Frequently Asked Questions


Eligibility

Evidence of Insurability (EOI)

Beneficiary

Billing

Conversion

Death Claim Submission

Disability Claim Submission

Waiver of Premium

Dependent Life Insurance

Short-Term Disability

Long-Term Disability

Participation-Free Voluntary Program

Miscellaneous



Eligibility    back to top

  • Who is eligible for coverage under the group plan?

    All employees who belong to an eligible class and work the minimum number of hours as indicated in the application are eligible for group insurance. An employee must be actively at work for his or her insurance coverage to become effective.
  • Will Consumers Life offer coverage to dependents?

    If requested, Consumers Life will offer coverage to dependents.
  • What is the effective date of coverage for dependents?

    The effective date of life insurance for dependents is the date the employee’s coverage becomes effective, the effective date of the dependent life benefit or the date that the employee enrolls their dependents.
  • When is a dependent no longer eligible for coverage?

    A dependent is no longer eligible for coverage when the employee is no longer insured, the policy is canceled or the dependent child reaches an age at which coverage is not available.
  • Will Consumers Life offer coverage to retirees?

    If requested, Consumers Life will offer coverage to retirees on a case-by-case basis.
  • What is the effective date for non-contributory benefits?

    The effective date for non-contributory benefits is the day following completion of the employee waiting period, provided the employee is actively at work that day. If an employee waives all or a portion of their non-contributory coverage and chooses to enroll at a later date, the employee is considered a late applicant and must provide evidence of insurability. Coverage will become effective on the date Consumers Life determines the evidence is satisfactory and written notice of approval is provided.
  • What is the effective date of coverage for contributory benefits?

    An employee may apply for contributory insurance coverage at any time. If the enrollment form is signed on or before the end of the waiting period (if any), the coverage will become effective on the day following completion of the employee waiting period. If the enrollment form is signed within the 31 days following the end of the waiting period (if any), the coverage will become effective on the date the employee signs the enrollment form. If the enrollment form is signed after the 31-day period following the end of the waiting period (if any), the employee is considered a late applicant and must provide evidence of insurability. Coverage will become effective on the date Consumers Life determines the evidence is satisfactory and written notice of approval is provided.
  • What is the effective date of coverage when an employee has a change in salary, class or age?

    Any change in the amount of an employee’s benefits due to a change in employee class, change in salary, age reduction or amendment to the policy will become effective on the effective date of change.
  • If an employee is rehired, is he or she required to meet the eligible waiting period?

    If coverage ceases due to termination of employment and the employee returns to active work within six months, Consumers Life will not apply a new hire eligibility waiting period or require evidence of insurability if the employee re-enrolls within 31 days of the date of rehire.
  • What is the phone number, fax number and e-mail address for the Policy Administration department?

    Phone: 866.925.2542
    Fax: 440.878.6941
    E-mail: policyadmin@consumerslife.com

Evidence of Insurability (EOI)    back to top

  • What is evidence of insurability (EOI)?

    Evidence of insurability (EOI) is a statement of medical history and related information, which Consumers Life uses to determine whether an applicant will be approved for coverage.
  • When is EOI needed for life insurance?

    Evidence of insurability (EOI) is required when an employee is a late applicant, for insurance amounts in excess of the group’s non-medical maximum limit or for any other reason in accordance with standard Consumers Life underwriting procedures and guidelines.

Beneficiary    back to top

  • To whom are benefits paid if a beneficiary has not been designated?

    If a beneficiary has not been designated, the benefits will be paid in the following order:

    Spouse
    Children
    Parents
    Estate

    Consumers Life recommends that beneficiary designation forms be updated at least once a year. All policyholders have access to an online beneficiary tool at www.consumerslifeinsurance.com where they can designate beneficiaries.
  • Does Consumers Life need copies of the beneficiary designation forms?

    The employer should keep all beneficiary designation forms on file; Consumers Life will only request a copy in the event of a claim. All employees have access to the online beneficiary tool at www.consumerslifeinsurance.com.
  • Who is the beneficiary in the case of a claim for a spouse and/or children?

    The employee is the beneficiary for spouse and/or children.
  • Will Consumers Life accept a beneficiary form from a prior carrier?

    Yes, Consumers Life will accept a beneficiary form from a prior carrier.

Billing    back to top

  • What type of bill will we receive?

    Consumers Life offers two options for billing: List Bill: List bills are a great option for employers who need monthly documentation of covered employees and premium totals. Self-Administered Bill: Self-administered bills are useful for employers who have a Human Resources or Payroll system that maintains and reports employee benefit eligibility data such as salary, benefit elections, date of birth or age, etc. No monthly reconciliation is needed and the employer notifies Consumers Life of the number of lives, volume and premium due based on their own payroll/employee benefits record.
  • When are premium payments due?

    A group’s monthly payment must be submitted before the first day of the month for which the coverage applies.
  • Does the policy offer a grace period for premium payments?

