Plan Administrator: Sun Life Assurance Company of Canada
The Long Term Disability (LTD) plan provides income protection in the event that you are unable to work due to serious illness, injury or accident. Participation in the plan, which begins on the start date of employment at the University of Toronto, is mandatory if you have an appointment of 25% or more.
Before you are eligible to receive LTD benefits, there is a 15-week qualifying period during which you must be continuously unable to work. You may be eligible for sick-leave provisions during this transitional time.
If you remain unable to perform the essential duties of your own occupation beyond the qualifying period, LTD benefits are available for a maximum of 24 months. LTD benefits provide up to 70% of your regular salary, minus required deductions and withholdings.
You may be eligible for LTD benefits beyond 24 months. This extended coverage is available if you remain completely disabled from performing the duties of any job that you are qualified to perform and which would pay 75% or more of your normal earnings, whether or not such an occupation, job or work is available.
Coverage under the LTD plan ends on your date of termination, unless the disability or illness has already occurred. If the 15-week qualifying period extends beyond your termination date, you may be eligible for LTD benefits. Other provisions, including entitlement to continuing coverage for life insurance, pension, and health plans, cease at the date of termination. Your coverage also ends if you are within 15 weeks of your NRD.
Benefits During the First 24 Months
To receive LTD benefits following the 15-week qualifying period, you must be continuously unable to perform the essential duties of your occupation for medical reasons throughout the 24 months. You are responsible for providing satisfactory medical information in support of your disability claim to the plan administrator. LTD benefits begin once the plan administrator reviews and approves your application.
In order to receive benefits during the initial 24-month (“own occupation”) period, you must continue medical supervision and medical treatment that satisfies the plan administrator. The plan administrator, at any time during your disability, may require additional medical information or medical assessments. Your eligibility for LTD benefits depends on the results of these assessments.
After 24 months of LTD benefits, you must continue medical supervision and treatment satisfactory to the plan administrator. You must also remain unable, for medical reasons, to carry out the essential duties of any occupation that you are qualified to perform and which would provide 75% or more of your normal occupation earnings, whether or not such an occupation, job or work is available. Your previous training, education and experience will be taken into account in assessing possible occupations.
Benefit payments cease upon the earliest of any of the following dates:
- Normal retirement date (NRD), which is June 30 coincident with or following your 65th birthday
- Evidence that you are no longer totally disabled
- Inability to provide medical evidence to support your disability
- Failure to participate in appropriate medical supervision and treatment
Benefits may be approved for up to 12 months if you become disabled within 12 months of NRD, but not less than 15 weeks before NRD. In that case, your retirement would begin at the end of 12 months of LTD benefits. In all other cases, LTD benefits cease at the earlier of your NRD or another retirement date that was approved prior to your disability.
While receiving LTD benefits, you do not contribute to the LTD plan, University Pension Plan and Group Life Insurance Plan. Premiums for other benefit plans are deducted directly from your LTD payment.
You and the University share the cost of LTD income protection. The University pays 80% of the total plan premium and you pay 20%. Your contribution is deducted from your pay cheque. The maximum insurable annual salary is $125,000.
The plan provides up to 70% of your regular pre-disability salary. The initial maximum annual benefit payable is $87,500, or 70% of $125,000. LTD benefits are taxable.
Offsetting Benefits From Other Plans
If you earn income outside the University of Toronto, you may have LTD coverage under another plan. In this situation, the amount of coverage under the University plan will be reduced by the amount of your other coverage. If your insurance is based on combined income from both sources, the benefits will be reduced by the excess (if any) of your combined plan benefits minus the amount of benefit you would receive from the University plan.
Workplace Safety Insurance Board benefits and income from the Canada Pension Plan/Quebec Pension Plan (CPP/QPP), excluding dependant benefits, will reduce your eligible LTD benefits. When the plan administrator requires you to apply for CPP/QPP, you must provide the outcome of your application. Failure to apply for these benefits, or failure to notify the plan administrator of the outcome, will result in an estimated amount being offset from your LTD payment. If your injury or illness is work-related, LTD benefits may not be payable until the determination of Workplace Safety Insurance Board compensation.
Any other income you earn after the start of your disability benefits will offset your LTD payment. Please see the “Rehabilitation” section below.
After 12 consecutive months of LTD benefits, administrative staff will receive an annual increase equal to the lesser of 7% or the last across-the-board increase by the University. Benefits are increased on the anniversary of your first LTD payment.
You may be able to participate in an approved rehabilitation program or a return-to-work program through the University or the plan administrator. If you participate in such a program, 50% of your additional earnings will be subtracted from your disability benefits. You may continue to receive reduced LTD benefits and approved program earnings as long as the total from all sources does not exceed 100% of your pre-disability income.
If the total from all sources exceeds your pre-disability earnings, your LTD benefits will be reduced. A reduction will bring your total earnings from all sources to no more than 100% of your pre-disability income. LTD benefit payments cease completely if your rehabilitation or return-to-work earnings equal 75% or more of the current monthly earnings for your occupation.
The maximum period for which you can participate in a rehabilitation program is 24 months, or until the end of your 24-month “own occupation” period. With agreement of the plan administrator and the University, you may receive an extension in some circumstances. Entitlement to ongoing LTD benefit payments may depend upon your participation in a recommended rehabilitation or return-to-work program.
You earn $60,000 per year, or $5,000 per month. After the 15-week qualifying period, you receive a monthly LTD benefit of $3,500, or 70% of $5,000.
After several months, you participate in an approved return-to-work program. During the first month, you earn $1,000. For that month, your LTD is calculated as follows:
$3,500 LTD benefits minus $500 (50% of $1,000) = $3,000
Your total income for the month will be $4,000 based on $3,000 LTD benefit plus $1,000 return-to-work program earnings.
Recurrence of Disability
If you have received LTD benefits, but return to work only to have your original disability recur within six months, you will receive benefits immediately with the appropriate medical evidence. If the new illness or injury is not a recurrence, your LTD application is new and subject to another 15-week qualifying period.
Coverage While on Leave of Absence
If you are on a paid leave of absence and your salary is at least 25% of your regular monthly or bi-weekly salary, your regular contributions will be deducted from your pay and your participation will continue.
While on an approved unpaid leave of absence, the terms and conditions of your employment will govern your eligibility for continued LTD coverage.
Exclusions and General Information
Disabilities arising from active participation in a war or riot, or arising from intentional self-inflicted injuries, may not be covered under the LTD plan.
For questions about your eligibility or enrolment, please contact your Divisional Human Resources Office.
If you need to apply for LTD benefits of have questions about the plan provisions, contact Health and Well-being Programs and Services (416) 978-2149.