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DISABILITY
Short-Term Disability

Short-term disability (STD) benefits continue your base pay (up to 26 weeks) when you become disabled from illness or injury for more than 15 consecutive calendar days and cannot work.

Definition of Short-Term Disability: You will qualify as disabled if you are unable to perform the essential functions of your occupation for more than 15 consecutive calendar days due to a non-occupational illness or injury. Since your illness or injury must be non-occupational, you will not receive STD benefits for any occupational illness or injury that is covered by Workers' Compensation.

If you become disabled as defined under the plan, the short-term disability benefits for all eligible associates will be 66 2/3% of base pay for 24 weeks (the 24 weeks plus your 15 day waiting period encompass the 26 week benefit period).

After receiving all of your STD benefit payments, salaried, sales and hourly associates may be eligible for long-term disability (LTD) benefit payments. The company may request an independent physician's report, which is subject to review by Valassis, to verify your condition.

Coordination with Other Disability Benefits
The company coordinates your STD benefits with any other company-paid disability benefits and with any state disability benefits you may receive. If you receive benefits from these other sources, your STD benefits will be reduced by the amount you receive from these other sources.

Successive Periods of Short-term Disability
If you are receiving STD benefits, return to work for less than 15 calendar days and become disabled again as a result of the same condition, your STD benefits will continue as part of the same 26-week period.

If you are receiving STD benefits, return to work for 15 calendar days and become disabled again as a result of the same condition, you will be eligible for up to another 26 weeks of STD benefits.

If you are receiving STD benefits, return to work for one full day and become disabled again as a result of a different condition, you will be eligible for up to 26 weeks of STD benefits.

If you are receiving STD benefits, and a period of disability is extended by a new cause while weekly benefits are payable, weekly benefits will continue while you remain disabled, subject to the following: weekly benefits will not continue beyond the end of the 26 weeks and any exclusions and preexisting conditions limitations will apply to the new cause of disability.

Applying for Benefits
If you have a medical condition that will keep you out of work, you need to report your disability to your supervisor. If your absence is likely to last more than 15 calendar days, contact your Human Resources Representative or the Associate Resource Center to request a short-term disability leave. You must also report your disability to Sun Life, our disability carrier, by either calling them at 800-247-6875 or file online at https://www.sunlife-usa.net/claims/claimsOnline/index.cfm.

You should make sure that your doctor has a medical authorization form on file. This form allows your doctor to discuss your progress with the disability carrier to help process claims and get you back to work as soon as you are healthy.

Impact on Other Benefits
Your coverage under other company-sponsored group benefit plans (such as medical, dental, vision, FSA and life insurance) will continue while you are receiving STD benefits. You will be required to pay your share of the cost of benefits, as you did while you were working. Company-paid benefits (e.g., basic life insurance) continue at no cost to you.

When Eligibility for and Participation in the STD Plan Ends
Your eligibility for and participation in the STD Plan ends the date your employment with Valassis terminates or the date you cease to be regularly scheduled to work 37.5 or more hours per week, including but not limited to a reduction in hours due to a change in job status and/or leave of absence (other than approved Family and Medical Leave).

When STD Benefits End
STD benefit will terminate on the earliest of the following unless continued in accordance with any of the policy Continuation Provisions:

  • the date you are no longer disabled;
  • the date you fail to furnish proof of loss;
  • the date you are no longer under the regular care of a physician;
  • the date you refuse Sun Life's request that you submit to an examination by a physician or other qualified medical professional;
  • the date of your death;
  • the date you refuse to receive recommended treatment that is generally acknowledged by physicians to cure, correct or limit the disabling condition;
  • the last day benefits are payable according to the maximum duration of benefits;
  • the date your current weekly earnings exceed 80% of your pre-disability earnings if you are receiving benefits for being disabled from your occupation; or
  • the date no further benefits are payable under any provision in the policy that limits benefit duration.

Short-term benefits will not be paid for any longer than 26 weeks for any one period of disability. After 26 weeks, you may be eligible for long-term disability coverage.

Exclusions and Limitations
The STD policy does not cover and will not pay a benefit for any disability:

  • unless you are under the regular care of a physician;
  • that is caused or contributed to by war or act of war, whether declared or not;
  • caused by your commission of or attempt to commit felony;
  • caused or contributed to by you being engaged in an illegal occupation;
  • caused or contributed to by an intentionally self-inflicted injury;
  • for which Workers' Compensation benefits are paid, or may be paid if duly claimed;
  • sustained as a result of doing any work for pay or profit for another employer; or
  • elective cosmetic or plastic surgery, except when required due to the injury or sickness.

If you are receiving or are eligible for benefits for a disability under a prior disability plan that:

  • was sponsored by your employer; and
  • was terminated before the effective date of the policy;

no benefits will be payable for the disability under the policy.

Disabled and Working
If, while covered under this benefit, you are disabled and working as defined by the policy, Sun Life will use the following calculation to determine your weekly benefit.

Weekly Benefit = (A-B)XC

A

  • A=Weekly pre-disability earnings
  • B=Current weekly earnings)
  • C=Weekly Benefit payable if you were totally disabled

If you are participating in a program of rehabilitative employment approved by Sun Life, they will determine your weekly benefit by the rehabilitative employment benefit. Days which you are disabled and working may be used to satisfy the benefits commence period.

Rehabilitative Employment Benefit
If, while you are totally disabled or disabled and working, you accept rehabilitative employment, Sun Life will continue to pay a weekly benefit. The weekly benefit paid will be equal to your total disability weekly benefit less 50% of any income received from the rehabilitative employment. The sum of the weekly benefit and total income received from rehabilitative employment may not exceed 100% of your pre-disability earnings. If this sum exceed the pre-disability earnings, the weekly benefit paid by us will be reduced by the excess amount.

Sun Life reserves the right to review, at the end of every 6 month period, any rehabilitative employment you participate in while benefits are being paid under the policy. If you remain totally disabled after a period of rehabilitative employment, you may continue to receive benefits under the total disability benefit or disabled and working, subject to the maximum payment period for such benefit.


Topics
Short-Term Disability
Long-Term Disability
Filing a Claim
   
   

 

 

   Important Legal Information: This site is designed to provide easy-to-understand explanations of the key features of the Valassis benefit plans. These descriptions do not necessarily include all the plan details, which are contained in the official plan documents. In the event of any contradiction between the information in these Summary Plan Descriptions and the official plan documents, the official plan documents will govern in all cases. More information...