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Accelerated Life Benefit
The Accelerated Life Benefit pays a lump sum benefit if you or your insured dependent is diagnosed with a terminal condition and has a life expectancy of twelve months or less. Group life benefits are reduced by the amount of the Accelerated Life Benefit payment.
Accidental Bodily Injury
A violent, external bodily injury resulting, directly and independently of all other causes, from an accident occurring while both the Group Contract is inforce and insurance is in force for the Employee and/or Dependent whose death or bodily injury is the basis of a claim, except as limited or excluded by the provisions of the Group Contract.
Accidental Death
Loss of life as a direct result of an Accidental Bodily Injury.
Accidental Dismemberment
Dismemberment is the loss of one or more of the following due to an Accidental Bodily Injury: your hand by actual severance through or above the wrist; loss of your foot by actual severance through or above the ankle joint; and loss of your sight in one eye resulting in total and permanent loss of vision that cannot be recovered by surgery or other means.
Active Employee
An Employee means an Employee as defined in the Act.
Approved Practitioner
A person who provides medical service and care within the scope of his or her licensure and training which is consistent with national and community medical practice standards and acting within the scope of his or her license (other than a hospital resident or intern), who is a Doctor of Medicine or Doctor of Osteopathy. The term "approved practitioner" shall not be deemed to include a Doctor of Chiropractic, a Doctor of Dentistry, a Doctor of Optometry, a Doctor in Psychology, a Licensed Audiologist, a Licensed Master Social Worker-Advanced Clinical Practitioner, a Licensed Chemical Dependency Counselor, a Licensed Hearing Instrument Fitter and Dispenser, a Licensed Dietitian, a Licensed Marriage and Family Therapist, a Licensed Professional Counselor, a Licensed Speech-Language Pathologist, a Doctor of Podiatry, an Advanced Practice Nurse, a Physician Assistant, a Licensed Occupational Therapist, a Licensed Physical Therapist, a Licensed Acupuncturist, a Licensed Psychological Associate or a Licensed Surgical Assistant. An acute and temporary total disability may be certified or attested to by a Doctor of Podiatry licensed by the Texas State Board of Podiatric Medical Examiners if the acute and temporary total disability is caused by a sickness or injury that may be treated within the scope of the license of such Doctor of Podiatry. Such terms shall have the meaning assigned to them by the Texas Insurance Code. |
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Conversion Privilege
The conversion privilege allows you to convert your Group Term Life Insurance (both Basic and Optional amounts) to an individual policy of whole life insurance if your employment ends for any reason or if you are no longer eligible for these coverages.
Your covered spouse may convert his or her Dependents' Group Term Life Insurance amount to an individual policy of whole life insurance if:
- your employment ends for any reason;
- you are no longer eligible for Dependents' insurance under these coverages; or
- you die.
Evidence of Insurability is not required if application is made for the individual life insurance policy and the first premium is paid within 31 days after your or your spouse's group life insurance ends. Reference the Active Employees or Retirees current benefits book for complete details. |
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Disabled
Referring to a Child, means a Child whose mental retardation or physical incapacity is a medically determinable condition which prevents the Child from engaging in self-sustaining employment; provided that the disability commences and the Child was covered immediately prior to such Child's attainment of age 25 and that satisfactory proof of such disability and dependency is submitted by the Employee/Retiree within 31 days following such Child's attainment of age 25 and at such intervals thereafter as may be required by ERS or Dearborn National. |
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Eligible Dependent
- Your spouse; and
- your unmarried eligible children, from date of birth up to age 26, or a Disabled Child, including:
- the natural child of the Employee/Retiree;
- a legally adopted child (including a child living with the adopting parents during the period of probation);
- a stepchild whose primary place of residence is the Employee/Retiree's household;
- a foster child whose primary place of residence is the Employee/Retiree's household and who is not covered by another governmental health program;
- a child whose primary place of residence is the household of which the Employee/Retiree is the head and to whom the Employee/Retiree is the legal guardian of the person;
- a child who is in a parent-child relationship to the Employee/Retiree, provided that:
- the child's primary place of residence is the Employee/Retiree's household; and
- the Employee/Retiree provides the necessary care and support for the child; and
- if the natural parent of the child is 21 years of age or older, the natural parent does not live in the Employee/Retiree's household;
- a child who is considered a dependent of the Employee/Retiree for federal income tax purposes and who is a child of the Employee/Retiree's child;
- an eligible child for whom the Employee/Retiree has received a valid court order requiring the Employee/Retiree to provide medical support for such child; or
- a Disabled child.
Employee
Employee means an individual eligible to participate in the Group Benefits Program under Chapter 1551, Texas Insurance Code, as provided in Section 1551.101 in that chapter.
Evidence of Insurability
Evidence of Insurability means such evidence, provided at no expense to ERS or FDL, including medical records and a physical examination, as may be required by FDL, to determine that the individual for whom coverage is sought is an acceptable risk for issuance of new coverage or for increases in existing coverage, required pursuant to the Rules of the Board of Trustees of the Employees Retirement System of Texas.
FDL must review the Evidence of Insurability and approve coverage before such coverage becomes effective. The effective date of coverage will be later than the approval date. The types of optional coverages that may require EOI are Life, Disability Income and Dependent Life. EOI is required when enrolling in Optional Term Life Elections III and IV at any time.
EOI applications are located in the Forms section of this Web site. Completion and filing Instructions are also located on this page.
