The AOA Group Long-Term Disability Income Insurance Plan - aoa
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A Split-Second Accident Could Change Your Career Forever
Imagine you're driving home from work one evening when an SUV runs a red light and hits the driver's side of your car. The result may very well be severe back injuries...leaving you disabled and unable to work for months. Just think of the impact on your practice – and your income.
But as a member of the AOA, you can plan ahead for all-too-real situations like these. The AOA Group Long-Term Disability Income Insurance Plan (underwritten by New York Life Insurance Company) can help you protect your income in case an accident or illness keeps you from working as an optometrist.
Monthly Benefits Up to $7,500 Available
One of the top concerns for many doctors of optometry is finding a disability plan that delivers benefits high enough to adequately cover their income. That's why the AOA made sure this Group Disability Income Insurance Plan featured generous coverage with up to $7,500.00 in monthly benefits.
Employees of an AOA member can apply for monthly benefits up to $3,000 as long as their benefit amount doesn't exceed 65% of their regular pay.
Benefits Paid If You Can't Work As An Optometrist
Another concern is setting up benefits tailored to the level of training and expertise you've achieved as a doctor of optometry. You can rest assured this plan helps protect you if you can't work in your OCCUPATION. (Some plans may only pay if you can't work in ANY occupation. It's an important distinction to keep in mind.)
If you are an AOA member, under age 55, actively-at-work at least 30 hours a week, and a U.S. resident*, you are eligible to apply for a monthly benefit amount up to $7,500 (in $100 increments), provided the benefit you select does not exceed 80% of your average monthly income. If you're under age 45 and have practiced for 6 months or less, you can apply for up to $2,000 in monthly benefits.
If you own your own practice, your employees can also apply for the AOA Group Long-Term Disability Income Insurance Plan through your membership. Employees must be under age 55, reside in the United States*, and work at least 30 hours a week to be eligible. Employees of an AOA member can apply for monthly benefits up to $3,000 as long as their benefit amount doesn't exceed 65% of their regular pay.
*Coverage may not be available in all states, please contact the plan administrator for more details.
Offers Choice of Benefit Plans and Waiting Periods
Depending on your needs and budget, you can select from the following plans:
- Two-Year Plan: Pays monthly benefits for up to two years for Covered Total Disabilities through age 64. For disabilities commencing at age 65 benefits will be paid up to 12 months.
- Five-Year Plan: Pays monthly benefits for up to five years for Covered Total Disabilities through age 64. For disabilities commencing at age 65 benefits will be paid up to 12 months.
- To Age 65 Plus Plan: Pays monthly benefits up to age 65 for Covered Total Disabilities through age 64. For disabilities commencing at age 65 benefits will be paid up to 12 months.
Plus, you can choose among five waiting periods: 45, 60, 90,180 and 365 days. The longer the waiting period, the less your premium will be.
Employees of the AOA Members:
- Two-Year Plan with 90 day waiting period: Pays monthly benefits for up to two years for Covered Total Disability through age 64. For disabilities commencing at age 65, benefits will be paid up to 12 months.
Income Safety Net For Doctors Of Optometry
When you take advantage of this program for the AOA members, you're setting up an extra measure of protection for your earning power as a doctor of optometry. That's because the AOA Group Long-Term Disability Income Insurance Plan pays benefits if you can't work in your OWN OCCUPATION.
You Owe No Premiums If You're Disabled And Collecting Benefits
If a covered accident or injury leaves you totally disabled and unable to work as a doctor of optometry, we'll waive any further premium payments after you've been totally disabled for three consecutive months. Your coverage will remain in full force as long as your disability continues from that injury or sickness.
Collect Again If Your Disability Comes Back
It's not unusual to recover from a disability … go back to work … and then find your disability once again prevents you from performing your duties as a doctor of optometry. So the AOA Group Long-Term Disability Income Insurance Plan gives you benefits for these types of situations.
After you meet your original elimination period (the waiting period before benefits begin) for a disability, any disability due to the same or related medical condition will be treated as one continuous period of disability. That means your disability benefits can start again … right away … if you become disabled again after returning to continuous full time work for LESS than six months. If you worked for six months or more, you will need to satisfy the elimination period again before disability benefits can resume and it will be considered a separate period of disability.
Save Money With Affordable Rates
The AOA leveraged the professional status of more than 25,000 doctors of optometry to negotiate the affordable rates for this Insurance Plan. This significant financial advantage helps the AOA's Group Long Term Disability Plan stand out in comparison to programs you may find on your own or through an employer.
