| Professional Overhead Expense |  |
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| What Would Your Practice Do Without You? |
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If you were to become disabled, what would happen to your practice? You may have enough disability insurance to cover your personal needs during this period, but how will you pay your office expenses?
The AAO Professional Overhead Expense Insurance Plan is designed to help solve this problem. It can pay up to $20,000 monthly during a covered disability to help provide the necessary funds for office expenses. You may avoid using your personal savings or diverting your regular disability benefits to stay in business.
The cost of this coverage is very competitive due to AAO’s group purchasing power. The cost can be deducted as a business expense under current IRS rules, if you are self-employed. Of course, tax considerations should be discussed with your attorney or accountant.
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Where can I find more information, and how can I apply?
- Review the Plan Details below
- Print, fill out, sign and date the application form,
and mail it to:
Plan Administration Office
159 E. County Line Road
Hatboro, PA 19040-1218
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| Is This Plan Right for You? |
| How Will You Benefit? |
| When Are Benefits Paid? |
| Here's How It Works |
| What Is the Future Increase Option? |
Plan Features
Who Is Eligible? |
| When Does Coverage Become Effective? |
| How Will You Know You're Approved for Coverage? |
| How and When Can your Coverage End? |
| Definitions |
| ANNUAL PREMIUMS |
| Premiums |
| What Is a Waiver of Premium? |
| Exclusions and Limitations |
| IMPORTANT NOTICE - How New York Life Underwrites Your Request for Insurance |
| For more information... |
| Administered by |
| Underwritten by |
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| Is This Plan Right for You? |
When you set up your practice you planned for everything. The one thing you probably didn't plan on was being disabled. Hopefully, the disability plan you selected will provide the coverage you need. But does your plan cover the overhead expenses that you must pay to keep your practice open while you're disabled? Probably not. Thanks to the AAO Endorsed Professional Overhead plan you can be sure that in the event of a covered disability you may receive up to $20,000 monthly, to help cover your office expenses. You may avoid using your savings or diverting your regular disability benefits to stay in business.
Due to AAO's mass purchasing power we are able to offer this coverage at a competitive cost. Under current IRS rules, the cost may be deducted as a business expense if you are self-employed. Of course, tax considerations should be discussed with your accountant.
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| How Will You Benefit? |
You may apply for $500 to $20,000 in $100 units. But the plan won't pay a benefit that exceeds the least of:- The overhead expenses actually incurred
- The monthly average of overhead expenses incurred in the 6 months before disability
- The monthly benefit level in force
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| When Are Benefits Paid? |
Benefits start on the 31st day of total covered disability and continue for up to 24 months while continuously disabled.
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| Here's How It Works |
Simply calculate your average monthly overhead for the past 6 months. These are the expenses that must be paid to keep your practice up and running in your absence.
COVERED EXPENSES INCLUDE:- Rent
- Principal and interest payments on outstanding business debts
- Utilities (heat, water, electricity, telephone, etc)
- Uniform and auto allowance
- Employees' salaries and payroll taxes
- Postage and stationery
- Equipment maintenance
- Monthly average of taxes on premises
- Accounting fees
- Professional membership dues/subscriptions
- Insurance premiums for:
- Professional Liability/Malpractice
- Workers' Compensation
- Employee Taxes
- Employee Medical Plans or
- General Liability
EXPENSES WHICH ARE NOT COVERED:- Salaries, fees, drawing accounts, profits or other remuneration to you or a partner
- Salaries of all persons hired after your disability began
- Charges for professional services of individuals in your profession
- Cost of goods, merchandise or office equipment
- Income taxes, or any expenses you would not reasonably be expected to incur while disabled
- Equipment depreciation
Note: If you are incorporated, or a partner, or a joint tenant, overhead expenses include only your share.
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| What Is the Future Increase Option? |
This Plan includes a Future Increase Option that allows you to receive additional benefit amounts, as long as you are under age 50, with no medical underwriting, provided you are not disabled on the effective date of the increase. Two hundred dollars of monthly benefits may be issued to you on any October 1st billing date prior to age 50, not to exceed a combined total of $1,000 per month. Obtaining additional coverage under this option is subject to the plan's benefit maximum of $20,000 and the requirement that all overhead expense insurance under this and other plans does not exceed your actual monthly overhead expenses.
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Plan Features
Who Is Eligible? |
If you are an orthodontist under age 65 residing in the U.S. or Canada and an AAO member who regularly works at least 20 hours a week, or a full-time student member, then you are eligible for coverage. All coverage is subject to approval by New York Life.
