Free! Prior Plan Amendment Premium Eligibility Period Waiting Period Offset Attending Physician’s Statement Basic Compensation Late Applicant Waiver of Premium Maximum Benefit Period Maximum Benefit Partial Disability Grace Period Short Term Disability (STD Self- Billed Effective Date Evidence of Insurability Date of Disability Contributory Class Pre- Existing Condition Open- Enrollment Period Eligibility Date Benefit Period Minimum Benefit List Billed Census Elimination Period Benefit Percentage Eligibility Proof of Loss Recurrent Disability Enrollment Form Pending Claim Policy Total Disability Exclusion Non- Contributory Free! Prior Plan Amendment Premium Eligibility Period Waiting Period Offset Attending Physician’s Statement Basic Compensation Late Applicant Waiver of Premium Maximum Benefit Period Maximum Benefit Partial Disability Grace Period Short Term Disability (STD Self- Billed Effective Date Evidence of Insurability Date of Disability Contributory Class Pre- Existing Condition Open- Enrollment Period Eligibility Date Benefit Period Minimum Benefit List Billed Census Elimination Period Benefit Percentage Eligibility Proof of Loss Recurrent Disability Enrollment Form Pending Claim Policy Total Disability Exclusion Non- Contributory
(Print)
Free!
Prior Plan
Amendment
Premium
Eligibility Period
Waiting Period
Offset
Attending Physician’s Statement
Basic Compensation
Late Applicant
Waiver of Premium
Maximum Benefit Period
Maximum Benefit
Partial Disability
Grace Period
Short Term Disability (STD
Self-Billed
Effective Date
Evidence of Insurability
Date of Disability
Contributory
Class
Pre-Existing Condition
Open-Enrollment Period
Eligibility Date
Benefit Period
Minimum Benefit
List Billed
Census
Elimination Period
Benefit Percentage
Eligibility
Proof of Loss
Recurrent Disability
Enrollment Form
Pending Claim
Policy
Total Disability
Exclusion
Non-Contributory