Current 2018 AOA Group Long-Term Disability Monthly Rates per $100 of Benefits
45 Day Waiting Period
|2 Year Plan||5 Year Plan||To Age 65 Plus Plan|
60 Day Waiting Period
|2 Year Plan||5 Year Plan||To Age 65 Plus Plan|
90 Day Waiting Period
|2 Year Plan||5 Year Plan||To Age 65 Plus Plan|
180 Day Waiting Period
|2 Year Plan||5 Year Plan||To Age 65 Plus Plan|
365 Day Waiting Period
|2 Year Plan||5 Year Plan||To Age 65 Plus Plan|
* Rates listed are applicable to AOA Members and AOA Member Employees
** The Age 55-74 rate are for renewals only
*** Benefits are payable for up to one year for covered disabilities commencing after age 64 but before age 75
Note: If you're under 45 and have been inactive for 6 months or less, your maximum benefit is $2,000
The premium contributions shown reflect the current rate and benefit structure. Premiums increase on the premium date coinciding with or next following the date that a member enters a new age bracket. Premium contributions may be changed by New York Life Insurance Company on any premium due date and any date on which benefits are changed. However: your rates may change only if they are changed for all other in the same class of insureds under this group policy. For example, a class of insureds is a group of people all with the same issue age, waiting period, and plan benefit option amounts are not guaranteed and are subject to change by agreement between New York Life Insurance Company and the AOA.
Call 1-866-331-0180 for more information.
How long will the AOA Group Long-Term Disability Income Insurance Plan pay benefits?
While other programs may only protect you for a few years, the AOA's Long-Term Disability Income Insurance Plan can continue through age 65 for any covered disabling illness or injury, plus if you become disabled after age 65, the maximum benefits period is 12 months to age 75, depending on the plan you choose. This extended payment period is designed to provide the AOA members with maximum protection during the working years.
What kinds of disability will the Plan pay for?
The AOA Group Long-Term Disability Income Insurance Plan pays valuable benefits if a covered injury or illness leaves you totally disabled and unable to perform the material and substantial duties of your occupation. You can also collect benefits for residual disabilities that cause a loss of earnings of at least 20% (and less than 80%) while you're performing at least one of the material and substantial duties of your occupation on either a part-time or full-time basis. You must also be under the regular care of a physician. Material and substantial duties are those that are normally required in your occupation and cannot be reasonably omitted or modified. In addition, a disability that causes a loss of earnings of 80% or more will be considered a total disability. Please refer to the Terms tab for more information on exclusions and limitations.
Will I have to pay taxes on my benefits?
Under current tax law, your AOA Group Long-Term Disability Income Insurance benefits are tax-free as long as you pay your own premiums. That means you will receive the benefit amount you applied for in the event of a covered disability. If you own your own business, you may choose to claim your premium as a tax deduction. Check with your accountant for details.
Will I have to pay premiums while I'm disabled?
No. After three consecutive months of total disability, we will waive any further premiums that come due. Your coverage will continue in full force as long as you remain totally disabled from that injury or sickness.
When Coverage Begins: Your coverage will begin on the first of the month following the date your application is approved, provided you are actively-at-work full-time on the date, meet required evidence of insurability requirements and the premium is paid. If you are not Actively-At-Work, the insurance will not take effect until you return to full-time work for at least 10 consecutive workdays, if such day is within three months of the date insurance would otherwise have taken effect and the insured member is still eligible to obtain the insurance on that day. Benefits will begin on the first day of a covered total disability after completion of the applicable Waiting Period. Benefits will continue until the earlier of (a) the day the insured ceases to be totally disabled or (b) the end of the maximum benefit period.
When Coverage Ends: Your coverage will end when you are no longer an AOA member or employee of a member or you are no longer at full-time work, you reach age 75, you stop paying your premiums when due, when you receive covered total disability benefits for the maximum benefit period, when you begin active duty in the armed forces, or the date the group policy ends.
Average Monthly Income means a person's average monthly wages, salaries, commissions, fees and any other amounts received by such person for personal services, including the cost of his or her fringe benefits and share of total surpluses. It does not include income from interest, dividends, rent, royalties, annuities, other insurance and other unearned income.
Covered Total Disability is an incapacity that completely and continuously prevents the insured member from doing the material and substantial duties of his/her regular occupation. Such covered disability must begin while the insured member is insured under the Policy and be the result of: (1) an injury. For a covered disability to be considered to have resulted from an injury, the covered total disability must begin within 90 days after an accident, if the accident occurs while the insured member is insured under the policy. If more than 90 days has elapsed, such covered disability will be considered to have resulted from an injury sickness; (2) a sickness; or (3) an organ donation that an insured member makes, provided he/she has been insured under the Policy for at least six consecutive months on the day of such donation.
