Group Long Term Disability Income Insurance

QuickDecision is a process available on this coverage that allows us to make an underwriting decision in real time based on your answers to health questions in the application along with database information gathered. Since we are often able to receive everything we need through this process, we can deliver your answer sooner. We review your records, including driving record, and prescriptions, and may be able to let you know our underwriting decision by the end of the application, or if more details are needed.

While the QuickDecision process is only available on amounts up to $7,500 per month of Group Long Term Disability Insurance, you can apply for more coverage. Higher amounts require additional information to be gathered about you. If we need more information, a representative will call you to schedule a convenient time to answer questions or, if needed, have a medical professional visit you at our expense.

QuickDecision is available to individuals age 60 and under for long term disability insurance.

Your coverage will begin on the first of the month following the date your application is approved, provided you are actively-at-work full-time on the date, meet evidence of insurability requirements and the premium is paid. If you are not Actively-At-Work, the insurance will not take effect until you return to full-time work for at least 10 consecutive workdays, if such day is within three months of the date insurance would otherwise have taken effect and the insured member is still eligible to obtain the insurance on that day. Benefits will begin on the first day of a covered total disability after completion of the applicable Waiting Period. Benefits will continue until the earlier of (a) the day the insured ceases to be totally disabled or (b) the end of the maximum benefit period.

Yes! You are under no obligation today.

If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it without claim within 30 days. Your coverage will be invalidated, and you will receive a full refund – no questions asked! 

Your coverage will end when you are no longer at full-time work, you reach age 75, you stop paying your premiums when due, when you receive covered total disability benefits for the maximum benefit period, when you begin active duty in the armed forces, or the date the group policy ends.

Some disability policies limit their definition of total disability to the inability to work in any job. This means you might be eligible for benefits if you are sick or injured but still able to work in another profession. This policy uses an own occupation definition of disability, meaning you’re eligible to receive benefits if you can’t perform the duties of your own profession as an optometrist. 

You can apply for a monthly benefit amount up to $12,500 (in $100 increments), provided the benefit you select does not exceed 60% of your average monthly income. If you’re under age 45 and have practiced for six months or less, you can apply for up to $2,000 in monthly benefits.

Monthly benefits from employer-paid disability insurance are likely to be taxable, reducing the true amount of protection the coverage provides. The benefits from this AOA-sponsored coverage are tax-free under current tax law as long as you pay your own premiums. If you own your own business, you may choose to claim your premium as a tax deduction. Consult your tax advisor.

As your income has probably increased over time, the level of protection you now carry may no longer be enough to help cover the living expenses that would continue should you become disabled. Using this policy to increase your total coverage can help you avoid having to use savings and investments intended for other purposes, including retirement.

Also, unlike many employer-provided policies, you can keep this coverage without interruption, even if you change jobs or become self-employed, provided premiums are paid when due and you remain actively at work. This policy can add an extra layer of protection that will move with you throughout your career.

Enjoy 20% savings thanks to a premium credit! Due to a positive financial experience of the program, AOA members receive 20% SAVINGS on this coverage in the form of a premium credit. This 20% savings is applied as a discount on your statement.

Premiums are not guaranteed. Although future credits are dependent upon actual claims experience and cannot be promised or guaranteed, the Program has been granting premium credits for years.

You can select from the following benefits payment period options for covered total disabilities starting before age 65:

1. Up to two years.

2. Up to five years.

3. Until age 65.

For disabilities starting after you reach age 65, all three choices pay benefits up to 12 months. 

The waiting period is the length of time you must be totally disabled before benefits are paid. You can choose from five waiting periods: 45, 60, 90, 180 and 365 days. The longer the waiting period, the lower your cost. If you suffer a covered disability due to an organ donation, there is no waiting period.

This insurance pays you benefits if a covered injury or illness leaves you totally disabled and unable to perform the material and substantial duties of your occupation. You can also collect benefits for residual disabilities that cause a loss of earnings of at least 20% (and less than 80%) while you’re performing at least one of the material and substantial duties of your occupation on either a part-time or full-time basis. You must also be under the regular care of a physician. Material and substantial duties are those that are normally required in your occupation and cannot be reasonably omitted or modified. In addition, a disability that causes a loss of earnings of 80% or more will be considered a total disability.