    Following the first premium, Consumers Life allows a grace period of 31 days for the payment of any premiums due. We advise that payments are made on time, as late payments can result in delays of claims payment and other services, or cancellation of the policy.
  • When will notification of a rate renewal be received?

    Rate notification will be provided to the broker at least 30 days prior to the renewal date.
  • If an employee leaves employment or is no longer eligible, when does his/her coverage terminate?

    Coverage will terminate on the date the employee leaves employment or is no longer eligible.

Conversion    back to top

  • If an employee’s life insurance reduces due to age, can he or she convert the difference in coverage as a result of the reduction in benefits?

    No, age reduction is not a trigger for conversion.
  • Can an employee convert if their insurance ends due to retirement?

    Yes, an employee can convert if their insurance ends due to retirement as long as they do not remain in a class that is eligible for life insurance.
  • Are conversion rights available for a spouse and/or children?

    Yes, dependents may convert to an individual life insurance policy due to eligibility or policy termination.

Death Claim Submission    back to top

  • Where can I get a death claim form?

    A death claim form can be obtained from the Consumers Life website, www.consumerslifeinsurance.com, or by calling our toll-free number: 866.925.2542.
  • How is a claim for life insurance filed?

    The group is responsible for completing the death claim form and submitting it to Consumers Life with a certified death certificate, a copy of the original enrollment form and the beneficiary designation forms, if applicable. If accidental death benefits are being claimed, a copy of the police report, newspaper clippings, witness statement, OSHA accident report or any other available supporting documentation should also be included.
  • Can the life insurance claim be faxed to Consumers Life?

    Yes, the claim form and related documents can be faxed to Consumers Life at 440.878.6916. The original certified death certificate, however, must be mailed.
  • What address should the certified death certificate be mailed to?

    The certified death certificate should be mailed to:

    Consumers Life Insurance Company
    17800 Royalton Road
    Strongsville, Ohio 44136
    Attn: Claims department
  • What is the phone number, fax number and e-mail address for the Claims department?

    Phone: 866.925.2542
    Fax: 440.878.6916
    E-mail: claims@consumerslife.com

Disability Claim Submission    back to top

  • Where do I get a disability claim form?

    A disability claim form can be obtained from the Consumers Life website, www.consumerslifeinsurance.com, or by calling our toll-free number: 866.925.2542.
  • When should a disability claim be filed?

    A claim for disability benefits should be filed when it appears the employee’s absence due to disability will extend beyond the contractual elimination period.
  • How is a disability claim filed?

    The claimant, the group and the claimant’s physician are each responsible for completing their respective portion of the disability claim form. After the form is completed, it should be faxed or mailed to the Consumers Life Claims department for processing.
  • If the disability claim form is faxed to Consumers Life, will the original need to be mailed?

    If the disability claim form is faxed, the original does not need to be mailed.
  • Where should the disability claim be sent?

    The claim can be faxed or mailed to:

    Consumers Life Insurance Company
    17800 Royalton Road
    Strongsville, Ohio 44136
    Attn: Claims department
    Fax: 440.878.6916
  • What is the phone number, fax number and e-mail address for the Claims department?

    Phone: 866.925.2542
    Fax: 440.878.6916
    E-mail: claims@consumerslife.com

Waiver of Premium    back to top

  • What happens when a person is disabled but not yet eligible for waiver of premium when the group policy under which they are insured cancels?

    Consumers Life will continue an employee’s life insurance benefit for a contractually specified period of time without the further payment of life insurance premium if the employee becomes totally disabled, provided he or she is insured under the policy and is actively at work on or after the effective date of the group’s policy. Please note that the employee is not automatically placed on waiver of premium. An application needs to be submitted and approved by Consumers Life.

Dependent Life Insurance    back to top

  • If a husband and wife are employees of the same company, can they both insure their dependent children?

    If both husband and wife are covered as insured employees under the policy, only one may enroll the dependent children in life insurance coverage.
  • Can an individual be insured both as employees and dependents?

    A person cannot be insured as both an employee and as a dependent under a group’s policy. If both the husband and the wife are eligible employees, they must each enroll as an employee.

Short-Term Disability    back to top

  • Is it okay for the employer/policyholder to continue to pay an employee while they are collecting short-term disability benefits?

    If an employee is receiving any compensation from the employer, Consumers Life will not begin payment of short-term disability benefits until such compensation payments cease.
  • Does Consumers Life offer any special claim payment options?

    Consumers Life gives claimants the option to receive their claim payments by direct deposit. This option allows a claimant to request direct payment into a designated bank account.
  • How often will a claimant receive payments?

    After the initial claim payment, Consumers Life will send claim payments on a bi-weekly basis.

Long-Term Disability    back to top

  • What is the standard definition of “long-term disability”?

