Charles J. Sellers & Co., Inc.

Frequently Asked Questions

Accidental Death & Dismemberment Ins.	General
Accounting	Homeowners/Renters Insurance
Auto Insurance	Hospital Indemnity/Safeguard Insurance
Bonds	Life Insurance
Both Disability & Disability Overhead Insurance	Long Term Care Insurance
Claims	NYS DBL Insurance (with Standard Security Ins. Co.)
Disability Insurance	Office Package Insurance
Disability Overhead	Policy Underwriting
Employment Practice Liability Insurance (EPLI)	"Umbrella" or Personal Excess Liability Insurance
	Workers' Compensation Insurance

Accidental Death and Dismemberment Insurance
Q. What is meant by "Principal Sum"?
A. Principal Sum is the benefit paid in the event of an accidental death. If your policy also includes a dismemberment benefit, it is a percentage of the principal sum depending on the type of loss. If included, there would be a dismemberment benefit schedule in your policy. Most Accidental Death & Dismemberment policies also pay for accidental loss of speech, hearing or sight. For further details on the Principal Sum, please contact our customer service area.
Q. Am I covered 24 hours a day, 365 days a year?
A. Yes. The association group accidental death and dismemberment policies we administer provide protection 24 hours a day, 365 days a year. You are covered full time including while you are a passenger on a commercial airline or on other types of common carriers, such as buses, trains, etc.
Q. Am I covered when I travel outside the United States?
A. Yes. Coverage is worldwide for the Association Group policies we administer. For further details, please contact our customer service area.
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Accounting
Q. Can I change the date my premium is due?
A. This depends on the type of insurance and the insurance company. If you will call our office we can advise you of your options based on the coverage and the insurance company involved.
Q. Are premiums guaranteed?
A. Some coverages have guaranteed premiums such as a whole life insurance policy. The reason for this is that insurance companies are able to guarantee premiums for certain types of coverage where they can reasonably calculate the probability of loss based on past experience. With other types of coverage it is impossible to guarantee premiums since the coverage period involves a long period of time or the likelihood of future losses for the line of insurance coverage is difficult to predict. If you want to find out whether the premium is guaranteed for the specific policy you own please call our customer service area.
Q. What is a "Pro-Rata Premium"?
A. "Pro-Rata" premium is a proportional premium. When coverage is purchased on a group basis the policy is billed on common group billing dates. The saving realized by group billings is one of the ways that the saving can be passed to customers in the form of lower rates. When an individual buys coverage on a date other than a group renewal date, they are charged a "Pro- Rata" premium from the effective date of coverage up to the next group renewal date. Thereafter, their premiums are billed on the regular group date for the mode they have selected.
Q. What payment methods are available to me?
A. This depends on the type of coverage and the insurance carrier. Some individual policies allow payments monthly, quarterly, semiannually, annually, or on an installment basis. Most group policies allow payment on either a semi-annual or annual group billing date. The savings realized by using group billing is passed on to the insureds in the form of lower premiums. For more details concerning the payment method on a specific policy you own, please call our customer service area.
Q. Do I have a Grace Period on my policy?
A. Most life and accident and health policies have a thirty-day grace period in which to pay premium. If you would like specific information as to the grace period, if any, on your policy please call our customer service area.
Q. I am past my Grace Period; can I reinstate my coverage?
A. Whether or not you can reinstate a policy depends on the type of coverage, the insurance carrier involved, as well as how long it has been since your coverage lapsed. If the coverage is one that involves medical underwriting you must frequently fill out a reinstatement application with health related questions which is subject to the insurance company is acceptance. For more information about policy reinstatement on a policy you own, please call our customer service area.
Q. Can I pay all my premiums on one combined bill?
A. This depends on the type of coverage you own. Generally group coverages can not be combined into one bill. If you have a homeowners and auto policy with the same company, the bills can frequently be combined. If you have a Workers Compensation policy, office package, or other business coverages with the same insurance company these can frequently be combined. For specific information on policies you own, please call our customer service area.
