The minimum number of hours per week that an employee is required to work to qualify for and maintain eligibility for benefits.

The person who is receiving a benefit.

A trained expert who can help you understand or apply for benefit programs. Their goal is to help you avoid financial complications while developing a sustainable plan for the future. To find a benefits planner in California, use the DB101 Benefits Planner Directory.

The federal government pays benefits planners in communities around the country to help people think ahead about work incentives and benefits issues. CWIC'S are benefits planners who are trained by the Social Security Administration to assist beneficiaries with programs including Supplemental Security Income (SSI), and Social Security Disability Insurance (SSDI) in addition to other related programs.

The date an individual is enrolled in coverage. The effective date is usually not the same as the date of hire.

Definition of disability may be two-tiered: an inability to participate in the employee's own occupation (regular work) on the first tier, and an inability to participate in any occupation (any work) on the second tier. Refer to policy for definitions of disability.

Income before taxes and other deductions are made.

The total pre-tax income paid to an individual by an employer before a disability began and while the individual was covered by disability insurance.

Coverage offered to an individual through a group, such as employer-sponsored, association-affiliated or professional group coverage.

Coverage that you buy directly from an insurance company, usually through an agent. You are responsible for paying for the entire premium, and most individual policies require medical underwriting.

The first time an individual is eligible to enroll in a group’s benefits programs. During this period, the individual’s medical history is not subject to review. Once enrolled, however, pre-existing condition exclusionary periods may apply.

The adjustment of payments when an individual is eligible for more than one benefit program.

The review of an individual’s medical history and/or medical records to determine if the individual is eligible for coverage. Medical underwriting, which may include new medical testing, can be used to deny coverage or determine if a particular pre-existing condition will be covered.

The benefit amount an insurance company pays after deducting income.

See Gross Pre-disability Salary.

Any condition for which “medical care” was received within six months prior to the effective date of insurance coverage. Medical care includes the use of prescription drugs and physician consultations and services. During a pre-existing condition exclusionary period, coverage for that condition is either not provided or can be limited.

The period of time from the coverage effective date that the insurer does not cover a pre-existing medical condition. The individual will normally be covered for the condition once the specified time has elapsed.

A regularly scheduled payment to an insurer or health care plan.

Payments made for the period between disability onset and application approval.

The period of time an individual is required to be employed by a company or be a member of an association before becoming eligible to enroll for the group’s health coverage. Also known as the minimum service requirements.

The amount of time you have to wait between becoming disabled and receiving a benefit. For example, many private disability plans begin paying benefits 7 days after an illness forces you to leave work.