Physician Disability Insurance Checklist: Does the A.C.S. Plan Pass? (Part 1 of 2)

Physician disability insurance Checklist Against Group Plans
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It is very important to “test” your physician disability insurance coverage before you have a serious illness or injury. Over the past few months, we have been “testing” coverage from various group plans. In this two part post, we will be looking at the American College of Surgeons (A.C.S.) plan and comparing it to high-performing private disability insurance using recurring topics from articles of well-respected national magazines.

The American College of Surgeons was founded in 1913. This is a scientific and educational association of surgeons that strives to improve the quality of care for the patient by assuring that its members maintain a high standard of continual surgical education and practice. To become a member of this association, surgeons must qualify through rigorous evaluations of their education, training, surgical competence and ethical conduct among other criteria. One of the benefits of becoming a member of the A.C.S is access to highly competitive discounts to a variety of insurance services including term life insurance, accidental death and dismemberment insurance, overhead disability insurance and long term disability insurance, among others. While many of these products offer quality coverage, the product we are most concerned with, for the purposes of this article, is Long Term Disability Insurance.

1. Is the policy non-cancelable and guaranteed renewable?
Look for contract language that states, “Until you reach age 65, your policy cannot be canceled, premiums cannot be increased and restrictions cannot be added, as long as you continue paying premiums as due.” A policy is non-cancelable if, until age 65, your policy premiums cannot be increased. A policy is guaranteed renewable if, until age 65, it can neither be canceled nor can restrictions be added.

-A.C.S. Plan Brochure – Premiums go up at five-year age brackets (35, 40, 45, 50, 55, 60). Per A.C.S. brochure, rates shown are current and may be changed by New York Life on any premium due date and on any date in which benefits are changed. Future benefits are subject to change by agreement between New York Life and the Trustees of the A.C.S Insurance Trust.

-A.C.S. Plan Brochure – When Coverage Ends: Your coverage will be continued until the premium due date coincident with or next following your 70th birthday as long as you remain an A.C.S member, the Group Policy is not terminated by New York Life or the policyholder; your premiums are paid, and you are actively at full-time work for pay or profit (unless disabled). Aside from not paying the agreed upon premium, your disability policy can be terminated by New York Life or by your policyholder (in this case, your policy holder is the A.C.S).

A.C.S. Plan Fails This Test – Coverage can be cancelled and premiums are not guaranteed.

2. Is total disability defined in your policy as Own Occupation/Own Specialty without qualifications?
Look for contract language that states, “Total disability means that you are not able to perform the material and substantial duties of your occupation. If you have limited your duties to a professionally recognized specialty, your occupation is that specialty. Income from a new occupation or specialty will not reduce your benefit.” It is important to have a policy in place that defines your occupation using “specialty specific” language [LINK]. In other words, if you are a brain surgeon, you don’t want your occupation to be defined under the same language as a family physician or even a general surgeon (as that could render you ineligible to receive your benefit). Furthermore, if you are unable to return to your specialty, it is important to have a policy that will not cease paying benefits if you decide to explore other career options, whether in a different medical field or a different industry all together.

-A.C.S. Plan Brochure – Total disability means your incapacity due to illness or accident to perform the material and substantial duties of your surgical or medical specialty or primary occupation provided you are not engaged in any other occupation for pay or profit.

A.C.S. Plan Fails this Test– Not true own occupation/own specialty coverage. In this coverage, if you are unable to perform surgery, but decide to explore a career in teaching, or any other career, you will no longer be eligible for total disability benefits. With true own occupation/own specialty coverage, if you are unable to perform in your profession, working in another profession or field will not interfere with your monthly disability benefit.

Stay tuned for our next post later this week that covers two more areas where we put the A.C.S. Plan to the test: residual benefits and recovery benefits. You’re welcome to contact us even sooner if you would like to run your current policy through the test. Whether it is a Group, Association or Individual disability insurance policy, we perform free policy reviews and quotes.

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