Frequently Asked Questions

Disability Insurance Questions

Why is it important that I have disability income protection?

Having a comprehensive disability program is essential for all working employees, and federal employees are no different, although a disability income protection program can be difficult to find for federal employees. While you do have leave and disability retirement, these programs work as a base. However, they can fall well short of what you may need if you were to suffer a prolonged disability.

Who is eligible to enroll?

All active federal employees and federal contractors* working at least 20 hours per week are eligible, except for postal workers. Postal workers (USPS employees) are eligible for Short Term Disability only.

*In order to be eligible for enrollment, federal contractors must receive compensation directly from their contracting agency.

Is maternity time included?

Yes, benefits are paid like any other disability. There is a ten-month waiting period for maternity.

How does it work?

Our program is designed to fill in the gaps with your federal programs; it does not replace any of your current benefits.

Short Term and Long Term Disability (LTD):

Bridges your income from the time that your leave stops or runs out until you are ready to return to work. All benefits coordinate with leave and sick leave to total no more than 60% of your gross income. This is usually pretty close to your take-home pay after taxes.

Supplements your income from disability retirement and increases your take home pay. In any case, you will not receive more than 60% of your gross income between Disability Retirement and policy benefits.

Please see the plan’s sample policy for more details.

How long are benefits paid?

Benefits under our program will be paid out for as long as you are disabled under the program, or until you reach the following maximum benefit periods:

Short Term Disability (STD): Up to one year (12 months) after waiting period

Please note that if your disability continues after one year, you can apply for Social Security Disability and FERS Disability Retirement

What are waiting periods?

Waiting periods are time deductibles that begin the day you become disabled. These deductibles are based on calendar days and each of our plan options offer the following waiting periods:

Short Term (STD)

Choice of 14 or 30 days

Do I pay my insurance policy or is it automatically withdrawn (allotment)?

Payments are made strictly through allotment administration which can be set up on your agency’s payroll website although there is an alternative if you have no more allotment slots available.

How do I enroll?

You need to complete an enrollment form on this website and set up the payment through allotment Instructions are also on this website. You will need to have access to your agencies payroll allotment setup.

Or, feel free to contact (833) 225-8815 and do the enrollment over the phone. It takes about 15 minutes total, and would be approximately another 5 minutes to set up your payroll deduction.

Feel free to set up a time here. There are also paper enrollment forms that can emailed to or mailed to the following address:

Federal Employee Insurance Benefits

℅  T.M. Professionals

1109 W. San Bernardino Rd. Suite 250

Covina, CA, 91722

Do I have to take a physical exam?

No, a physical exam or evidence of health is not required. Anyone with a new hire date within 13 months of effective date will be given a guaranteed issue of up to $4000. There are a few simple questions if you wish to purchase (and qualify) for the $5000 benefit.

Is there a Pre-existing Condition Provision?

While no medical questionnaire is required to enroll in the disability insurance program, please be aware that a Pre-existing Condition Provision applies if you become disabled within 12 months of becoming insured.

A Pre-existing Condition is a mental or physical condition whether or not diagnosed or misdiagnosed for which you have:

Consulted a physician or other licensed medical professional;

Received medical treatment, services, or advice;

Undergone diagnostic procedures, including self-administered procedures; or

Taken prescribed drugs or medications

Which, as a result of any medical examination, including routine examination, was discovered or suspected during the 12 months just before your insurance became effective.

What other exclusions or limitations exist?

Exclusions include war, insurrection or rebellion, self-inflicted injury, attempted suicide, or commission or attempt to commit a felony. Limitations on benefits apply to mental illness, anxiety, and alcohol, drug, or substance abuse and are limited to 12 months. For a more complete description of the exclusions and limitations, please consult the group certificate.

Can I change or cancel the plan?

Yes. Each year during our open enrollment season you can make changes to or cancel your plan at any time.

How does my leave and disability impact finances?

There are at least five reasons you are financially exposed:

Since leave and disability retirement are separate programs with different eligibility requirements and do not coordinate, you could find yourself in extended periods of LWOP with no income coming in.

Leave donations are just that – donations which are not guaranteed for a specific period of time and are not tied to your monthly bills.

Now that you can convert your unused leave to increase your retirement income, like most federal employees, you should become more reluctant to make donations.

Disability retirement provides a base pension benefit that offers a two–year step rated down income stream that levels off at 40% of your high-3 average salary. This pension benefit is not only taxable, it doesn’t come with COLA. As an actively working employee you may find it difficult to live on this benefit amount.

The combination of LWOP with the reduced income received from disability retirement may force you to withdraw funds from your TSP, or other savings and investments, before you are ready. The premature liquidation of your TSP or other savings and investments will have a negative impact on your future income security.

How do I pay for the plan?

Premiums are paid bi-weekly from your paycheck through salary allotment. Monthly-paid employees would pay monthly. All premiums are after-tax. Instructions are on this website after filling in your quote information.

Will my premiums increase with age?

The short answer is no. This is not designed for the costs to go up with age. However, the benefit does not automatically go up as your pay goes up. We will need to physically update coverage over the phone when you get a raise or promotion. The coverage is guaranteed renewable. As a matter of fact, with future pay increases and new updated coverage information, you will pay for the amount based on the rate when you originally took out your coverage. For example, a 30 year old policyholder taking out more coverage as a 40 year old will pay the 30 year old rate.

What are my federal leave and disability benefits?

Under FERS, you are considered disabled if you are unable to perform “useful and efficient service” in your position because of illness or injury. To qualify for disability retirement benefits, you must have at least 18 months of creditable service and your disabling condition must be expected to last at least 1 year.

If approved for FERS disability retirement, your two part pension formula is:

First 12 months (Second year of the Disability)

60% of High-3 – 100% of Social Security Benefit = Disability Retirement Benefit

Starting the 13th month (Third year of the Disability and forward)

40% of High-3 – 60% of Social Security Benefit = Disability Retirement Benefit

What’s wrong with my leave and disability benefit?

 Your Paid Leave isn’t enough – Your employer restricts your ability to adequately bank enough leave to support you during times of a prolonged disability. Once exhausted, you are in a Leave without Pay (LWOP) status.

 You will have to live on a fixed pension – Disability retirement provides a base pension income of approximately 40% of your high-3 salary to those who qualify. As an actively working employee, you may find it difficult to live off of this pension benefit.

Your employer doesn’t offer any assistance in helping you get back to work – Without any services to retrain disabled employees, you are trapped, living indefinitely on a fixed income that is below your current income standards and unable to improve your situation.