eidson

Just so I am not accused of giving out "erroneous" information I have copied and pasted the information I got from ALPA legal when I went through this. Group insurance is section C. Aeromedical should call you back but they are volunteers so it might take a day or so to call you back. All the aeromedical information is on the XJT ALPA web site under committees. They were very helpful for me. Good luck.

Loss of License Information for Express Jet Pilots

(Original disability incurred on or after January 1, 1998)

Updated November 2005


The Long Term Disability Program for Pilots is among the best in the industry. It is important to understand how the program works, if you need it, and you are a participant in the LTD program. Here are the steps you should follow if you experience an illness or injury that prevents you from exercising the privileges of your medical certificate.


1 – Advise your CPO of your situation.


2 – Submit a Claim for Benefits


Do not hesitate to start the LTD claim process unless it is abundantly clear that you have enough sick pay to cover the absence. Waiting until the last minute can delay your LTD benefits.



Call Harvey Watt & Company at 800-241-6103, ask for Michael Young (Extension 239) and request a claim form. There are three parts to the claim form. You may also receive applications for state disability if you are based in Newark. If your disability is due to an occupational injury, covered by Worker’s Compensation or you are based in Cleveland or Houston, advise Harvey Watt the New Jersey Disability Insurance is not applicable to you.



When you receive the forms, complete your portions of the claim forms, the authorization to release medical information to Harvey Watt and have your physician(s) complete the physician’s portions. Be sure that you review the submission with the physician to insure that it is complete and legible. Physicians may not submit documentation in a timely manner. It is your responsibility to insure that all three parts of the claim form are returned to Harvey Watt.



3 – Claim Review by the LTD Program Administrative Committee


The LTD Administrative Committee meets once each month (normally on the first Tuesday of each month) and reviews new claims. Based upon the medical evidence provided with your claim, they will approve your claim, ask for more information or deny your claim. The Committee will also determine an initial benefit period. You may appeal a denied claim by submitting additional documentation to the Committee.



4 – Use of ALPA Aeromedical


Do not hesitate to call the Aeromedical Office in Denver. They can assist you in your efforts to return to active status and are experts in FAA requirements. Office hours are Monday through Friday, 0830 to 1600 Mountain Time. The phone number is 303-341-4435; Fax number is 303-341-4803. When you call, identify yourself and give them your ALPA member number. Generally they will take down your information and questions on your initial call. One of the five physicians will then call you one or two workdays later to discuss your situation.


When your LTD claim has been approved – here is how the program works.


A - Approved Claim Benefit Payment Start Date


Your LTD benefit will start when you have been paid all of your sick pay and/or occupational injury pay and vacation pay. The LTD benefit is paid at the end of the month. The transition month (the month in which you receive partial payment for sick, oi or vacation pay) is confusing. Example – your pay, when you incurred the disability was $56.99 per hour and you are paid at that rate for 48:00 hours of sick/oi/vacation or $2,735.52. This payment is taxed (lets say at 20%) so your take home pay is $2,188.42 after taxes. You would not receive an LTD benefit payment for this month because the $2,735.52 exceeded the $2,679.95 ($56.99 x 85.5 hours x 55%) you were due from the LTD program. While the LTD benefit is tax-free, offsets are assessed on the gross amount.



B - Offsets to Your LTD Benefit



Your LTD Benefit payment will be offset as noted above, for any disability payment you receive from Workers compensation, state disability, Social Security disability or any wages paid to you by ExpressJet or any Continental controlled subsidiary.



If you remain on LTD for 8 months, Harvey Watt will request that you file for Social Security Disability. This is routine and is required by the Pilot LTD Plan. However, the Social Security Disability definition generally means that you are unable to work at any occupation. As a result, very few Pilot LTD recipients are approved for Social Security Disability.



Although Express is normally advised of these offsets, if your LTD payment is not adjusted in a timely manner, it is your responsibility to notify Express. Any overpayment you receive from Workers Compensation Insurance, State Disability or Social Security Disability will be offset from you future LTD benefits. Conversely, wages you earn elsewhere and benefits you receive from private Loss of License Insurance are not offset against your LTD benefit.