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| When Does Coverage Become Effective? |
In order to become insured, you must provide satisfactory evidence of insurability and pay the required premium. Insurance will take effect on the first day of the month following the date your coverage is approved by New York Life provided the initial premium deposit is paid to the Plan Administration Office within 31 days of that date and you are performing the normal activities of a person in good health of like age and sex on the later of the date of approval and the date the premium is paid.
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| How Will You Know You're Approved for Coverage? |
Once you are approved you will receive a Certificate describing your coverage under the Policy Form GMR.
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| How and When Can your Coverage End? |
New York Life cannot terminate coverage or change premiums on an individual basis; it may only do so on a class-wide basis. The benefits provided under the group policy may be changed upon agreement between New York Life and AAO. New York Life has agreed not to exercise its right to terminate the group policy as long as AAO Continues to endorse only the New York Life plan. While the group policy continues in force, you may renew your coverage until age 72. But coverage will terminate earlier if you cease active full-time work (at least 20 hours per week) before that time. You must continue to be an AAO member and pay your premium on time to renew your coverage.
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| Definitions |
Definition of Disability - You are totally disabled if, due to a covered illness or injury, you are unable to perform the substantial duties of your own occupation as a specialist in orthodontics for which you have been specifically educated and trained. You must also be under a physician's care and not working at any gainful occupation.
Definition of Successive Disability - Successive Disabilities are considered as on continuous disability unless separated by 180 days of active full-time work or due to entirely unrelated causes.
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| ANNUAL PREMIUMS |
ANNUAL PREMIUMS
Benefits are available from $500 to
$20,000 per month (in $100 units) |
Age |
Premiums
per $1,000 |
< 40
40-49
50-59
60-64
65-69*
70-72*+ |
$30
$50
$95
$170
$250
$390 |
+ Termination age date *Renewal only
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| Premiums |
Premiums for this AAO plan are payable semi-annually on October 1st and April 1st. To determine semi-annual premiums divide the above rates by two. All premiums are based on your age each October 1st and increase as you attain a new age bracket (e.g. 35, 40, etc.). New York Life reserves the right to change rates on any premium due date or on any date which benefits are changed.
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| What Is a Waiver of Premium? |
If you become totally disabled while insured before age 60 and remain so for 6 consecutive months, you may not have to pay premiums to continue your coverage while you remain disabled. This benefit is retroactive to the first day of disability.
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| Exclusions and Limitations |
Benefits are not paid for disabilities resulting from: war or military service; self-inflicted injuries (unless the injury is caused by an attempted suicide while insane); pregnancy, except for specific complications; or conditions for which an impairment restriction has been placed on your coverage. Benefits are not paid for the first 30 days of a disability.
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| IMPORTANT NOTICE - How New York Life Underwrites Your Request for Insurance |
Information regarding insurability will be treated as confidential. In considering your request for insurance, we will rely on the medical information you provide, and on the information you authorize us to obtain from your doctor, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, Inc. (Medical Information Bureau). New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. We may make a brief report to MIB; however, we will not disclose our underwriting decision. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a "need to know" basis in considering your request. Upon receipt of all requested information we will make a determination as to whether your request for insurance can be approved.
MIB is a non-profit, membership organization of life insurance companies, which operates an information exchange on behalf of its members. When you apply for insurance or submit a claim for benefits to a MIB member company, medical or non-medical information may be given to the Bureau, which may then be furnished to members companies.
If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information, generally medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB's information office is P.O. Box 105, Essex Station, Boston, MA 02112, telephone 617-426-3660. For Canadian residents, the address is 330 University Avenue, Suite 403, Toronto, Canada M5G 1R7, telephone (416) 597-0590.
For NM residents, PROTECTED PERSONS (1) have a right of access to certain CONFIDENTIAL ABUSE INFORMATION (2) we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request tot he Administrator at the address listed on the application. Please include your full name, date of birth and address.
(1) PROTECTED PERSON means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured or prospective insured.
(2) CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close personal, family or abuse-related counseling relationship.
If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean there is any insurance in force before the effective date is determined by New York Life.
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| For more information... |
Please contact us at the Plan Administration Office, 159 E. County Line Road, Hatboro, PA 19040-1218 or call toll-free: 1-800-622-0344 or fax us at: 1-800-527-8930
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| Administered by |
Affinity Insurance Services, Inc.
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| Underwritten by |
New York Life Insurance Company, New York, NY 10010
This brochure briefly describes the general highlights of the Insurance Plan, and is for illustrative purposes only. Please consult the insurance policy for complete details of all terms, conditions and exclusions.
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  Find out more about your member benefits today! |
Administered by:
Affinity Insurance Services, Inc.
Michael Loughran licensed in Arkansas (License#: 233963)
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