LONG TERM DISABILITY (LTD) 

• Group #:  677313
• Contact:

Benefit Management Services
Sacramento Disability Claim Office
The Hartford
PO Box 14302
Lexington, KY 40512-4302

Office:  (800) 289-9140
Fax:  (866) 583-8237 

 Website:  www.thehartford.com

Forms and Billing

• Hartford Long Term Disability Application Form (LTD)

Additional Information

• LTD Benefits Highlights - CLASSIFIED
• LTD Benefits Highlights - FACULTY
• Hartford Long Term Disability Explanation of Coverage
• Buy-Up LTD Benefits Highlight

Buy-Up Long Term Disability

Forms and Billing

• Hartford Buy-Up Long-Term Disability Enrollment Form (LTD)
• Hartford Buy-Up Long-Term Disability Claim Form
• Hartford Buy-Up Long-Term Disability Insurance Premium Rates

Additional Information

• Voluntary Benefits
• Insurance premium is self-funded by the employee through post-tax contribution.
• The program is restricted to members with an annual base-salary income of $108,000 or more.
• The benefits coverage is 2/3 of salary up to $12,000 per month less any deductible sources of income such as disability pension, etc.  Any benefits elected during this enrollment period will take effect January 1, 2015, subject to the active work requirement.
• Evidence of Insurability (EOI) is waived for the initial enrollment for Plan Year 2015.  Thereafter, EOI is required.