Long Term Disability

Evidence of Insurability Form

Rates Per 26 and 20 Week Pay Periods
(For illustrative purposes only)

New:

Enrolled LTD particpants are eligible for EAP(Employee Assistance Program) benefits from The Standard. Please click here (PDF File) for more information.

Enrollment Form
(DOC file)

Brochure Click Here
(PDF file)

LTD Claim Forms
(PDF file)

Employee Certificate
For Enrolled Members Only
(PDF File)

If you were previously offered Long Term Disability and you declined participation, you have given up your legal acceptance rights to automatically be accepted, subject to the terms of the LTD contract.

However, you may be considered after you complete and return to The Standard Insurance the evidence of insurability form. Please print and return this form to your EBR Schools payroll office for submission. No LTD coverage goes into effect until you and EBR Schools are notified by The Standard Insurance