DBP for Administrative Executive: Staff Pension Plan Members

The Disability Benefit Plan (DBP) for Administrative Executive Members Enrolled in the Staff Pension Plan is an employee-funded fully-insured plan that provides you with a monthly income if you are unable to work for six months or more due to illness or injury.

This information is effective June 1, 2010.  If you were disabled prior to June 1, 2010, please see information in the old M&P Sun Life handbook.

Eligibility for Coverage
Contributions
When Coverage Begins
When Coverage Ends
Eligibility for Benefit Payments
Elimination Period
How to Apply
Benefit Payments
Monthly Benefit Payment Amounts
Reductions and Limitations
Cost of Living Adjustment
Other Group Benefits
Rehabilitation Assistance
Returning to Work
Recurrent Illness
Your Responsibility During Total Disability
Termination of Benefit Payments

Further information on applying for benefits from the Disability Benefit Plan (including application forms) is available by calling the DBP Claims Assistant at 604-822-8696.

Important note: This is only a brief overview of the plan. The Sun Life booklet with complete details will be posted shortly.

Eligibility for Coverage

All continuing full-time and part-time employees who work at least 17.5 hours per week will automatically be enrolled in the Disability Benefit Plan on their date of hire, if hired prior to their Normal Retirement Date (last day of the month in which they turn age 65).

Contributions

The Disability Benefit Plan is an employee-paid benefit, and any benefits received are non-taxable income for those on the plan.

Effective Jan. 1, 2012, the contribution rate is 1.346% of a member’s monthly salary, and is automatically deducted from your paycheque once you meet the eligibility criteria.

When Coverage Begins

Your coverage begins on the date:

• You become eligible if the University has received your enrolment on or before such date;
• The University receives your enrolment information, if the information is received by the University within 31 days of your becoming eligible;
• The Plan Administrator approves your proof of good health, if your application is received by the University later than 31 days following your eligibility for coverage (the cost of providing proof of good health is your responsibility).

If you are not actively working on the date coverage would normally begin, the coverage will not begin until you return to active work with the University.

If you go on an unpaid leave and elect not to continue DBP contributions, your DBP coverage will be reinstated upon your return to active work.

When Coverage Ends

Coverage under the plan will end on the earlier of the following dates:

• Your employment ends;
• The plan terminates;
• You reach your Normal Retirement Date (last day of the month in which you turn age 65) less six months;
• You enter the armed forces of any country on a full-time basis;
• You begin a period of layoff;
• You are no longer working unless you are on a paid leave of absence or an unpaid leave of absence and elected to continue to pay premiums and remain covered;
• You no longer satisfy the eligibility requirements.

Eligibility for Benefit Payments

To receive benefits, you will be considered eligible if during the elimination period and the following 24-month period you are continuously unable due to an illness to do the essential duties of your own occupation. An illness is a bodily injury, disease, mental infirmity or sickness. Any surgery needed to donate a body part to another person which causes total disability is an illness.  See Reductions and Limitations for more information on limitations.

Afterwards, you will be considered eligible if you are continuously unable due to an illness to do any occupation for which you are or may become reasonably qualified for by education, training or experience, and for which your current basic monthly earnings are 66 2/3% or more of your pre-disability basic monthly earnings for your normal occupation.

If you become disabled in accordance with the provisions of the plan and you are able to perform only a portion of your normal job duties, you will be eligible to apply for partial disability benefits.

When applying for DBP benefits, you will be asked for proof that you became totally or partially disabled while covered and that you have been following appropriate treatment for the disability since its onset.

DBP benefits are payable after you have been totally or partially disabled for an uninterrupted period of six months (also known as the elimination period).

Elimination Period

The elimination period is the period which must be completed before disability benefits become payable. The elimination period is six months commencing from the date your total or partial disability prevented you from working.

However, if your period of total or partial disability is broken by one or more periods after the first 30 days of the date of your total or partial disability, and the interruption is less than 30 days, the periods of disability can be accumulated to attain the six months, provided they are accumulated in one 365-day period.

How to apply

During your third month of absence from work, we encourage you to apply for benefits from the Disability Benefit Plan. Further information on applying for benefits (including application forms) is available by contacting the DBP Claims Assistant at (604) 822-8696.

It’s important that the information in your application is complete to avoid any delays in setting up your DBP payments. From time to time, the Plan Administrator will request further information about the applicant, which can take time to process.

Note: you must file your DBP claim no later than six months after the elimination period (also six months), or you will not be eligible for benefits under the Disability Benefit Plan.