Q. Can I pay my premium via a charge card?
A. This option is currently not supported by any of the insurance companies that we represent.
Q. Can I pay my premiums online?
A. This option is currently not supported by any of the insurance companies that we represent.
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Auto Insurance
Q. I am adding/deleting a car, what do I need to do?
A. Please call our Property & Casualty customer service department during regular business hours.
Q. What should I do if I have an accident?
A. Please call our Property & Casualty customer service department during regular business hours. You may also use the carrier contact number on your insurance card.
Q. I am adding/deleting a driver. What do I need to do?
A. Please call our Property & Casualty customer service department during regular business hours.
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Bonds
Q. What bonds are typically needed by Professionals?
A. Professionals frequently need a pension or 401K-plan bond as required by ERISA. Professionals also frequently purchase employee dishonestly bonds, which covers them from losses due to employee dishonestly. For more information, please contact our customer service area.
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Both Disability and Disability Overhead Insurance
Q. What is Recovery Benefit Rider?
A. Once you return to work following a disability, the recovery benefit rider pays a lump sum benefit in addition to the monthly disability benefits received during disability. In order to be eligible for the recovery benefit, you have to have been receiving disability benefits for 45 days or longer. Recovery benefits increase as the length of disability increases. The amount of the lump sum payment is equal in amount from 1/4 of your monthly disability benefit to a maximum of 3 months. The recovery benefit rider can be added to either a disability or disability overhead insurance policy. It is designed to help with cash flow when you return from disability. For more details, please contact our customer service department.
Q. What is Waiver of Premium?
A. A waiver of premium benefit generally waives payment of premium while keeping the policy in force after six continuous months of disability. Some policies provide waiver of premium for disability commencing before a specific age (e.g. Age 60). For more information on waiver of premium, please contact our customer service department.
Q. What is the Guaranteed Purchase Option (GPO)?
A. A Guaranteed Purchase Option is an optional benefit that allows you to increase your monthly benefit at certain specified dates regardless of future medical insurability. Typically, a GPO will allow you to increase on the second, fourth, six and eighth annual renewal of your policy. For more information concerning a GPO benefit, please contact our customer service area.
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Claims
Q. How do I report a claim for disability or hospitalization?
A. It is important that you call our office during regular business hours to report a claim for disability or hospitalization at your earliest convenience. Early reporting allows us to send you the appropriate forms and to process your claim so that you can be paid for benefits for which you are entitled, without delay. Please call our disability claim department to report a claim.
Q. How do I report a Homeowners or Automobile insurance loss?
A. Please call our office during regular business hours at your earliest convenience. Prompt reporting allows our agency and the insurance company to process your claim as expeditiously as possible.
Q. How do I report claims for other types of policies?
A. There are claim notice requirements for many policies and coverage can be voided by the insurance company if notice is not made within the time required. Please call us immediately if you know of a claim or potential claim on any of your policies. If you are served legal papers concerning a covered loss, please call us, as it is imperative that the insurance carrier be notified immediately. If you have any questions regarding claim notice, please call our customer service department.
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Disability Insurance
Q. What is Disability Insurance and who needs it?
A. Disability insurance is a form of insurance designed to protect earned income that would cease in the event of disability. Most employees in New York State are covered by Workers Compensation for occupational related disabilities and New York State DBL for non-occupational disabilities. There are some exceptions. Self employed individuals and especially those with higher incomes generally need to purchase their own disability insurance. In addition, many municipal employees need to purchase disability coverage if they are not covered by NYS DBL. Most people believe they would be covered by Social Security disability in the event they were disabled. Even if they qualify, it does not protect them until after they have been disabled for more than six months with a disability that is expected to last beyond one year. It is important every few years to review what benefits are available to you from all sources to replace earned income in the event you become disabled. If you would like further information concerning disability insurance please contact our customer service department.
Q. How much Disability Insurance do I need?
A. While this varies from individual to individual, one rule used by those in the insurance industry, is to obtain disability insurance in an amount that together with benefits from all other sources, would replace 60% of your pre-disability earnings. The tax treatment of disability benefits can affect how much disability insurance you need. Please contact our customer service department for more information.