Extended Life Insurance Benefit (Waiver of Premium)
Extended Life Insurance Benefit (EIB) is the continuation of Group Term Life Insurance coverage without payment of premium by employees, under the age of 60, who become totally disabled for six continuous months or more and cannot be gainfully employed in any occupation. |
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Initial Period of Eligibility
The first 31 days of employment a person is eligible to enroll in Optional Group Term Life, Short-term Disability and Long-term Disability, Dependents' Group Term Life and Voluntary AD&D with fewest restrictions. Those persons who decide to enroll in, add dependents to, or increase some optional coverages after those first 31 days will be required to provide evidence of insurability (EOI) which is acceptable to Fort Dearborn Life.
Integration
The reduction of your Short-term Disability or Long-term Disability monthly income benefit due to other sources of income such as Workers' Compensation, ERS or TRS disability retirement benefits, social security (for Long-term Disability) and other group disability benefits, is called Integration. If Integration is used to reduce your Short-term Disability or Long-term Disability monthly income benefit, 70% of your insured monthly salary is used in the calculation of your benefit. |
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Long-Term Disability
Long-term Disability insurance pays a monthly benefit to replace a portion of your income for an extended period of time if you are totally disabled and unable to work. |
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Monthly Income Benefit
The amount of any Short-term Disability or Long-term Disability payment that will be made on a monthly basis as the payment of an approved claim for such Short-term or Long-term Disability plan benefits. |
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Qualifying Life Event
A qualifying life event allows you to apply for or change coverages outside of Annual Enrollment. This includes a change in marital status, a change in dependent status, a change in employment status, a change of address that results in loss of benefits eligibility, a change in Medicare or Medicaid status, a significant cost of benefit or coverage change imposed by a third party provider, or a change in coverage ordered by a court. |
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Retiree
An employee who has retired or an annuitant as defined in the Act. |
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Short-Term Disability
Short-term Disability insurance pays a benefit to replace a portion of your income for up to five months if you are totally disabled and unable to work.
Social Security Disability
Social Security Disability insurance pays benefits to you if you are "insured," meaning that you worked long enough and paid Social Security taxes. For more information regarding Social Security Disability Insurance, visit Social Security Online.
Suicide Exclusion
Group Term Life Insurance benefits under the Employee's or Retiree's Optional Group Term Life Insurance and Dependents' Group Term Life Insurance coverages will not be paid if the Employee's, Retiree's or Dependent's death is a result of intentionally self-inflicted injuries, suicide or attempted suicide, while sane or insane, unless the insurance coverage was continuously in effect for two years immediately prior to the death.
Benefits available under any of the AD&D or Voluntary AD&D coverages will not be paid if the Employee's or Dependent's death is the result of intentionally self-inflicted injuries, suicide or attempted suicide, while sane or insane. |
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Term Life
- Employee Basic: Employer-paid term life insurance coverage, including an accelerated life benefit, accidental death and dismemberment, and conversion privilege for active employees who are enrolled in a Group Benefits Program health plan. An extended insurance benefit is also included for active employees who become totally disabled prior to age 60.
- Retiree Basic: Employer-paid term life insurance coverage, including an accelerated life benefit and conversion privilege for retirees who are enrolled in a Group Benefits Program health plan.
- Optional: Additional optional term life insurance for active employees and retirees. You are responsible for paying the cost of optional term life insurance. This coverage contains a two-year suicide exclusion.
- Dependent: Term insurance for your spouse and dependent child(ren). Dependent Term Life pays you a benefit in the event of your spouse's or dependent child's death. This coverage contains a two-year suicide exclusion.
Terminal Condition
A non-correctable health condition that, with reasonable medical certainty established by medical evidence based on objective clinical findings using current American Medical Association guidelines will result in death within twelve months from the date of the attending Physician's Statement.
Total Disability or Totally Disabled (for the Short-term and Long-term Disability Income Benefit)
For the first 24 months benefits are payable, this means the inability of the covered Employee, because of an injury or sickness established by medical evidence based on objective clinical findings using current American Medical Association guidelines and certified by an approved practitioner operating within the scope of his or her licensure and practice, to perform the usual tasks of his or her occupation in such a way as to procure or retain employment.
After benefits have been paid for 24 months of continuous disability, Total Disability will mean the inability of the covered Employee, because of an injury or sickness established by medical evidence based on objective clinical findings using current American Medical Association guidelines certified by an approved practitioner operating within the scope of his or her licensure and practice, to perform the usual tasks of any compensated occupation for which the covered Employee is reasonably suited by training, education or experience, in such a way as to procure or retain employment. Inability to pass a periodic physical examination required by flight personnel or having a temporary impairment does not constitute Total Disability. The Employee will be conclusively deemed not to be disabled if employed and compensated in any manner.
Total Disability or Totally Disabled (for the Extended Life Insurance Benefit)
Total Disability or Totally Disabled, for the purposes of the Extended Life Insurance Benefit, means an Employee's inability to engage in any occupation for which he or she is reasonably suited by training, education, or experience because of a proven physical or mental impairment which is established by medical evidence based on objective clinical findings using current American Medical Association guidelines, and certified by an Approved Practitioner operating within the scope of his or her licensure and practice. |
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Viatical Settlement Option
The Viatical Settlement Option is available to you if you are diagnosed with a terminal condition. An irrevocable beneficiary designation will be accepted in conjunction with a viatical settlement. In order to locate a viatical company, you can contact the Texas Department of Insurance at 800-252-3439 for the names and phone numbers of such companies.
A viatical settlement is an agreement between you and a viatical settlement provider under which you name the viatical settlement provider as the irrevocable beneficiary to your term life insurance coverage or to your dependent's term life insurance coverage in exchange for a cash settlement. |
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Waiting Period
The number of consecutive days of total disability in which no insurance benefits are paid, beginning at any one period of disability. After the Employee has stopped working, the waiting period begins the date total disability is established by medical proof which must include but is not limited to certification by an Approved Practitioner. |
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