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44910 G000BV4XShort-Term Disability InsuranceWe’ve Got You CoveredAs an active employee of Juvenile Law Center, you have accessto a disability income insurance policy from United of OmahaLife Insurance Company.A disability income insurance policy can help provide securitywhen you need it, plus give you peace of mind so you canrecover faster and get back on the job sooner.Coverage guidelines and benefits are outlined below.ELIGIBILITY - ALL ELIGIBLE EMPLOYEESEligibilityRequirementYou must be actively working a minimum of 30 hours per week to be eligible forcoverage.PremiumPaymentThe premiums for this insurance are paid in full by the policyholder. There is no cost toyou for this insurance.BENEFITSEliminationPeriodIf you become disabled, there is an elimination period before benefits are payable. Yourbenefits begin:· On the 15th day of your disabling injury.· On the 15th day of your disabling illness.Weekly BenefitYour benefit is equivalent to 60% of your before-tax weekly earnings, not to exceed theplan’s maximum weekly benefit amount less other income sources.Maximum BenefitPeriodUp to 11 weeksMaximum WeeklyBenefit$1,500Minimum WeeklyBenefit$25

Partial DisabilityBenefitsIf you become disabled and can work part-time (but not full-time), you may be eligiblefor partial disability benefits, which will help supplement your income until you are ableto return to work full-time.DEFINITIONSDefinition ofDisabilityDisability and disabled mean that because of an injury or illness, a significant change inyour mental or functional abilities has occurred, for which you are prevented fromperforming at least one of the material duties of your regular job and are unable togenerate current earnings which exceed 99% of your weekly earnings from your regularjob. You can be totally or partially disabled during the elimination period.Definition ofWeekly EarningsWeekly earnings for salaried employees is the gross annual salary in effect immediatelyprior to the date disability begins, divided by 52. Weekly earnings for hourly employeesis the hourly rate of pay multiplied by the average number of hours worked per weekduring the 12 month period immediately prior to the date disability begins. If employedfor part of the prior 12 month period, weekly earnings is the hourly rate of pay multipliedby the average number of hours worked.FEATURESVoluntaryVocationalRehabilitationBenefitIf you become disabled and choose to participate in the vocational rehabilitationprogram, you will be eligible for a monthly benefit increase of 10%.SERVICESHearing DiscountProgramThe Hearing Discount Program provides you and your family discounted hearingproducts, including hearing aids and batteries. Call 1-888-534-1747 or visitwww.amplifonusa.com/mutualofomaha to learn more.

This information describes some of the features of the benefits plan. Benefits may not be available in all states. Please refer to the certificatebooklet for a full explanation of the plan’s benefits, exclusions, limitations and reductions. Should there be any discrepancy between thecertificate booklet and this summary, the certificate booklet will prevail. Benefits availability is subject to final acceptance and approval ofthe group application by the underwriting company. Disability income insurance is underwritten by United of Omaha Life InsuranceCompany, 3300 Mutual of Omaha Plaza, Omaha, NE 68175, 1-800-769-7159. United of Omaha Life Insurance Company is licensednationwide, except in New York. Policy form number 7000GM-U-EZ-2010.SHORT-TERM DISABILITY INSURANCEWho is eligible for this insurance?You must be actively working (performing all normal duties of your job) at least 30 hours per week.How long will my benefits be paid?Benefits begin after the end of the elimination period and can be payable up to the maximum benefit period as long as youremain disabled.Will my benefits be reduced by other sources of income?Yes, depending on the type of income you receive. Your benefit amount may be reduced by other sources of income such asretirement/government plans, other group disability plans, paid family leave, salary continuance/sick leave, settlements onpayments received and no-fault benefits.Does this plan cover me if I become disabled due to an injury at work?No, your STD insurance only provides benefits for off-the-job coverage for disabilities due to injury or sickness.Are there any limitations or exclusions?The benefits payable are subject to the following:· A pre-existing condition limitation does not apply.· Benefits are not payable for any disability or loss that:- Results from an act of declared or undeclared war or armed aggression- Results from participation in a riot or commission of or attempt to commit a felony- Arises out of or in the course of employment with the policyholder for benefits under any workers’ compensation oroccupational disease law, or receives any settlement from the workers’ compensation carrier- Results, whether the insured person is sane or insane, from an intentionally self-inflicted injury or illness, suicide, orattempted suicide- Occurs while incarcerated or imprisoned for any period exceeding 31 days- Is solely a result of a loss of a professional license, occupation license or certificationAll exclusions may not be applicable, or may be adjusted, as required by state regulations.