A loss of license, in and of itself, does not constitute an incapacity that prevents the insured member from doing the material and substantial duties of his or her regular occupation and will not be deemed a Covered Total Disability.
Mental Disorder means a condition due to or resulting from psychiatric or psychological conditions, regardless of cause, such as: (a) schizophrenia; (b) depression; (c) manic depressive or bipolar illness; (d) anxiety; (e) personality disorders; and/or (f) adjustment disorders or other conditions, usually treated by a mental health provider or other qualified provider using psychotherapy, psychotropic drugs or other similar modalities used in the treatment of the above conditions. This limitation does not apply to dementia, if due to: (a) stroke; (b) trauma; (c) viral infection; (d) Alzheimer's disease; or (e) other conditions not listed above which are not usually treated by a mental health provider using psychotherapy, psychotropic drugs or other modalities.
Chemical Dependency means the abuse of or psychological or physical dependency on or addiction to alcohol or a controlled substance. For purposes of this definition, "controlled substance" means a toxic inhalant, a volatile chemical, abusable glue or aerosol paint, or a substance designated as or considered a controlled substance under applicable federal, state or local authority.
Successive Periods of Disability will be considered one period of disability if such disabilities are due to the same or related causes, and which are separated by less than six months of return to continuous full-time work during which you are not totally disabled or different or unrelated causes are not separated by return to full-time work.
Waiting Period is the initial, continuous period of a Covered Total Disability which must be completed before such Covered Total Disability benefits become initially payable.
Note: The Maximum Benefit Period for all Covered Disabilities of an insured which are due to or related to Mental Illness and/or Chemical Dependency while such person is insured under the Policy, whether insurance has been continuous or interrupted, cannot exceed the lesser of: (a) 24 months; or (b) the Maximum Benefit Period for a Covered Disability due to an injury, sickness or organ donation. This limitation does not apply to any period during which such insured is institutionalized.
The AOA Group Long-Term Disability Income Insurance Plan does not cover and we will not pay a benefit for any loss or disability: Due to Crime/Illegal Occupation/Illegal Activity: Participation in or incarceration resulting from any of the following in a role other than as a victim: (a) the commission of a felony; (b) an illegal occupation or activity; (c) an insurrection; (d) terrorist activity; or (e) a riot. Intentional self-inflicted injury or an attempt at intentionally injuring oneself; while sane. Engagement in any of the following in a role other than a victim: (a) in war, (b) an act of war, or (c) an armed conflict which involves the armed forces of one or more countries; a pre-existing condition; an impairment restriction; a disability that is due to or related to service in the military, naval or air force of any country, alliance or international organization or in a civilian unit which serves such force. A disability that is due to a pregnancy or childbirth or a related medical condition, except for complications of pregnancy; Regular Care that does not require a doctor's regular care of, or attendance to, the insured; or for any period of disability for which the insured is not under the regular care and attendance of a doctor, except that: This requirement will not apply if such care is no longer required for prudent medical management of the injury, sickness or organ donation. For the purpose of satisfying the requirement that the insured be under the "regular care" of a doctor, doctor does not include the insured or a member of his or her immediate family. Occurs during, is due to, or is related to the insured member's travel in, travel on, fall from or descent from any aircraft when the aircraft is used to train, test, or experiment or is part of any military, naval or air force. Additional exclusions or limitations may apply as a condition of approval of your application for coverage.
Mental Disorder and Chemical Dependency Limitation:If you are disabled due to mental illness or substance abuse, the maximum benefit period for total and residual disability benefits is the lesser of: 1) the maximum benefit period shown on your schedule; or 2) 24 months during your lifetime. We will continue to pay benefits beyond the limited pay period if you are an inpatient under a physician's care in either a hospital or an institution which treats and cares for mental illness or substance abuse. In no case will benefits be paid beyond the maximum benefit period.
Pre-Existing Condition Limitation: Pre-existing Condition means an injury or sickness or any condition related to such injury or sickness for which a person consults a doctor, receives medical services or supplies or takes any medication during the 12-month period immediately before the insured's initial insurance date. Pre-existing Condition does not include: (a) any such injury or sickness or condition after such person has been continuously insured under the Policy for 12 months; or (b) an injury or sickness or condition classified as an Impairment Restriction.
