Details Count When Employers Shift To New Group Life Plans

If any of these circumstances exists, terminal (run-out) liabilities could be passed from one carrier to the next, changing the nature of underwriting and pricing for new life insurance prospects.

Other life contract provisions are equally critical to consider.

Waiver of premium is intended to extend life insurance coverage for a disabled employee at no cost to the employer or employee. Typical group life contract language allows an employee to qualify for waiver of premium if he or she becomes totally disabled prior to age 60 and is able to satisfy the definition of disability. Additionally, the employee must remain disabled for a minimum period of time, either 6, 9 or 12 consecutive months, depending on the contract. If an employee does not meet these requirements, the waiver of premium is nullified.

The waiting period also can differ by carrier, further emphasizing the need to understand how all the contract provisions interact. A common requirement is that the claim needs to be filed within 12 to 24 months of the disabling event or the waiver-of-premium privilege may be denied. On the positive side, if approved, the employee’s coverage can be protected for several years.

A knowledgeable employee benefits consultant will communicate various options available at the point of sale.

It is not a requirement, for example, for a new carrier to honor the remaining duration of an extension-of-benefits period, although this can be a viable option. If the carrier’s sales representative does not offer to include this provision, the advisor should request its inclusion and make the employer aware of its availability.

Other options to consider include applying a “prior insurance credit upon transfer of life insurance” amendment, issuing a waiver of the actively-at-work requirement, educating employees about the conversion privilege or delaying the effective date to lessen change-of-carrier impact on employees. Working with a carrier to offer one or more of these options will ensure the best possible transition.

Nobody wins in a poorly executed group life carrier transition, and everyone shares in the risk. All the participants in the transaction have certain liabilities: the employee who may lose coverage or benefits; the employer who does not fully understand its liability; the broker who may face an errors and omissions claim for alleged mishandling of the case; and the new carrier, for alleged lack of appropriate due diligence and counsel to the employer and broker.

Even when a reputable carrier is selected, employees can lose coverage if the transition is not handled carefully. In some cases, this may be unavoidable. With the transient nature of employment in the current market environment, employees do not always understand that they potentially are losing coverage, and it is not an obligation of the employer to refrain from moving the coverage for financial gain (in other words, controlling premiums).

The message here is clear: When you are working in the group life benefits arena, it is critical for you to work with someone who understands group life coverage. Don’t be dazzled by the lowest rate.

Julie Fried is vice president of marketing at Jefferson Pilot Benefit Partners, Omaha, Neb. She can be reached at [email protected].