Disability Financial Impact Analysis

Our disability insurance is intended to “fill the gaps” in your leave and disability retirement benefits. To see a detailed financial impact exhibit on how our program enhances your existing benefits complete the following information and we’ll send it over to you

All Fields Required

Your Name:
Phone: xxx-xxx-xxxx
 
Email:
 
Date of Birth: mm/dd/yyyy
Base Annual Salary: $ddd,ddd
 
Are you currently enrolled under the The Standard disability insurance plan?:
 
Special Group Qualification please check if covered
I am a Law Enforcement Officer, Firefighter, or Air TrafficController covered under the "Special Groups" retirement provisions of FERS?
I am currently receiving LEAP (Availability Pay).
 
How many 'Years of Service' do you have?
How much leave (hours) do you have saved?
What is your current 'High 3' salary?
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