Impairment Restriction - A disability that is due to or related to a condition which has an Impairment Restriction. Impairment Restriction means an exclusion or limitation of insurance on an INSURED MEMBER. An Impairment Restriction will be: (a) established by New York Life; and (b) continued by New York Life if it is in effect on the day before: (1) the INSURED MEMBER becomes insured under the Policy; or (2) a change in insurance takes effect; whether or not satisfactory medical evidence of insurability is furnished or medical evidence of insurability is required. All Impairment Restrictions are stated in the certificate. Insurance with such Impairment Restrictions is subject to the APPLICANT'S acceptance. Payment of one CONTRIBUTION after the INSURED MEMBER is advised of the Impairment Restriction will establish such acceptance.
Important Information from New York Life Insurance Company
New York Life Insurance Company reserves the right to request medical information to determine applicant's medical eligibility for coverage. Based on the age of the person proposed for insurance and the amount of coverage requested, a physical examination, EKG, blood test or other information may be required. Not all applicants will have to supply additional information. However, if it is required, New York Life will arrange for an independent professional paramedic to contact you to perform these simple tests at your convenience. The exam and blood test are free-of-charge. If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life.
How New York Life Obtains Information and Underwrites Your Request for the AOA Group Long Term Disability Income Insurance
Information regarding insurability will be treated as confidential. In considering your request for insurance, we will rely on the medical information you provide, and on the information you authorize us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, Inc. (formerly known as Medical Information Bureau). MIB and other insurance companies may also furnish New York Life, its subsidiaries or the plan administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other application for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.
New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing, however, this will not be done in connection with test results concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but we will not disclose our underwriting decision.
New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a "need to know" basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.
If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB's information office is: MIB, Inc., 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 866- 692-6901. For Canadian residents, the address is: MIB Information Office, 330 University Avenue, Suite 501, Toronto, Ontario, Canada M5G 1R7, telephone 416-597-0590. Information for consumers about MIB may be obtained on its website at www.mib.com.
For NM Residents: PROTECTED PERSONS1 have a right of access to certain CONFIDENTIAL ABUSE INFORMATION2 we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.
1PROTECTED PERSON means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured person or prospective insured person.
2CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.
New York Life Insurance Company 8.12 ed.
If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life.
Questions? Call toll-free 1-866-331-0180
When program experience has been good New York Life Insurance Company will periodically return excess premiums in the form of dividends to the AOA as the policyholder. The AOA will retain these dividends in a Dividend on Deposit Account with New York Life. The AOA will in turn periodically make these dividends available through premium credits to existing insureds in the programs which generated the dividends. Sufficient reserves will be retained by the AOA in the Dividend on Deposit Account to cover administrative and marketing costs generated by the New York Life Insurance Programs sponsored by the AOA. These programs are administered together to take advantage of the savings resulting from this integrated approach.
Administrative expenses incurred by the AOA to provide the valuable membership benefits resulting from these sponsored insurance programs are reimbursed from available program dividends. New York Life may also, out of premium, pay a reasonable fee to the AOA for making the AOA assets available to it to promote these programs to the membership. These assets include the AOA Intellectual Property Rights and mailing lists of eligible members.
AGIA Insurance Services, Inc.
P.O. Box 26860
Phoenix, AZ 85068
A.G.I.A., Inc., is licensed/authorized to transact business in all 50 United States, and the District of Columbia. Their state of domicile is California. J. Christopher Burke California Agent license number is 0F70947. J. Christopher Burke Arkansas Agent license number is 8876308.
The AOA Group Long Term Disability Income Insurance Plan is underwritten by:
New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
under Group Policy G-29336-1 on
Policy Form GMR-FACE/ G-29336-1
New York Life is licensed/authorized to transact business in all the 50 united states, District of Columbia and Puerto Rico.
Please note that this plan is not available in all states.
New York Life Insurance Company's state of domicile is New York and their NAIC ID # is 66915.
No Risk With 30-Day Free Look
As soon as your benefit request is approved, we'll mail your Certificate of Insurance outlining the terms and conditions of this AOA benefit program. Take up to 30 days to look it over. If it wasn't what you had in mind, mail back the Certificate, without claim and your insurance will be invalidated.
Act Immediately for Prompt Coverage
With the AOA's Group Long-Term Disability Income Insurance Plan, you can apply for up to $7,500 in monthly benefits to help replace your income if an injury or illness leaves you unable to work as a doctor of optometry.
Just download the Application Form on this website. Then complete, sign and date your application and mail it to: the AOA Group Long-Term Disability Income Insurance Plan, P.O. Box 26860, Phoenix, AZ. 85068-9961.
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30-DAY FREE LOOK
You are under no obligation today.
Your official Certificate of Insurance outlines the terms and conditions of this AOA program. Take up to 30 days to look it over. If it's not what you had in mind, mail back the Certificate for a 100% refund; less any claims paid.