Q. What is Residual Disability Benefit?
A. Residual Disability Benefit is a partial disability benefit. It is usually designed to pay benefits if you are unable to perform one or more of the substantial duties of your occupation or are unable to perform them for as much time as is normally required, and therefore suffer an income loss. Most residual disability benefit provisions pay a percentage of your total monthly benefit based on the percentage of your income loss. For more details as to the specific residual disability benefit available to you, please call our customer service department.
Q. What is Cost of Living (COLA)?
A. A Cost of Living benefit generally indexes (increases) your disability benefit while you are disabled to help offset the effects of inflation. COLA benefits are tied to the government standards of the Consumer Price Index (CPI). Most COLA benefits will index the disability benefit while you are disabled after you have been disabled for a specific period of time. The benefits are generally indexed to a maximum percentage. For more information on what COLA benefit would be available to you, please contact our customer service area.
Q. What is meant by a "Waiting Period" or "Elimination Period"?
A. A Waiting Period or Elimination Period is like a deductible to a disability claim. The waiting period or elimination period is the length of time at the beginning of a disability claim for which no benefits are payable. Generally the longer the waiting period the lower the premium. It is important that you make sure the waiting period you select fits in with your specific financial plan. Waiting period selection should take into consideration the possibility of recurrent disabilities for chronic conditions and the provisions of your specific policy. For more information, please contact our customer service department.
Q. What is meant by a "Benefit Period" or "Plan"?
A. A Benefit Period or Plan is the maximum period for which benefits would be paid for any one disability. Frequently, the benefit period is a stated number of years (e.g. Five years for accident and sickness). Some plans call for benefits to a specific age (e.g. To Age 65). Frequently benefit periods reduce for disabilities commencing after a certain age. For example, a benefit period to age 65 may provide two years of benefits for disabilities that start between age 63 and 70. For more information as to your specific benefit period, please contact our customer service department.
Q. Are the disability insurance premiums tax deductible?
A. Whether or not premiums are tax deductible depends on how the premium is paid. If benefits are paid for by a professional corporation, for example, the premiums can be tax deductible. Generally, premiums paid by individuals are not tax deductible while, in this circumstance, disability income benefits would be tax-free to the insured. For more information concerning tax deductibility, please contact our customer service department and/or your tax or legal advisor.
Q. Are the disability insurance benefits subject to income tax?
A. Generally benefits received from disability insurance paid for by individuals with after-tax premium dollars, are received income tax free. If premiums were paid for and deducted by a Professional Corporation (PC) the benefits would be subject to FICA and Medicare withholding as well as income tax. For more information about taxability of disability payments, please contact our customer service area and/or consult with your legal or tax advisor.
Q. My employer carries disability income insurance on me. Should I consider buying a policy on my own?
A. There are many reasons why it may be in your best interest to consider buying a policy on your own. So that you can review your specific circumstances, please call our customer service department during regular business hours.
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Disability Overhead
Q. What is Disability Overhead Insurance?
A. Disability Overhead or Business Overhead Expense insurance is a form of disability insurance. It provides benefits during the disability of a business owner. The benefits provided under a disability overhead policy reimburse the business owner for covered office expenses that continue while the business owner is on disability. Most employers have spent considerable time in training and developing key employees. Disability overhead expense can reimburse you for the continuation of the salaries and benefits of these key employees, which allows you to retain them in your employ if you are disabled. For more information concerning overhead insurance, please contact our customer service area.
Q. What are typically covered overhead expenses?
A. Typically covered overhead expenses include but are not limited to rent, electricity, heat, water, depreciation, insurance for the office including professional malpractice insurance, employees' insurance plans, employees' salaries, accountants' services, professional association dues, laundry, telephone, depreciation and office equipment rental. For shared expenses, the Company will reimburse you for your proportional share. For additional covered expenses and specific details on overhead expense reimbursement, please contact our customer service area.