For a covered disability to be considered to have resulted from an injury, the covered total disability must begin within 90 days after an incident, if the accident occurs while an insured member is insured under the policy. If more than 90 days has elapsed, such covered disability will be considered to have resulted from an injury sickness.

After you’ve been totally disabled for three consecutive months. Your coverage will remain in full force while your disability continues from that injury or sickness.

Rest assured that your rates will never increase as a result of the number of claims you’ve made. Rate increases occur as you move from one age bracket to the next. Premium contributions may be changed by New York Life Insurance Company on any premium due date and any date on which benefits are changed. However, your rates may change only if they are changed for all others in the same class of insureds under this group policy.

You are under no obligation today. Once your application is approved and coverage issued, you’ll receive a Certificate of Insurance. If you’re not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated, and you will be sent a full refund, no questions asked. 

The AOA Group Long-Term Disability Income Insurance does not cover and we will not pay a benefit for any loss or disability: Due to Crime/Illegal Occupation/Illegal Activity: Participation in or incarceration resulting from any of the following in a role other than as a victim: (a) the commission of a felony; (b) an illegal occupation or activity; (c) an insurrection; (d) terrorist activity; or (e) a riot. Intentional self-inflicted injury or an attempt at intentionally injuring oneself; while sane. Engagement in any of the following in a role other than a victim: (a) in war, (b) an act of war, or (c) an armed conflict which involves the armed forces of one or more countries; a pre-existing condition; an impairment restriction; a disability that is due to or related to service in the military, naval or air force of any country, alliance or international organization or in a civilian unit which serves such force. A disability that is due to a pregnancy or childbirth or a related medical condition, except for complications of pregnancy; Regular Care that does not require a doctor’s regular care of, or attendance to, the insured; or for any period of disability for which the insured is not under the regular care and attendance of a doctor, except that: This requirement will not apply if such care is no longer required for prudent medical management of the injury, sickness or organ donation. For the purpose of satisfying the requirement that the insured be under the “regular care” of a doctor, doctor does not include the insured or a member of his or her immediate family. Occurs during, is due to, or is related to the insured member’s travel in, travel on, fall from or descent from any aircraft when the aircraft is used to train, test, or experiment or is part of any military, naval or air force. Additional exclusions or limitations may apply as a condition of approval of your application for coverage.

Mental Disorder and Chemical Dependency Limitation: If you are disabled due to mental illness or substance abuse, the maximum benefit period for total and residual disability benefits is the lesser of: 1) the maximum benefit period shown on your schedule; or 2) 24 months during your lifetime. We will continue to pay benefits beyond the limited pay period if you are an inpatient under a physician’s care in either a hospital or an institution which treats and cares for mental illness or substance abuse. In no case will benefits be paid beyond the maximum benefit period.

Pre-Existing Condition Limitation: Pre-existing Condition means an injury or sickness or any condition related to such injury or sickness for which a person consults a doctor, receives medical services or supplies or takes any medication during the 12-month period immediately before the insured’s initial insurance date. Pre-existing Condition does not include: (a) any such injury or sickness or condition after such person has been continuously insured under the Policy for 12 months; or (b) an injury or sickness or condition classified as an Impairment Restriction.

Impairment Restriction – A disability that is due to or related to a condition which has an Impairment Restriction. Impairment Restriction means an exclusion or limitation of insurance on an INSURED MEMBER. An Impairment Restriction will be: (a) established by New York Life; and (b) continued by New York Life if it is in effect on the day before: (1) the INSURED MEMBER becomes insured under the Policy; or (2) a change in insurance takes effect; whether or not satisfactory medical evidence of insurability is furnished or medical evidence of insurability is required. All Impairment Restrictions are stated in the certificate. Insurance with such Impairment Restrictions is subject to the APPLICANT’S acceptance. Payment of one CONTRIBUTION after the INSURED MEMBER is advised of the Impairment Restriction will establish such acceptance.

