Disability (STD/LTD)
WKU Coverage End Date:
Last day of the month of separation.
Continuation, Portability or Conversion Options of Existing Coverage:
Short Term Disability Portability– This policy provides portability for up to 12 months, when an Insured person’s insurance under this Policy terminates because his or her employment with the employer ends; provided: 1) The insured person is not disabled, retired or on a leave of absence; and 2) the insured person was insured under the employer’s short term disability plan for at least 12 months in a row, just prior to the date employment ended. Continuation of insurance under the Portability provision will follow any state required continuation or other continuation allowed under the Ceasing Active Work section of this Policy. Portability is not available to an Insured Person whose insurance terminates because 1) the Insured person’s employer ceases to be a participating employer; or 2) this Policy is terminated by the employer or the company.
Short Term Disability Policy # 000010179084
Group ID: WESTKENTUC
APPLICATION FOR PORTABILITY
Contact WKU-HR, Employee Wellness & Benefits, to complete the Employer section
Insurer/Administrator's Contact Information:
Lincoln Financial Group
Website: www.lfg.com
Phone: 800-423-2765
WKU Coverage End Date:
Last day of month of separation.
Continuation, Portability or Conversion Options of Existing Coverage:
Long Term Disability Conversion Privilege – This Policy provides a conversion privilege, when an insured employee’s insurance under this Policy ends. The insured employee may obtain converted long term disability insurance, without medical evidence of insurability. To be eligible for a converted policy, the insured employee must have been insured under the employer’s group plan for at least 12 months in a row, just before his or her insurance under this Policy terminated.
Long Term Disability Policy # 000010179083
Group ID: WESTKENTUC
EMPLOYEE APPLICATION FOR CONVERSION OF GROUP LONG TERM DISABILITY INSURANCE FORM
Contact WKU-HR, Employee Wellness & Benefits, to complete the Group Employer Questionnaire
Insurer/Administrator's Contact Information:
Lincoln Financial Group
Website: www.lfg.com
Phone: 800-423-2765
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