Q. How much Disability Overhead Insurance do I need?
A. Generally we recommend determining your ongoing overhead expenses from your previous year's tax return. Most applicants insure a set percentage of their previous years' overhead expenses as shown on their tax return. Some expenses may go down while you are disabled. For this reason, applicants generally insure 80% to 90% of their continuing overhead expenses. For more information, please contact our customer service department.
Q. I practice in a Partnership or Corporation with other MD's. Do we need this insurance?
A. Even in a group practice where partners can cover your workload, you still need to consider overhead business expense protection because (1) other partners could become disabled at the same time, placing increased financial pressure on the group and (2) you still need the funds to cover your portion of the group's ongoing business expenses. For more information, please call our customer service department.
Q. Are the disability overhead premiums tax deductible?
A. Generally the premiums for overhead insurance are tax deductible (IRS Ruling 55-264 IRB 1955-19 Page 8). It is advisable to secure the advice of your tax counsel in determining your eligibility for tax deductibility. For more information, please call our customer service department.
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Employment Practice Liability Insurance (EPLI)
Q. What is covered by EPLI?
A. An Employment Practice Liability policy provides coverage for defense and covered losses for wrongful employment practices which can include: Sexual harassment Wrongful termination Wrongful discipline Defamation Invasion of privacy Misrepresentation Equal pay violations Wrongful infliction of emotional distress or retaliation Breach of employment contract Negligent evaluation Wrongful deprivation of career opportunity Failure to employ/promote You are also generally covered for employment related acts of discrimination. For further information, please contact our customer service area.
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General
Q. I am just starting a new business. What insurance do I need?
A. When starting a new business it is important to contact an insurance agent who is familiar with the type of business you are conducting. An experienced insurance agent can make sure that you meet your needs for business related coverages such as Worker's Compensation, New York State DBL, Office Packages including Liability and Property coverage. For more information please call our customer service area.
Q. What happens to my insurance if I retire?
A. What happens to policies when you retire varies by the type of policy. If you would like information concerning retirement and how it affects your insurance coverage with our Agency, please call our customer service department.
Q. If I purchased my coverage through a Medical Society/Bar Association Group, do I need to retain my membership?
A. For most policies purchased through a medical society or bar association endorsement, you need to retain your membership to continue to qualify for the special benefits or lower rates, provided by the group policies. If you drop your membership there is frequently an increase in rates and/or decrease in benefit when the policy is changed over to the individual form of the policy. For more details how your specific policy would be affected, please call our customer service area.
Q. How can I get a Certificate of Insurance?
A. Please contact us during regular business hours. You can also fax or mail a request with the address of the requested certificateholder and the policy involved. Please call our customer service department if you have any questions.
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Homeowners/Renters Insurance
Q. How do I know if I have enough coverage on my home?
A. You should be insuring your home for the replacement value not the market value. The replacement value is the amount that it would cost to rebuild your home in the event of a total loss. In many cases, replacement cost can be more than the market value. One of the reasons that you need to insure for a replacement value is that you could have a loss without adequate coverage to restore your home if you do not have full replacement value coverage. There are a number of methods to calculate replacement costs based on construction type, age of construction, square footage or unit count, built-in upgrades, and location of construction. Sellers and Co. has guides used by the insurers we represent for replacement cost calculation. There are companies that will do a more accurate appraisal of your home's value for a fee. For further information, please call our customer service department.
Q. How do I put a value on my home's contents?
A. Homeowners and renters frequently ask how can they determine the value of the contents. Most homeowner's policies provide the contents coverage as a percentage of the coverage on the dwelling. When replacement cost is selected on the contents this is a higher percentage. The amount of contents can be increased based on particular needs. Renters select the amount of contents coverage to insure. We recommend doing an inventory of your home's contents on a room by room basis. You would add up the value of all contents, which would be those things that do not form a part of the dwelling. For Instance, you would not count wall to wall carpeting, but you would count an area rug such as an oriental rug. You should be sure that your value of your contents coverage is at least the value that you arrive at after adding up the contents. Please see the next question for further information on inventory.