Average Monthly Income means a person’s average monthly wages, salaries, commissions, fees and any other amounts received by such person for personal services, including the cost of his or her fringe benefits and share of total surpluses. It does not include income from interest, dividends, rent, royalties, annuities, other insurance and other unearned income.

Covered Total Disability is an incapacity that completely and continuously prevents the insured member from doing the material and substantial duties of his/her regular occupation. Such covered disability must begin while the insured member is insured under the Policy and be the result of: (1) an injury. For a covered disability to be considered to have resulted from an injury, the covered total disability must begin within 90 days after an accident, if the accident occurs while the insured member is insured under the policy. If more than 90 days has elapsed, such covered disability will be considered to have resulted from an injury sickness; (2) a sickness; or (3) an organ donation that an insured member makes, provided he/she has been insured under the Policy for at least six consecutive months on the day of such donation.

A loss of license, in and of itself, does not constitute an incapacity that prevents the insured member from doing the material and substantial duties of his or her regular occupation and will not be deemed a Covered Total Disability.

Mental Disorder means a condition due to or resulting from psychiatric or psychological conditions, regardless of cause, such as: (a) schizophrenia; (b) depression; (c) manic depressive or bipolar illness; (d) anxiety; (e) personality disorders; and/or (f) adjustment disorders or other conditions, usually treated by a mental health provider or other qualified provider using psychotherapy, psychotropic drugs or other similar modalities used in the treatment of the above conditions. This limitation does not apply to dementia, if due to: (a) stroke; (b) trauma; (c) viral infection; (d) Alzheimer’s disease; or (e) other conditions not listed above which are not usually treated by a mental health provider using psychotherapy, psychotropic drugs or other modalities.

Chemical Dependency means the abuse of or psychological or physical dependency on or addiction to alcohol or a controlled substance. For purposes of this definition, “controlled substance” means a toxic inhalant, a volatile chemical, abusable glue or aerosol paint, or a substance designated as or considered a controlled substance under applicable federal, state or local authority.

Successive Periods of Disability will be considered one period of disability if such disabilities are due to the same or related causes, and which are separated by less than six months of return to continuous full-time work during which you are not totally disabled or different or unrelated causes are not separated by return to full-time work.

Waiting Period is the initial, continuous period of a Covered Total Disability which must be completed before such Covered Total Disability benefits become initially payable.

Note: The Maximum Benefit Period for all Covered Disabilities of an insured which are due to or related to Mental Illness and/or Chemical Dependency while such person is insured under the Policy, whether insurance has been continuous or interrupted, cannot exceed the lesser of: (a) 24 months; or (b) the Maximum Benefit Period for a Covered Disability due to an injury, sickness or organ donation. This limitation does not apply to any period during which such insured is institutionalized.

If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life Insurance Company.

When program experience has been good New York Life Insurance Company will periodically return excess premiums in the form of dividends to the AOA as the policyholder. The AOA will retain these dividends in a Dividend on Deposit Account with New York Life. The AOA will in turn periodically make these dividends available through premium credits to existing insureds in the programs which generated the dividends. Sufficient reserves will be retained by the AOA in the Dividend on Deposit Account to cover administrative and marketing costs generated by the New York Life Insurance Programs sponsored by the AOA. Dividends are not guaranteed. These programs are administered together to take advantage of the savings resulting from this integrated approach.

Administrative expenses incurred by the AOA to provide the valuable membership benefits resulting from these sponsored insurance programs are reimbursed from available program dividends. New York Life may also, out of premium, pay a reasonable fee to the AOA for making the AOA assets available to it to promote these programs to the membership. These assets include the AOA Intellectual Property Rights and mailing lists of eligible members.

Yes, Group Long Term Disability Insurance is endorsed by AOAExcel.

Administered by:
AGIA Insurance Services, Inc.
P.O. Box 26860
Phoenix, AZ 85068

A.G.I.A., Inc., is licensed/authorized to transact business in all 50 United States, and the District of Columbia. Their state of domicile is California. Joseph Guerrero California Agent Insurance license number is 0B54298. Joseph Guerrero Arkansas Agent Insurance license number is 766720.