CA DOJ Special Agents Group Plan

Monthly Cost$25.12 per month, level cost payroll deduction

Percentage Of Wages Protected*

 

 

 

85% of wages Non-Industrial Disability

70% of wages Industrial Disability

(100% of wages for Catastrophic Disabilities for up to 30 months  – not to exceed maximum monthly benefit)

(No Workers’ Compensation Permanent Disability offsets)

Maximum Benefit of $10,000 per month, tax-free

Waiting Period30 Calendar days – If less than 60 calendar days of personal leave, you may receive 70% of wages after 30 calendar days.  Otherwise, 60 calendar days.
Benefit PeriodLifetime: Sickness, Accident and Pregnancy
(Industrial Disability and Non-Industrial Disabilities)
Freeze of Personal Leave OptionAfter 60 calendar days
Personal Leave
Integration Benefit
After 60 calendar days, you may use personal leave and receive a supplemental benefit from the Plan up to the Maximum Percentage or use 100% personal leave and receive $1,000 per month ($100 per month for Industrial or Disputed
Workers’ Comp.)
Cost of Living Benefit (COLA)4% compounded per year (years 3-8) thereafter, CPI increase to age 65 and then continued lifetime benefits
Return To Work Incentive Benefit$1,800 per month for Non-Industrial Catastrophic Total Disability if a Participant returns to gainful employment.
Waiver of PaymentWaiver of Payment after no-pay status
Stress & Psychological Conditions

18 months maximum benefit amount 3 months per occurrence.

Must return to work for 1 year between each occurrence. No limit if hospitalized.

Benefits Payable During Challenged Workers’ Compensation CasesAfter 60 calendar days – 70% of wages to a Maximum Benefit of $10,000 per month (Repayable only if settled in your favor)
Minimum Monthly Benefit

$1,000 per month – paid in addition to personal leave after 60 calendar days.

($100 per month for Industrial or Disputed Workers’ Compensation claims.)

Death Benefit

$65,000 Death Benefit on- or off-duty natural, accidental or terminal illness
($15,000 initial benefit then $1,000 per month for 50 months)

$10,000 for suicide ($2,000 first 2 Years in Plan**)

(Benefits may be payable within 24 hours of notification)

Survivorship BenefitSix (6) months additional benefits to dependent beneficiary

Pre-Existing Medical

Condition Coverage

If you enroll during your initial enrollment period, all pre-existing medical conditions will be covered once you have been in the Plan for twenty-four (24)/
forty-eight (48)*** months, unless you are eligible for the Prior Coverage Credit – otherwise, pre-existing medical conditions will not be covered.
Ownership of PlanOperated, managed and funded by its Participants through a representative Board of Directors (non-profit California Corporation since 1985)

* Maximum percentages reflect amount payable after completion of (a) waiting period, (b) freeze of personal leave option, or (c) personal leave integration. Offsetting Benefit/Income Amounts are applied to reduce amount from the Plan

** The Death Benefit for suicide is limited to $2,000 for the first 24 months of participation in the Plan.

*** Forty-eight months for Death Benefits, and for HIV, AIDS, and ARC.

Request a Summary Plan Description (SPD)

11-19 This is a highlight page only – certain exceptions & limitations apply. See the Summary Plan Description or the complete Plan Document provisions for a more complete description of coverage.  CA Insurance Lic. #0544968