Q. What are your recommendations regarding an inventory of my home?
A. We recommend an inventory of your home, which is kept off site. It is a wise idea to use a video camera and video tape each room of your home including all the contents. You can open cabinets and drawers and video tape the contents as well. As you do the video taping you can dictate what you are video taping. We would then recommend that you give the videotape to a trusted friend or relative to store in a safe place. Frequently, when individuals have a total loss, they cannot recall all the items that are contents of their home. The videotape would serve as a useful reminder at the time of loss as well as a visual documentation of your contents for the insurance adjuster. You should revideo tape every few years or anytime you make any substantial changes to your home.
Q. What is Comprehensive Personal Liability Coverage?
A. Comprehensive Personal Liability Coverage which is automatically included in a homeowners or renters policy provides coverage for the negligence of you or any of the relative residents of your household. While there are some standard exclusions, an example could be accidentally hitting someone with a golf ball and causing bodily injuries.
Q. I have a home business. Is this covered under my homeowner's policy?
A. Generally home businesses and business equipment are an exclusion of a homeowner's policy. They can be covered for additional premium. Please contact our customer service department if you would like additional information.
Q. What if I add an addition or make renovations to my home?
A. If you put an addition or renovate your home, please call us so that we can review the values on your home to make sure that they reflect this change.
Q. Why do I need Renters insurance?
A. You need renters insurance to cover your contents from loses such as fire and thefts. In addition renters insurance provides you with comprehensive liability coverage, which can protect you as described above.
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Hospital Indemnity/Safeguard Insurance
Q. What is a "Safeguard" policy?
A. A Safeguard policy is a conversion of a former disability policy that could no longer be renewed due to age or retirement. The Safeguard policy provides daily hospital benefits regardless of other insurance. Benefits begin from the first day of hospitalization and can be used in any way you wish. For more information on Safeguard coverage, please contact our customer service area.
Q. What is a "Hospital Indemnity" policy?
A. A Hospital Indemnity policy provides daily hospital benefits regardless of other insurance. Benefits begin from the first day of hospitalization. Benefits can be used in any way you wish. They can help to pay for extra expenses associated with hospitalizations such as nursing care, childcare, etc. The hospital indemnity policy allows you to add benefits for your spouse and/or dependent children. For more information on Hospital Indemnity coverage, please contact our customer service area.
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Life Insurance
Q. What is Term Insurance?
A. A Term insurance policy is a Life Insurance policy that furnishes life insurance protection for a limited number of years. The face value of the policy is payable only if the death occurs during the coverage period. There is no cash value to a Term insurance policy. There are various optional riders that can be added. Contracts vary between insurers. Premiums are lower since there is no investment value to the policy. Customarily, Term insurance policies are issued for a stated number of years (e.g. 5,10,20) or to a stated age. Premiums can be level for a certain period or increase at specified attained ages. Renewal and conversion provisions vary by policies and should be reviewed when purchasing. One form of Term Insurance, known as "Reversionary Term", requires medical requalification at a specified date to retain favorable rates. Some Term Life policies have decreasing benefits (e.g. Mortgage Term Life) at specified dates or ages.
Q. What is Whole Life Insurance?
A. Whole Life insurance is a "permanent" form of life insurance that combines life insurance with cash value savings. The cash value accumulation, which is largely attributable to the effect of interest over time, is not taxed as it accumulates. There are various optional riders that can be added. Contracts vary between insurers. Premiums are typically paid for life or to age 100. Premiums are usually level based on the age at purchase. If coverage is surrendered, cancelled or lapses after being in effect for a few years, there generally is a cash value that provides the insured with various options. The policyholder can usually borrow their accumulated cash value to keep coverage in force in lieu of surrendering. They need to pay interest on this policy loan since the borrowed funds are not available for investment by the insurance company. In event of death, any un-repaid policy loan would be deducted from the proceeds paid to the beneficiary. These would include using the funds for reduced "paid up" life insurance or extended term insurance, taking the cash or structuring some other settlement option. Tax consequences should always be considered. The interest and cash value guarantees vary by contract and should be examined closely when purchasing. For more information, please contact our customer service area.