C - Your Group Insurance


When you run out of sick pay and vacation pay, your CPO will put you on leave of absence. The initial leave is normally Family Medical Leave for the first 90 days. During the time that you are on Family Medical Leave, you may continue your medical, dental, vision and life insurance coverage (in effect at the point you went on LTD) at active pilot rates. Your basic (company paid) life insurance will also be maintained. You will be sent a billing by the Express Benefit Center and it is important for you to make prompt payment for the coverage you want to maintain. You do not have to pay for your LTD coverage premium or ALPA union dues while you are receiving benefits from the LTD program. However, your Personal Accident Insurance (PAI) will terminate when you go on any type of Leave of Absence.



After Family Medical Leave ends, if you are still on LTD, your CPO will place you on Long Term Medical Leave. At this point, you may continue your medical, dental and vision coverage at active pilot rates, but your basic (company paid) life insurance and supplemental life insurance will end unless within 30 days of the expiration of your Family Medical Leave. You should contact the Benefit Center at 800-693-9538 and ask for the forms you need to continue such coverage. Note that the cost will be higher than you paid as an active pilot.



Regardless of your decision on the continuation of your benefits, when you return from LTD to active status, all benefits that were in effect when you went on LTD should be restored. It’s prudent to confirm this with the Benefit Center upon your return to active status.



D - Your Passes


If you are over age 55 when disabled, you will retain your passes (on-line only) to age 60 and will then have retirement passes.



If you are under age 55 when disabled, you will retain your passes (on-line only) for two years from the date your LTD payments start. If you subsequently retire directly from LTD status, and meet the minimum 10 years of service, you will be eligible for retiree passes upon retirement, even though you have not had passes since the expiration of the initial 2-year period.


F – Medical Exams


The Administrative Committee reviews each case several times each year. It may be necessary for you to undergo an Independent Medical Review at the LTD program’s expense. Failure to submit to such an exam or seek appropriate medical treatment for your disability can result in loss of LTD benefit payments. Harvey Watt will contact you if the Committee has requested that you undergo a Medical Review.



G– Offset for subsequent year vacation.


While on LTD, you should bid vacation earned in the current year for the subsequent year. Any vacation due in the year after initial LTD will be paid as bid and will be offset from your LTD benefit on the same basis as the transitional month.



H – Payment Errors



Occasionally, administrative errors occur resulting in your LTD benefits being overpaid or under paid. If this occurs you are responsible for repaying any overpayment of LTD benefits. Under payment of LTD benefits will be corrected as soon as it is discovered.



I - Funding, Cost of Benefits and Benefit Calculation



The Pilot LTD Plan is a VEBA Trust funded entirely by Express and pilot members. It is not an insured plan. The company pays 55% of the cost and pilots pay 45%.



Multiplying the pilot’s hourly rate by 85.5 hours and multiplying the result by 55% determine the monthly LTD benefit. The hourly rate used is the same rate the pilot is paid for sick pay. The hourly rate for benefit payment is fixed at the point that the LTD Administrative Committee determines, based upon medical evidence, that the pilot has incurred a loss of license or the inability to exercise the privileges of the pilot’s medical certificate.


J - Exclusions


No benefit is payable for a disability resulting from: commission of a violent felonious crime; alcohol or drug abuse; attributable to a pre-existing condition unless the pilot’s LTD coverage has been in effect for at least 12 consecutive months in which the pilot missed fewer than 60 days of work for any reason relating to the LTD condition; agricultural flying (crop dusting); for any period when the pilot is confined for any reason in a penal or correctional institution; if the pilot obtained the FAA medical certificate by fraud or concealment; in the event of misrepresentation of any material information in the pilot’s application for benefits, or following the pilot’s disappearance.


Other Information on the LTD Program:


Administrative Committee


An Administrative Committee made up of 3 members of management and two members appointed by ALPA administers the LTD program.



Automatic Enrollment


Effective August 1, 2001 all new hire pilots at Express are automatically enrolled in the LTD program, unless the pilot declines or cancels such membership.


Late Entrant Enrollment


A pilot who did not enroll in the LTD program when originally eligible, or who enrolled but later dropped membership may apply for enrollment in the plan at any time. However such late enrollment requires that the pilot call the Benefits Center at 800-693-9538 for an enrollment form and submit such completed form to Harvey Watt & Company for underwriting. Underwriting includes Harvey Watt & Company obtaining the pilots complete FAA medical history from the FAA.



Pilots with no history of medical problems or family history of medical problems will normally be approved for membership about six months after application.



Pilots who have a history of medical problems or previous serious illnesses will probably be denied membership.