Benefits Payments

Once you have applied, your first DBP benefit payment is made on the first month after your elimination period expires, or as soon as possible after this time.

If you become totally or partially disabled during a lay-off or approved leave and your coverage continues during this time, you will be eligible for benefit payments following your recall or scheduled return to work to full-time. You must have been totally or partially disabled for an uninterrupted period of six months and still be totally or partially disabled on the date you are recalled or scheduled to return to full-time work.

Monthly Benefit Payment Amount

The monthly benefit is calculated as follows:

70% of the first $1,110 of your basic monthly salary, plus

60% of the next $1,110 of your basic monthly salary, plus

40% of your monthly salary in excess of the first $2,220.

For example, based on a monthly salary of $4,000:

70% of $1,110: $777

60% of $1,110: $666

40% of $1,780: $712

Total monthly benefit $2,155

There is no maximum monthly benefit, and net monthly payments from DBP are not subject to Income Tax. (See Reductions and Limitations for information on net payments)

Changes in the amount of coverage may occur as a result of an employment status change or a change to the Plan. Any resulting changes take effect on the date of the change in status or Plan. If you are not actively working when the change occurs, the increase does not take effect until you return to active work.

Please refer to Other Group Benefits for more information on benefit coverage while you are receiving DBP benefits.

Reductions and Limitations

Reductions

If you are entitled to receive benefits from other sources as a result of your disability, the amount of benefit paid under this plan may be reduced by additional sources of income, such as the following:

• CPP or QPP disability benefits (excluding dependents’ benefits);
• Disability payments from any other government plan (excluding Employment Insurance and Department of Veterans’ Affairs benefits);
• Disability benefits from any other group, association or franchise plan (this does not include private plans paid for by individual members);
• Worker’s Compensation benefits;
• Income replacement benefits from any automobile insurance plan or policy;
• Income from other group benefit, pension or retirement plans provided by any employer when benefits are based on UBC earnings and as a result of UBC employment, including any coverage resulting from your membership in an association of any kind;
• Payments or earnings from any employer for any work for wage or profit as approved by the Plan Administrator, except for vacation pay and payments from the Living Benefits Loan Program;
• Any past or future wage loss recovered through a legally enforceable cause of action against some other person or corporation in accordance with provisions under Third Party Liability.

If your monthly DBP benefit plus the above sources of income exceed 85% of your pre-disability basic earnings, your monthly DBP benefit will be reduced by the excess. The maximum DBP benefit payable is 85% of your pre-disability basic earnings after income tax.

If you are eligible for any of the benefits from other sources listed above and you do not apply for these benefits, the Plan Administrator will still consider them part of your income and will estimate the amount you would be eligible for, had you applied.

Limitations

DBP benefits are not paid for disabilities resulting from:

• Pre-existing conditions which existed on or before the date your coverage began. However, this limitation will not apply if:
  • you have been actively working continuously (up to 3 days of absence does not count) and covered for any 13 consecutive week period within the first 12 months after coverage began and during this time has not been treated by a doctor, or any medical personnel under the direction of a doctor, for the condition, or
  • you became totally disabled more than 12 months after the employee’s coverage began.
• Intentionally self-inflicted injuries or attempted suicide, while sane or insane;
• The hostile action of any armed forces, insurrection or participation in a riot or civil commotion;
• Participation in a criminal offense;
• Illnesses that are sustained while you are working for wage or profit, outside of your duties and responsibilities with the University;
• A total or partial disability which results directly or indirectly from an impairment which existed on or before the date your coverage began under this plan (pre-existing condition); however this limitation will not apply if:
  • You have been covered by this plan for at least 13 weeks during which you have been actively working continuously (up to three days absence does not count) and you have not been treated by a doctor, or any medical personnel under the direction of a doctor for the condition, or;
  • You became totally or partially disabled more than 12 months after your coverage began under this plan.
• The health-related portion of a maternity or parental leave where benefits are payable under UBC’s Supplemental Employment Plan (SEB).

You must reside in Canada to receive DBP benefit payments.

Cost of Living Adjustment

A cost of living adjustment will be applied to your monthly benefit each January 1st. The adjustment will be based on the percentage increase to the Canadian Consumer Price Index to a maximum of 6%.

Other Group Benefits

Making a claim under the Disability Benefit Plan doesn’t mean that your other group benefits with UBC end. If you were enrolled in the following benefits on the date prior to being accepted on DBP claim (the start date of receiving DBP benefits), the following benefits will be maintained by the University per the terms of the plan provided your employment status with the University is not terminated:

• Basic Medical (MSP)
• Extended Health
• Dental
• Basic Group Life Insurance
• Employee and Family Assistance Program (EFAP)

Your coverage will be maintained in accordance with the terms of the plans as on the date prior to being accepted on DBP claim (the start date of receiving DBP benefits).