Q. What is Universal Life Insurance?
A. This form of life insurance provides a death benefit and builds cash value, which accumulates at a current non-guaranteed interest rate. This cash value earns tax-deferred interest until the time it is withdrawn. There are various optional riders that can be added. Contracts vary between insurers. For more information, please contact our customer service area.
Q. What is Variable Life Insurance?
A. Variable life insurance is like whole or cash value life insurance in that it accumulates a cash value. Variable life differs in that the funds are invested in index or equity based investments which can be more responsive to changes in interest rates and inflation. There is a guaranteed minimum death benefit and the potential of increased insurance benefits based on favorable performance. The cash value accumulation, which is largely attributable to the effect of interest over time, is not taxed as it accumulates. There are various optional riders that can be added. For more information on this type of life insurance protection, please contact our customer service area.
Q. How much Life Insurance do I need?
A. It is important to protect your family's financial security by having the proper amount of life insurance. A general rule of thumb is that you should have life insurance that is equal to 6 to 10 times your annual income. While the "6 times" formula will help your family pay for your final bills and ongoing living expense the "10 times" formula takes into account the present value of . your potential lifetime earnings with assumed salary increases. It also takes into consideration of inflation. For more information on determining your need for life insurance, please contact our customer service area.
Q. What is Accelerated Death Benefit?
A. An accelerated death benefit is a mechanism for an individual to collect their death benefit in advance based on a terminal illness or a significant impaired life expectancy. How accelerate death benefits are structured varies by the type of contract. They are frequently set up to allow an insured diagnosed with a terminal illness to collect a set percentage to a maximum dollar amount of their death benefit in advance. This accelerated death benefit can then be used to assist the family with the expenses of a terminal illness. For more information concerning the Accelerated Death Benefit, please contact our customer service area.
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Long Term Care Insurance
Q. What is Long Term Care Insurance?
A. Long Term Care insurance is a coverage designed to reimburse you for Nursing Home Costs and/or Home Health Care costs if you can no longer care for yourself due to chronic illness or prolonged disability. Generally policies are selected to provide a set daily Nursing Home Benefit and a set Home Care benefit (if elected) starting after a specified waiting period and payable for a selected benefit period. For more information on Long Term Care insurance, please contact our customer service area.
Q. What is Home Health Care?
A. Home Health Care involves reimbursement for medically required care provided in the home due to a chronic illness or prolonged disability. Items covered could include: nursing care, physical therapy, home care aids and similar types of services. For more information on Home Health Care coverage, please contact our customer service area.
Q. What does Long Term Care Insurance cover?
A. Long Term Care insurance normally provides benefits for care or assistance received in a nursing home, assisted living facility, adult day care, community based care, alternative care facility or hospice care. Most long-term care policies also provide benefits for home care if elected.
Q. What is the Partnership Plan?
A. New York State established a Partnership for Long-Term Care (Partnership) program designed to assist residents of NYS in planning for the cost of Long Term Care. Partnership LTC policies have to meet certain standards to earn the partnership designation from the NYS Insurance Department. If you are covered by a partnership policy and benefits are exhausted, you can apply for Medicaid without regard to the type or amount of assets you can keep. Partnership status does not protect income. For more information on Partnership policies, please contact our customer service area.
Q. What does it mean if a policy is Tax Qualified?
A. A "Tax Qualified" Long Term Care policy is one that meets the requirements for Federal Tax deductibility. All LTC policies effective before 1/1/97 are automatically qualified for federal tax purposes. Those effective after 1/1/97 must meet certain standards to be eligible for federal tax deductibility. Premiums for Long Term Care are now deductible for New York State income tax up to a specified dollar amount. It is always best to consult your tax advisor. For more information, please contact our customer service area.
Q. How does one qualify for benefits on a Long-Term Care policy?
A. Generally benefits are provided if you meet a certain number of triggers "generally 3 of 5". Typical triggers or Activities of Daily Living (ADL) can be: loss of the ability to do certain activities, such as bathing, dressing, eating, transferring, toileting, continence or cognitive impairment. Which triggers and how many are used affects the premium and benefits. For more information, please contact our customer service area.
