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Frequent Questions

AFSPA Disability Plans FAQs

AFSPA is proud to offer three coverage options for disability, exclusively designed for our members.

With both the Lloyd’s of London and Cigna plans, the benefit period will not be extended. 

Depending on your specific circumstances, a Federal Retirement System such as the Federal Employees Retirement System (FERS) or the Foreign Service Retirement and Disability System (FSRDS), may provide you with disability coverage. 

The Lloyd’s of London plan does offer an Optional Lump Sum Benefit, which must be elected at the time you apply for the plan. It cannot be purchased once coverage is in effect, and it cannot be purchased once you have become disabled. The Optional Lump Sum Benefit, with a separate premium, will provide you with either $250,000 or an amount up to 5X your salary, whichever is less. This optional benefit is paid out only if you are still medically certified as being totally disabled after receiving your monthly benefit for the full two years. 

Disability coverage provides salary replacement only when one experiences lost income due to a sickness or injury that has been medically certified by a physician. No health or medical coverage is included.

Both the LOL and Cigna plans pay out a benefit of up to 60% of your annual salary, up to a maximum of $5,000 per month for LOL and the Cigna 30-Day plan, and up to $7,500 for the Cigna 90-Day plan, for a limited period (2 years for the LOL plan, and either 2 years or 5 years for the CIGNA plans). 

Whether you are asked questions about your health history depends upon which of the two plans you choose, Lloyd’s of London or CIGNA.

The Lloyd’s of London plan does require an application containing some health questions. Depending upon your current health status and the severity of any medical condition, you could be turned down for coverage.

The CIGNA plans do not require an application, you simply enroll. It is important to understand that the CIGNA plan does follow a “3/6/12 Rule” for pre-existing conditions. If you are treated for a medical condition 3 months prior to your effective date, any disability arising from that condition will not be covered unless you are treatment free for 6 consecutive months after your effective date of coverage or after you have been insured and still active at work for 12 consecutive months.

No, it provides wage/salary replacement only.

Both plans have a qualifying period, which is typical with disability insurance. This period is also known as an “elimination” or “ waiting” period. Think of your need to cover living expenses without income during this time, similar to having to meet the deductible through your health insurance plan. During the elimination period, you remain financially responsible for your living expenses. 

  • The Lloyd’s of London plan will provide benefits for 24 months, after a 45-day elimination period.
  • The CIGNA plans will provide benefits for 2 years or 5 years, after a 30-day or 90-day elimination period depending on the plan you choose at the time of enrollment.

The Optional Lump Sum Benefit of $250,000 or up to five times (5X) your salary, whichever is less, must be elected at the time of application. A separate premium is applicable for this additional coverage. The Optional Lump Sum Benefit is payable after the maximum benefit period of 2 years has been met and, if you are still medically certified as being totally disabled.

 

No, disability coverage will cease for either the Lloyd’s or Cigna plan once the FERS or FSRDS disability coverage begins.

Both plans are payable only by a monthly deduction from a designated financial institution. Unlike other plans sponsored by AFSPA, premiums must be paid monthly to both Lloyd’s and CIGNA.

No. Only active duty employees who are AFSPA members, or eligible for AFSPA membership, can apply.

Due to security and concerns for protecting your privacy, ALL Direct Debit enrollments/changes will be handled through the AFSPA Member Portal.

Three e-mails will be generated: (1) an e-mail containing a secure PDF of your signed enrollment for your records; (2) an acceptance e-mail from the AFSPA Accounting Team that your Direct Debit has been processed and accepted; and (3) an e-mail when the first debit has occurred from your bank account.

All changes made online to your Direct Debit will be confirmed via e-mail.

You can also use the edit button to change bank information quickly and immediately.

To cancel direct debit, send a request via email or our secure forms page and indicate the date on which direct debiting should be cancelled. 

No, annual leave is not taken into account when a claim is submitted/considered.

Regarding sick leave, the certificate booklet states on page 14:
“An employee for whom Disability Benefits are payable under the Policy may be eligible for benefits from Other Income Benefits. If so, the Insurance Company may reduce the Disability Benefits by the amount of such Other Income Benefits. Other Income Benefits Include:
*Any sick leave or salary continuation plan”

 

No, you are not required to use your sick leave to receive claim reimbursement. However, you do have the option of receiving sick leave benefits that will be coordinated with this disability policy. Or, you may choose to save your sick leave and only utilize your disability benefits.

All claims are adjudicated based on the claimant’s answers, the medical certification received from the Physician and the employer’s statement. For ALL claims, the Plan will not start benefit reimbursement(s) until the elimination period (30 days, 45 days or 90 days) has been exhausted.

It is expected that a member will use employer leave (sick and/or vacation) to cover wages during the elimination period. If a claimant does not have enough leave to meet the elimination period, they may be required to default to LWOP status.

Yes, your Physician is required to provide a statement or official documentation to validate your medically necessary disability to receive disability benefits.

Medically necessary maternity leave is any leave from work that is medically certified by a Physician as a result of a pregnancy.  There are various reasons for doctor-ordered maternity leave including bed rest, complications or the time needed to simply recover from the delivery.

The standard recovery period for routine vaginal delivery is 6 weeks and 8 weeks for Cesarean delivery. NOTE: The 30-day elimination period is applied to ALL claims therefore, the insurance will pay 2 weeks for vaginal and 4 weeks for C-section deliveries after the 30 days has been met. If your physician medically certifies your need to have a longer recovery period, Cigna will pay claims until the doctor clears you to go back to work or, you exhaust your maximum benefit period.

No. A disability plan covers the inability to work due to a medical condition as certified by a physician. It is not intended to extend maternity leave for bonding with your newborn or to be used for paternity leave.

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