With proof of total disability, other benefits premiums, such as Optional Life Insurance, Accidental Death and Dismemberment, and Spousal Life Insurance may be waived by Sun Life Canada, the University’s life insurance carrier. If you are covered for these benefits, UBC’s DBP Claims Assistant will apply for waiver of premiums on your behalf at the time your DBP claim is submitted.

If you return to work on a gradual basis, your benefits will revert back to the normal cost-sharing arrangement after three months of rehabilitative employment at 50% FTE or more. This means that you will be responsible to pay the employee share of any benefits costs (contributions/premiums).

If you are Partially Disabled and receiving DBP benefits:

You will be responsible for your portion of any benefit costs (contributions/premiums) including any Staff Pension Plan contributions pro-rated on your partial UBC earnings, during any period of partial disability.

Please note the following regarding the Staff Pension Plan:

If you were approved for DBP benefits prior to July 1, 2009: you will continue to accrue pensionable service without being required to contribute to the Staff Pension Plan.

If you were approved for DBP benefits on or after July 1, 2009: you will no longer accrue pensionable service unless you contribute both the employer and employee portion to the Staff Pension Plan. Since this may or may not be to you advantage, contact the UBC Staff Pension Office at (604) 822-1889 to discuss your options.

Rehabilitation Assistance

You may be required to participate in a rehabilitation program approved by the Plan Administrator.

It may include the involvement of a rehabilitation team (consisting of a rehabilitation specialist, your physician, your department and UBC’s Return to Work coordinators), part-time work, working in another occupation or vocational training to help you become capable of normal work week employment.

During your rehabilitation program, you will continue to be eligible for DBP benefits. However, the DBP benefits will be reduced by 50% of the income you receive under the rehabilitation program. During any month, the total income you receive from all sources cannot be more than 100% of your pre-disability basic earnings (after income tax if the benefit is non-taxable), indexed for inflation. In cases where the total income exceeds this limit, the DBP benefits will be reduced by the excess. Benefits will be paid for a maximum period of 24 months.

Returning to Work

After a disabling accident or illness, many people return to work gradually. The Return to Work Program can help to coordinate this.

While you are gradually increasing your work activity, and being paid for the time you work, your DBP benefit will be replaced with a rehabilitative subsidy. Your net income will increase as the amount you work also increases. The combination of your rehabilitative subsidy plus the net salary will not be greater than your pre-disability net earnings as of the time your total or partial disability began.

Recurrent Illness

After you have been on an DBP claim, you will be instated immediately, if:

• You are not able to continue working due to the same or related causes of the original disability, or
• The recurrent disability occurs during the first six months of your return to work.

If you are disabled because of accident or illness not related to your first disability claim, this is treated as a new claim, and will be subject to the usual six month elimination period, and eligibility criteria.

Your Responsibility during Total Disability

During any period of total disability you must make reasonable efforts to:

• Recover from the disability, including participating in any reasonable treatment or rehabilitation program and accepting any offer of reasonable modified duties from the University, and
• Obtain benefits that may be available from other sources.

If you fail to do any of the above, the Plan Administrator may withold or discontinue benefits.

Termination of Benefit Payments

As long as you continue to meet the eligibility requirements, you will continue to receive DBP benefit payments up to the following date, whichever occurs first:

• Date you are no longer totally or partially disabled;
• End of the maximum benefit period;
• Your Normal Retirement Date (last day of the month in which you turn age 65);
• Last day of the month in which you retire with a pension or are eligible to retire with a full pension or a full pension equivalent;
• Date you are incarcerated in a prison or mental institution by authority of a criminal court;
• The date you die. In such event, the last payment will include the date of death.

Benefit payments may cease before the dates mentioned above, if:

• You are not receiving appropriate treatment;
• Further proof of your disability is requested but is not received within 90 days of the request;
• You fail to take a medical examination requested by the Plan Administrator;
• You do any work for wage or profit except as approved by the Plan Administrator;
• You are not participating in an approved rehabilitation program, if required by the Plan Administrator;
• You refuse to provide the Plan Administrator with requested information if you have a claim against a Third Party for loss of income which could have been earned while disability benefits are paid or payable under this plan;
• You are serving a prison sentence or are confined in a similar institution;
• You are absent from Canada longer than four months due to any reason, unless the Plan Administrator agrees in writing in advance to pay benefits during this period.