Q. What is inflation protection and are there different types?
A. There are many different types of inflation protection offered. The compound interest benefit is the best and is also the most expensive. Many carriers also offer a simple interest inflation protection. Some carriers provide an increase in daily benefit tied to inflation. Generally this type of inflation protection also increases the premium if elected. For this reason it is important to understand the type of inflation protection selected and its effect on both premium and benefits. For more information, contact our customer service area.
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New York State DBL Insurance (with Standard Security Insurance Co.)
Q. What does DBL stand for?
A. DBL stands for Disability Benefits Law. New York is one of six states in the United States that require employers to carrier Disability Benefits Law (DBL) coverage for their employees. DBL provides benefits to employees who suffer a non job related accident or sickness.
Q. What do I do if my number of employees change?
A. With Standard Security, any change in number of employees will be reported on renewal billing and your premium will be adjusted accordingly. There will be no additional charge for adding employees nor will there be a refund when reducing employees between billings. If you have a significant change in number of employees due to something such as a merger, please contact our customer service department so that we can be sure you are properly covered.
Q. What happens if I close my office/business?
A. Please notify our customer service office as soon as this occurs. Once all payroll ceases, you will no longer need New York State DBL coverage. The Workers' Compensation Board will be notified and there will be a refund of unearned premium, if any.
Q. What do I do if my business/ practice merges, changes names, incorporates or changes in a similar manner?
A. Please contact our customer service department as soon as you know any changes that involve a change in your name or Employer ID. When you make a change in your employer ID, the Workers' Compensation Board must be notified with a new DB820. When you are insured with our Agency and notify our office, we will take care of this for you. If there is a significant change in the number of employees, there will be a premium adjustment as well.
Q. What payment options are available to me?
A. With Standard Security, premiums are paid annually if you have seven employees or less. If you have more than seven employees, you can pay your premiums either annually or quarterly.
Q. What is covered under DBL Insurance?
A. DBL insurance provides benefits for loss of income due to non occupational accidents or sickness. There is a seven day waiting period before benefits are payable. The benefits provided are one-half of the employee's wages to a maximum of $170.00 a week. Benefits are payable for a maximum of 26 weeks in any 52 week period.
Q. Who is required to carry DBL Insurance?
A. Most employers in New York State are required to carrier DBL insurance for their employees. There are a few exceptions such as certain municipal employees. Please call our customer service area for further details.
Q. How is the premium determined for DBL Insurance?
A. With Standard Security, the premium is determined by employee count. There are specific rates for male and female employees. Please call our customer service area for premium details.
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Office Package Insurance
Q. What are the typical coverages on a Business Owner's policy?
A. A typical Business Owners policy provides coverage for the following: (1) property coverage on the building if you are a building owner (2) property coverage on the business contents and (3) business liability insurance. There are many optional coverages available on a Business Owners policy. For more information, please contact our customer service department.
Q. What is meant by a "Stretch" endorsement?
A. A Stretch endorsement is an optional endorsement that can be added to a business owners policy. Generally, the stretch endorsement provides a number of additional optional coverages packaged on to one endorsement at a lower cost than if each of those coverages were added individually. For more information, please contact our customer service area.
Q. What should I do if I add or delete a new location, new equipment, or contents?
A. Please phone our customer service department to report this change so that we can be sure your policy values are adjusted accordingly.
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Policy Underwriting
Q. In applying for underwritten Disability or Life insurance, what tests are done in a routine blood or urine test? Can these be done at any laboratory?
A. When you apply for underwritten life and disability insurance over a certain amount, most insurance companies require blood and/or urine testing. The tests that are performed vary by insurance company. Tests generally include blood sugar testing, liver function testing, lipid testing, Nicotine, drug and HIV screening. These tests cannot be performed at any laboratory, as they are specialized insurance tests. Tests can be scheduled at times and locations convenient to you. Insurance companies perform these tests to help keep experience sound. If your coverage that you applied for is declined based on the results of the tests, you can specify to have the test results sent to a physician of your choice. Your physician can then discuss these results with you.