    Consumers Life defines long-term disability as an employee who is unable to perform the material and substantial duties of his or her regular occupation, or those of a reasonable employment option offered during the elimination period and for the first 24 months of disability benefits. As a result, the employee is earning an income less than or equal to 80% of pre-disability earnings. After the first 24 months of disability benefits, an employee is further unable to perform the material and substantial duties of any gainful occupation. As a result, the employee is earning an income less than or equal to 60% of his or her pre-disability earnings. Different policy provisions can be quoted upon request.
  • Does Consumers Life provide Social Security assistance?

    If an employee is receiving a payment from Consumers Life, we can also provide advice regarding the disability claim and assist with the application for Social Security disability benefits or appeals.
  • Does the long-term disability benefit reduce income from an Individual Disability Income policy?

    Consumers Life will not subtract any amounts received from an Individual Disability Income policy.
  • Are long-term disability benefits taxable?

    Long-term disability benefits are taxable only if the premiums are paid by the employer.
  • How long are benefits paid for mental/nervous conditions?

    Benefits for mental illness, substance abuse or special conditions are paid for a maximum of 24 months.
  • What happens if an employee returns to work on a part-time basis during the elimination period?

    If an employee returns to work during the elimination period for less than 30 days, the same elimination period will continue as long as the disability is due to the same sickness or injury.
  • What is a pre-existing condition?

    A pre-existing condition is a sickness or injury for which an employee received treatment during a specified period of time prior to the effective date of coverage.
  • Do long-term disability policies from Consumers Life provide continuity of coverage?

    Yes, Consumers Life will cover an employee under the plan if he or she was insured by the prior plan, and the cost of coverage under the prior plan was paid.

Participation-Free Voluntary Program    back to top

  • What are the employer requirements when offering participation-free voluntary life/accidental death and dismemberment insurance?

    To offer participation-free voluntary life/accidental death and dismemberment insurance, employers must sponsor basic life coverage through Consumers Life. Employers also must allow premium payments to be made via payroll deduction.
  • Is the participation-free voluntary life coverage portable?

    Yes, participation-free voluntary life coverage is portable, meaning that employees can continue coverage if they apply for portability within 31 days of the end of their employment.
  • What makes an applicant eligible to enroll in participation-free voluntary life/accidental death and dismemberment?

    All actively at-work full-time or part-time employees working 20 or more hours per week who have enrolled in basic life insurance with Consumers Life can enroll in participation-free voluntary life/accidental death and dismemberment insurance. Applicants must be able to answer “no” to five health-related eligibility questions. Late enrollees must provide evidence of insurability.
  • How much participation-free voluntary life/accidental death and dismemberment coverage is available to purchase?

    Eligible employees may elect participation-free voluntary life/accidental death and dismemberment benefits in increments of $10,000, up to $50,000.
  • What are the employer requirements to offer participation-free voluntary short-term disability?

    Employers must sponsor basic life and participation-free voluntary life/accidental death and dismemberment coverage with Consumers Life to offer participation-free voluntary short-term disability coverage. Employers must also allow premium payments to be made through payroll deduction.
  • What makes an applicant eligible to enroll in participation-free voluntary short-term disability?

    All actively at-work full-time or part-time employees who are enrolled in the employer-sponsored basic life and participation-free voluntary life/accidental death and dismemberment insurance plan are eligible for coverage.
  • Is there a pre-existing condition exclusion in the participation-free voluntary short-term disability policy?

    Yes. Disabilities that begin in the first 12 months after the employee’s effective date of coverage that are caused by, contributed to or result from a pre-existing condition are not covered.
  • How much participation-free voluntary short-term disability insurance is available to purchase?

    Eligible employees may elect voluntary short-term disability coverage in increments of $50. The minimum weekly benefit is $100 and the maximum weekly benefit is $750, not to exceed 66 2/3% of the employee’s basic wages. The employer may select either a 1/8/13 plan or a 1/8/26 plan (i.e., benefits are payable on the 1st day of absence due to an accident and on the 8th day of absence due to illness, and the employer may select either a 13-week or 26-week duration period).

Miscellaneous    back to top

  • Does your policy include a family status change?

    If the insurance program includes group term life insurance for dependents and an employee wishes to add dependent coverage, the employee must submit an application form requesting the change and listing all eligible dependents. Applications for dependent coverage should be made within 31 days after the employee acquires eligible dependents by marriage, a child’s birth or adoption. After 31 days, the coverage may be subject to evidence of insurability requirements.
  • When does an employee’s life/accidental death and dismemberment coverage reduce to age (birth date or anniversary)?

    Any change in the amount of an employee’s benefits caused by a change in class, change in salary, age reduction or amendment to the policy will become effective on the date of change.
  • Does an employee have to be actively at work when benefits are increased by the employer?

    Yes, if a change results in an increase in the amount of insurance, the employee must be actively at work on that date. If the employee is not actively at work, the increase will take effect on the day that he or she is next actively at work.

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