Who may apply for Office Overhead Insurance?
You are eligible to
apply if you are a member of the American Psychological Association, are under
age 65, reside in the
United States
, and you are working at least 20 hours per week.
What is covered under this policy?
Things such as
office rent or mortgage interest payments, employee's salaries,
professional association dues, office telephone bills, office
utilities, janitorial services, telephone answering service charges, business
liability and casualty insurance premiums including
professional liability, and other regularly occurring business
expenses are all considered reimbursable expenses. It is important to
accurately estimate your expenses so as not to pay for more protection than you
need (we can only reimburse you for actual expenses incurred that you can
substantiate). Our Office Overhead application has a worksheet listing various
office expenses that will help you determine the correct amount of coverage for
your situation.
What happens if my expenses are less than my total benefit?
Not to worry.
will create a Benefit Bank to allow any unused portion of the benefit you
purchased to be used during a month, in the same period of disability, when
actual expenses exceed your benefit limit.
Why should I choose Trust Office Overhead Insurance over another carrier?
Trust Office
Overhead Insurance is designed by psychologists for psychologists who
understand the commitment it takes to have a career in the profession and the
duties associated with the practice of psychology. All plans may be continued
for as long as you work at least 20 hours per week on a regular basis. You can
keep the coverage regardless of age and benefits are payable to reimburse your
office expenses while you are disabled and unable to perform the duties of your
“occupation." The Trustees are your ombudspersons in working with Liberty, making Trust Office Overhead coverage the insurance of choice
among thousands of psychologists.
When do plan benefits become effective and when do they end? Are there exclusions
and limitations?
Benefits begin at
the end of 28 continuous days of total disability and continue for up to 24
months per period of disability. If unused benefits have accumulated in the
Benefit Bank, they will be paid in a month in which your expenses exceed your
benefit. Benefits will end when you are no longer totally disabled, when the
maximum benefit has been paid, or when you close or sell your office. Benefits
are payable only for periods of disability for which you are under the care of
a fully licensed physician and you cannot perform the duties of your occupation
or profession.
If my disability ends and then returns, will I have to wait another 28 days?
If you become
totally disabled from the same or related cause within 6 months, that
disability is considered to be part of the same period of disability. In this
case, the covered person will not have a new waiting period. Benefits are
payable for the remaining months in the period of disability subject to the
overall 24 month maximum for a disability.
If you return to
work for at least 6 continuous months and become totally disabled again from
the same or related cause, this is a new period of disability and the covered
person must complete a new waiting period before benefits are payable.
Are there expenses not covered by the Trust Office Overhead Plan?
-
Expenses
in excess of your portion when expenses are shared with others in a
professional corporation or a partnership
-
State
or federal income taxes or payroll taxes incurred by the member
-
All or part of the principal portion of any loan of any kind
-
The cost of equipment or merchandise of any kind including books, periodicals,
stamps, or photocopying
-
Interest
payments which fall due before the end of the waiting period
-
Those
which are covered under any other group or group type insurance providing
benefits for Office Overhead expenses
-
Salaries
of your immediate family or for a person employed to perform your duties
-
Office
Overhead expenses incurred more than 3 months after the covered person's death
Will benefits be paid for disability resulting from pre-existing conditions?
Benefits will
not be paid for a disability caused by pre-existing conditions
(conditions which existed prior to being insured by this insurance) for which
treatment, including medications or prescriptions, was rendered or charges were
incurred within six months before the effective date of insurance. However,
pre-existing conditions are covered after six consecutive months (one year for
mental illness or emotional disorder) has elapsed where no treatment has been
rendered or charges incurred for the condition (this includes medication or
prescriptions.)
Are there exceptions to policy benefits?
Yes. Benefits are
not payable if a covered person becomes disabled due to:
war or an act of war (declared or undeclared)
pregnancy that is not a complicated pregnancy
intentionally
self-inflicted injuries, while sane or insane
drugs
that are voluntarily taken, ingested or injected, unless as prescribed or
administered by a physician
active
participation in a riot or committing or attempting to commit an indictable
offense
Will the Trust waive my premium while I am disabled?
Following the
completion of six months of continuous disability, the premium due will be
waived until the first semi-annual payment date which follows recovery or
receipt of maximum benefits.
Under what circumstances will my Office Overhead coverage terminate?
Your insurance will
terminate on the earliest of the following dates:
-
The
date you cease to be a member of the APA
-
The
date you fail to make any agreed payment of premium within the 31 day grace
period
-
The
date you cease to be gainfully employed as a psychologist on a full-time (at
least 20 hours per week on a regular basis) basis, except for a continuing
disability
-
The
date you become a member of the armed services of any country
-
The
date the master policy held by the Trustees is terminated
Do I have to prove my insurability when obtaining Office Overhead insurance?
APA members who are
eligible to enroll in any of the programs of Office Overhead Insurance must
submit evidence of insurability when making application. The insurance will not
become effective until the first day of the calendar month following the date
that Liberty Mutual determines that such evidence is satisfactory.
How often will I pay my premium?
Semi-annual
premiums are due each May 1 and November 1. In the event that you enter the
plan on any date other than on the first day of a premium due date, the premium
will be prorated to the next due date.
Who administers the Trust Office Overhead plan?
This plan is underwritten and administered by Liberty Life Assurance Company of
, a member of the Liberty Mutual Group. It is the only Office
Overhead program endorsed by the American Psychological Association Insurance
Trust. The Trust and Liberty Mutual have been working together for over 40
years. A group Office Overhead policy has been issued to the Trustees of the
APA Insurance Trust. Each participating member receives a certificate outlining
the benefits to which one is entitled under the policy.
How do I file a claim?
Detailed
information regarding claims procedures is issued with each new certificate.
Promptly report all claims to Liberty Life's Home Office in
New Hampshire.
Administrator
APA Group Insurance Plans
Liberty Mutual Insurance Company
P.O. Box 1525
Dover, NH 03821-1525