Q. In applying for Disability or Overhead insurance, why are prior tax returns requested?
A. When you apply for disability insurance it is purchased to protect the earned income you would lose in the event of disability. The insurance company will ask for prior tax return when you apply for coverage over a certain amount. The reason they request the tax return is that they want to verify that the amount of coverage requested would be in proportion to the net income you would have after expenses, taxes, etc. In other words the insurance company needs to make sure you would not be better off financially when you are disabled. With Overhead Insurance applications over a certain amount, the insurance company will request your prior business tax returns (personal tax returns if you are a sole proprietor). The reason they need these tax returns is to verify that the amount of overhead insurance you are purchasing would not exceed what you need based on past Overhead expenses. In both cases, these actions are taken to keep experience sound and premium costs reasonable.
Q. What is Medical Information Bureau? How Can I contact them?
A. MIB (Medical Information Bureau) is an association of Insurance Companies that provides information and data base management services to financial services industry. You can contact them to request a copy of your record at: www.mib.com or write /call: MIB, PO Box 105, Essex Station, Boston, MA 02110, 617-426-3660.
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"Umbrella" or Personal Excess Liability Insurance
Q. Who needs an "Umbrella" policy?
A. The "Umbrella" liability policy protects you from high limit liability losses that can arise from your home, personal activities, or use of your automobile or motor vehicle. Generally individuals who would be a target of a personal liability lawsuit or who have accumulated wealth or assets should consider a personal umbrella policy. The umbrella policy provides excess liability coverage over and above the basic automobile and homeowners policy.
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Workers' Compensation Insurance
Q. What is covered under Workers' Compensation?
A. Benefits are provided for disabilities resulting from employment related accidents and sicknesses. Loss of earning benefits can be paid for permanent total, permanent partial, temporary total, or temporary partial disability. There is a 7 day waiting period for loss of wages benefit. If the employee is out for more than 14 days, loss of wage benefit is retroactive to the first day. In addition, Workers' Compensation provides medical and surgical expenses with no waiting period, per the Workers Compensation fee schedule. Death benefits of up to fifteen hundred dollars are payable for funeral expense for an individual who is killed on the job. Benefits are also payable to a deceased worker's spouse and dependent children in the event of a job-related death.
Q. What happens if I close my office/business?
A. If you close your office or business, please call our customer service department. Once all payroll ceases, you no longer need Workers' Compensation coverage. When this happens, you will be sent a final payroll audit form. If the deposit premium paid is greater than the amount owed, you will receive a refund; otherwise you will owe a final premium.
Q. Who needs coverage under Workers' Compensation?
A. Almost all employers in New York State are required to carry Workers' Compensation coverage for their employees. Workers' Compensation is required in all fifty states. There are some exceptions for sole proprietors or a one person "PC" with no employees. Please call our customer service area for more details.
Q. How is the premium determined?
A. Premium is determined based on payroll and job description. The Workers' Compensation Board assigns rates for various occupations depending on the hazard of the occupation. The employer then pays a deposit premium based on estimated payroll. At the end of the policy period, an audit is conducted. If the actual payroll is greater, then the employer owes additional premium. If the actual payroll is less, the employer receives a refund. There are a number of credits, modifications and dividend programs available for employers with larger payrolls. Please call our customer service department for specific quotations.
Q. What if my number of employees or payroll changes?
A. If you have a significant increase in payroll, you should call our customer service area and report this. You can then be sent an adjustment bill so that you won't receive a large audit bill at the same time a renewal premium is due.
Q. What do I do if my business/practice merges, changes names, incorporates or changes in a similar manner?
A. Please contact our customer service department as soon as you know any changes that involve a change in your name or employer ID. When you make a change in your employer ID the Worker Compensation Board must be notified with a new DB820. When you are insured with our Agency and notify our office, we will take care of this for you. If there is a significant change in the number of employees, there will be a premium adjustment as well.
Q. What payment options are available to me?
A. Most carriers provide flexible payment options based on the size of the premium. Generally, the larger the premium the more installments that would be available. Please call our customer service for specific details.
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