MSMC Plan Benefits
Your plan will provide you with these valuable benefits:

Monthly Benefits:
You may apply for the following amounts:
AGE MONTHLY BENEFIT AMT*
Under Age 50Up to $10,000
Age 50 to 54Up to $5,000
Age 55 to 59Up to $3,000
*Please note: There are limitations to how much disability income protection you can apply for, based on your income. Please use the benefit calculator for more detailed information.

Benefit Periods:
You can receive disability benefits To Age 65.

To Age 65 Plan:
For total disability beginning:
    Before Age 63:   To Age 65
    Age 63, but under Age 70:   2 Years
    Coverage ends at age 70.

Waiting Periods:
Benefits begin after you have been totally disabled for 30, 60, 90, or 180 days.

Who's Eligible?
Only members of the Medical Society of Milwaukee County are eligible to apply for coverage. To be eligible applicants must be under age 60, work at least 30 hours a week, and live in the United States.

What's Covered?
This plan covers most disabilities due to accidental injuries, sickness or disease. To qualify for benefits, a period of total disability must begin while you are covered under this policy and you are under the regular care of a physician for that condition. The physician cannot be a family member.

What is a Total Disability?
You'll receive own-occupation protection for 5 years, which means you qualify for benefits if you cannot perform the substantial and material duties of your own regular occupation. Thereafter, the definition of disability is the continuous inability to perform any occupation for which you are reasonably suited in terms of education, training, and experience.

What If You Return to Work after a Disability, But Suffer a Relapse?
Since disabilities don't always start and stop in easily defined time frames, we've developed a plan that is flexible enough to accomodate various disability durations and scenarios. If you return to work for fewer than 15 days before the end of the waiting period and then suffer a relapse, you can qualify for benefits by satisfying only the remainder of the waiting period. This provision relieves you of having to start the entire waiting period again.

Periods of disability, if due to the same or related medical causes and separated by fewer than six months while you are actively at work, are considered a single period of disability. Actively at work is defined as working at least 30 hours per week. This means you won't have to satisfy a new waiting period before qualifying for benefits should you suffer a relapse upon returning to active employment after receiving benefits for a disability.

Does the Plan Pay for Partial Disability?
A Partial Disability Benefit is paid if you receive total disability benefits, but are then able to perform at least one of the substantial and material duties of your regular occupation, either part-time or full-time. You must suffer an income loss of between 20% and 80% and be under the regular care of a physician.

The Partial Disability benefit lets you rebuild your income to its pre-disability level as you return to full time employment. This provision is especially important for professionals or small business owners who must rebuild a professional practice or business after becoming disabled.

Will My Benefits be Reduced by Other Disability Benefits that I Might Receive?
The actual benefit you receive at the time of your claim may be different, depending upon your income, offsets for other income benefits and other variables. Other income means the amount of any benefit for loss of income that you or your family receive or are eligible to receive from Social Security Disability Income or similar plans; Workers' compensation or occupational disease laws, or similar laws; group, association, union or other organizational coverage; employer-related individual policies; governmental laws or programs that provide disability or unemployment benefits as a result of your job with any employer; disability coverage under any employer's retirement plan; damages or settlements for income loss; and no-fault automobile insurance plans.

Other income benefits also include retirement benefits from retirement plans that are wholly or partially funded by employer contributions, unless you were receiving them prior to becoming disabled or you immediately transfer the payments to another plan qualified by the U.S. Internal Revenue Service for the funding of a future retirement.

Finally, other income benefits include retirement benefits your or your family receive from Social Security or similar plans, unless you were receiving them prior to becoming disabled.

Is there any Waiver of Premium Provision?
Yes - Future premiums will be waived for as long as benefits are payable after you have been disabled for 6 months.

Will My Benefits Ever be Reduced?
If your monthly benefits are reater than $2,200, then your benefits will be reduced to $2,200 on the premium due date on or next followig the date you attain age 65 with an appropriate adjustment in premium.

What's Not Covered Under This Plan?
Benefits are not paid for losses due to war or acts of war, whether declared or not; intentionally self-inflicted injury, suicide or attempted suicide, while sane or insane; injury sustained while committing or attempting to commit a felony; losses due to sickness contracted or injury sustained while on full-time active duty as a member of the armed forces of any country or international authority; pregnancy or childbirth except complications of pregnancy.

Can My Coverage Be Cancelled?
Your coverage can only be cancelled if: When Will My Coverage Become Effective?
Your coverage will become effective on the day your application is approved by the insurance company, provided you are actively at work and your initial premium payment has been received. If you are not actively at work on that date, your effective date will be postponed until you are actively at work for 90 consecutive days.