Disability Income Insurance Plan


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ATTENTION: If applying for Life or Disability as a California or New York resident please contact HBI at 877-285-4445 or see the bottom of this page for a specified application.

This insurance program is not available to residents in all states.

Help Protect Your Most Valuable Asset: Your Ability to Earn a Living

An Injury or Sickness that results in disability could keep you from working for months. Your major medical insurance may cover much of your hospital and physician expenses, but how would you replace your income? Disability Income Insurance can help protect your income so you can continue to pay bills for your home and your children's education.

Are you wondering when to purchase your Disability Income Insurance plan?

Today! Because premium and policy eligibility are based on age and health status, the best time to buy a Disability Income Insurance policy is when you're young and healthy. This policy includes a Pre-Existing Condition Limitation.


All members of ACEP under age 65, residing in the United States and Actively-at-Work at least 30 hours per week are eligible to apply for coverage.


Thanks to your membership in the American College of Emergency Physicians, you now have the opportunity to apply for a Disability Income Insurance plan from Hartford Life and Accident Insurance Company at reasonable group rates. Disability Income Insurance will partially replace your income for a covered Sickness or Injury up to $10,000 a month depending on your Pre-Disability Earnings! Your plan will provide you with these valuable benefits:

  • Up to Age 65
  • $10,000 per monthly benefit
  • Occupation-specific
  • Affordable group rates
  • Return to work Incentive
  • Survivor Income Benefit
  • Recurrent Disability Benefit
  • Cost of living Adjustment Benefit
  • Waiver of Premium during Total Disability

Minimum Monthly Benefit Amount: $500
Maximum Monthly Benefit Amount: $10,000

Offset Provision

Offset Provision means that the benefit amount payable as the result of your Total Disability will be the lesser of the Monthly Benefit Amount or the Monthly Benefit Amount minus any Other Income Benefits. Other Income Benefits includes any benefits you are eligible for or that are paid to you or a third party on your behalf, for: Workers’ Compensation, employer or government plan, “no-fault” automobile insurance or Social Security.

Benefit cannot exceed 60% of Pre-Disability Earnings.

Offset Provision Example

This example is for purposes of illustrating the effect of the benefit reductions and is not intended to reflect the situation of a particular claimant under the Policy.

Insured's Monthly Pre-Disability Earnings $3,000
Long Term Disability Benefits Percentage  x 60%
Unreduced Maximum Benefit   $1,800
Less Social Security Disability Benefit Per Month - $900
Less State Disability Income Benefit Per Month    - $300
Total of Disability Income Benefit Per Month                                                                      $600

Plan I - Up to Age 65

Monthly Rates per $100 of Monthly Benefit

Insured's Age 90-Day Elimination Period 180-Day Elimination Period 365-Day Elimination Period
Under 30 $1.02  $0.82 $0.70
30 - 34 $1.60  $1.28 $1.09
35 - 39 $2.19 $1.76 $1.49
40 - 44 $3.19 $2.56 $2.17
45 - 49 $3.92 $3.14 $2.67
50 - 54 $8.10 $6.28 $5.34
55 - 59 $9.56 $7.37 $6.26
60 - 64 $12.81 $9.97 $8.47


Elimination Periods

Elimination Period means the number of consecutive days at the beginning of any one period of Total Disability which must elapse before benefits are payable.

  Payment Period Elimination Period
Plan I - To Age 65 Plan:
For Total Disability Beginning:
a. Before Age 63 To Age 65 90, 180 or 365 days
b. Age 63 or over, but under 65 2 Years 90, 180 or 365 days
Plan II - 5 Year Plan:
For Total Disability beginning:
a. Before Age 63 5 Years 30, 90 or 365 days
b. Age 63 or over, but under 65: 2 Years 30, 90 or 365 days

Rates are based on the attained age of the Insured person and increase as you enter each new age category.
Rates and/or benefits may be changed on a class basis

Explanation of Terms

  • Pre-Disability Earnings means the 12 month average of your regular monthly rate of pay, not including commissions, bonuses, overtime pay or any other fringe benefit or extra compensation, with such 12 month period ending on the last day of Active employment prior to becoming Disabled.
  • Injury means bodily Injury that results directly and independently of all other causes from an accident within 180 days of accident.
  • Total Disability means a disability that prevents you from performing one or more of the duties of your usual occupation.

Effective Date:

Your coverage will become effective on the first day of the month after your application is approved and you pay the first premium. If you are not Actively-at-Work on that date, your coverage will not become effective until you are once again Actively-at-Work.


The Policy does not cover, and we will not pay a benefit for any Disability:

  1. unless you are under the regular care of a Physician;
  2. that is caused or contributed to by war or act of war (declared or not);
  3. caused by your commission of or attempt to commit a felony;
  4. caused or contributed to by your being engaged in an illegal occupation;
  5. caused or contributed to by an intentionally self inflicted Injury; or
  6. Sickness contracted or Injury sustained while on full-time active duty as a member of the Armed Forces (land, water, air) of any country or international authority.

Pre-Existing Condition Limitation:

Benefits are not paid for any Disability resulting from a Pre-Existing Condition until you have not received medical care for the condition for one year while covered under the plan, or you have been covered for two years.


Your coverage will end on the day you attain age 65, cease to be an active member of ACEP, do not pay your premium when due, or the Policy terminates.

Waiver of Premium:

Once you have satisfied the Elimination Period and begin receiving Disability benefits, your premium will be waived for as long as your benefits are payable.

Print a PDF, complete application and mail to Hagan Barron Intermediaries P.O. Box 1889 Sioux Falls, SD 57101

Attention CA and NY residents: You cannot apply online at this time, instead please utilize the following PDF applications:

California Residents: Click Here
New York Residents: Click Here

Most people wouldn't dream of leaving their home, cars, boats or other valuables uninsured, but few think to insure their loss of income. It's too late to do anything about it once you've become disabled. That's why it's so important to safeguard your income now - while you're healthy and active.

You have 30 days from your effective date of coverage to look over the program and discuss with your family and advisors. If you are not satisfied, you may return your Certificate within 30 days for a full premium refund, less any claims paid.

Privacy Policy
MIB Notice

Acceptance into this plan is subject to medical evidence of insurability as determined by Hartford Life and Accident Insurance Company. Depending on your age, the amount of coverage you request, and your answers on the application, a medical examination, medical test(s), or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at your convenience and at no expense to you.

This website explains the general purpose of the insurance described, but in no way changes or affects the Master Policy AGP-5683 as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.

This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services.



Underwritten by:
Hartford Life and Accident Insurance Company
Hartford, CT 06155

Disability Form Series includes GBD-1000, GBD-1200, or state equivalent.




The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company.