Coverage Terminate?

Coverage ceases if:

• You are no longer a member of your organization.
  
  
• You are no longer the spouse of a member.
  
  
• You attain age 70.
  
  
• You have been paid benefits for the maximum benefit period.
  
  
• You do not pay the required premium when due.
  
  
• The date the policy ends.

Exclusions

The Plan will not cover any disabilities caused by, contributed to by, or resulting from:

• Intentionally self-inflicted injuries.
  
  
• Active participation in a riot.
  
  
• Loss of a professional license, occupational license, or certification.
  
  
• Attempt to commit or commission of a crime under state or federal law.
  
  
• Commission of a crime for which for which you or your spouse have been convicted under state or federal law.
  
  
• Flying in any aircraft other than as a passenger on a common carrier licensed for transporting passengers.
  
  
• A pre-existing condition.
  
  
• Disabilities which are primarily based on self-reported symptoms and disabilities due to mental illness have a limited pay period up to 12 or 24 months.
  
  
• War, any act of war, or service in the armed forces.
  
  
• Any period in which you or your spouse are incarcerated.

Policy Definitions

1. Disability:

The loss of the ability to perform two activities of daily living safely and completely without another person's assistance or verbal cuing, or cognitive impairment.

To be considered disabled under your coverage, you must lose two or more activities of daily living or become cognitively impaired while you are insured under the participating organization's coverage.

If you become disabled while you are insured under the Continuous Coverage provision, your disability must be due to the same sickness or injury that resulted in your eligibility for Continuous Coverage.

The loss of professional or occupational license or certification does not, in itself, constitute disability. This definition of disabled or disability also applies to your spouse, if she or he is insured under this coverage.

2. Cognitive Impairment:

A deterioration or loss of intellectual capacity which requires another person's assistance or verbal cuing to protect oneself or others, as measured by clinical evidence and standardized tests which reliably measure impairment in the following areas:

• Short or long term memory
  
  
• Orientation as to person (e.g. ability to identify oneself), place (e.g. ability to identify location), and time (e.g. ability to identify day, date, and year)
  
  
• Deductive or abstract reasoning

3. Activities of Daily Living (ADLS)

Bathing: The ability to wash oneself in the tub, shower, or by sponge bath with or without equipment or adaptive devices.

Dressing: The ability to put on and take off garments, medically necessary braces, or artificial limbs and to fasten and unfasten them.

Toileting: The ability to get to and from and on/off the toilet, maintaining a reasonable level of personal hygiene and caring for clothing.

Transferring: The ability to move into and out of a chair or bed, with or without equipment such as canes, quad canes, walkers, crutches, grab bars, or other support devices, including mechanical or motorized devices.

Continence: The ability to voluntarily control bowel and bladder function, or in the case of incontinence, the ability to maintain a reasonable level of personal hygiene.

Eating: The ability to get nourishment into the body by any means after it has been prepared and made available.

Certificate of Insurance

When you become insured, you will be sent a Certificate of Insurance summarizing the provisions of the Plan under which you are insured.

Effective Date of Insurance

All eligible members who make the first insurance payment and whose evidence of insurability is satisfactory to the insurance company will become insured on the date of approval of their request for coverage provided they are actively performing the normal duties of a person in good health of like age and gender on the later of the date of approval or the date the premium is paid.

30-Day Free Look

If you are not completely satisfied with the terms of your Certificate of Insurance you may return it, without claim, within 30 days of receipt of your certificate. Your insurance will then be voided and your premium refunded.

Payment and Claims

Once you are accepted into these plans, you will have a 31-day grace period for your payment of renewal premiums. When you want to submit claims, write the Administrator for claim forms or call 1-800-482-ATLA (2852).

HOW TO APPLY FOR COVERAGE

1. Complete and sign the application.
2. Make your check for the appropriate premium amount payable to: Administrator of ATLA Group Insurance Program.
3. Mail both your completed application and your check to:

Administrator of ATLA Group Insurance Program
1776 West Lakes Parkway
West Des Moines, IA 50398

Your Eligibility

Before you request coverage, you must be a member in good standing of ATLA or a member in good standing of a participating state trial lawyer association. Please wait until your application for membership is accepted before initiating your insurance requests. If you have any questions about membership, see ATLA home page.

Questions? We're Only a Phone Call Away

If you have questions about your eligibility, whether the Plan is available in your state, what the Plan covers, or how to complete the application, just give us a call toll-free 1-800-482-ATLA (2852) between 7:30 AM and 4:30 PM Monday through Friday, Central Time A customer service representative will be pleased to assist you. Also see Frequently Asked Questions.

About This Plan Information

This Plan Information contains a partial description of some of the principal provisions and definitions of the proposed insurance coverage. The complete terms, conditions, and limitations are set forth in the group policy issued by the insurance company.

This Plan is subject to rate changes on any policy anniversary or premium renewal date and on any date on which benefits are changed. Changes in coverage or other plan provisions can only be made upon agreement between Unum Life Insurance Company of America and the Plan Trustee.

The Catastrophic Disability Insurance Plan is administered by:		The Catastrophic Disability Insurance Plan is underwritten by:
		Unum Life Insurance Company of America Portland, Maine Association/Affinity Operations 15 Corporate Place South Piscataway, NJ 08855-1387
Administrator of ATLA Group Insurance Program 1776 West Lakes Parkway West Des Moines, IA 50398
To learn more about Marsh Affinity Group Services, see About the Administrator...		To learn more about UNUM Life Insurance Company, see About the Companies that Underwrite ATLA Group Insurance...

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