Expanded group WGA shortfall insurance
Informatiedocument over het verzekeringsproduct
- Onderneming:
- Elips Life Ltd, life insurer, license: 110355 (LI)
- Product:
- WGA Plus-verzekering
This document only provides a summary of the key features of the insurance. You will find all the terms and conditions in the policy conditions.
If an employee becomes incapacitated for work, the Employee Insurance Agency (UWV) may grant a WGA benefit after 104 weeks of illness. With the WGA Plus insurance, you insure a supplement to this WGA benefit for your employees.
If an employee comes under the scope of the Work and Income (Capacity for Work) Act (WIA), they will receive WIA benefits. The WIA has two benefits: a benefit under the Fully Disabled Persons Income Scheme (IVA benefit) and a benefit under the Return to Work (Partially Disabled Persons) Regulations (WGA benefit). The WGA has three different benefits (pay-related, the pay top-up and the follow-up benefit). More information can be found on the UWV’s website.
The insurance supplements the WGA benefit in case of partial incapacity for work. If 50% or more of the residual earning capacity as determined by the UWV is used, the benefit is 75% of your employee’s income before they became ill, minus 75% of the income they still earn, minus the WGA benefit. If less than 50% of that residual earning capacity is used, the benefit rate is not 75%, but 70%.
If an employee comes under the scope of the Work and Income (Capacity for Work) Act (WIA), they will receive WIA benefits. The WIA has two benefits: a benefit under the Fully Disabled Persons Income Scheme (IVA benefit) and a benefit under the Return to Work (Partially Disabled Persons) Regulations (WGA benefit). The WGA has three different benefits (pay-related, the pay top-up and the follow-up benefit). More information can be found on the UWV’s website.
You insure all your employees who must be insured for the employee insurance, including employees on temporary contracts.
We reimburse all or part of the reintegration costs that we have pre-approved in writing.
We will not pay if the employee was ill or incapacitated for work when they took up employment. We will also not pay if the employee was already sick or incapacitated for work when you took out the insurance.
If a sick or incapacitated employee takes up employment due to a change in the business situation, such as a merger or acquisition, they are not covered by this insurance.
We will not pay if fraud has been committed.
We will not pay if:
An employee will not receive a benefit under this insurance if they:
The salary above the WIA wage limit is not co-insured. The government determines the WIA wage limit.
This insurance applies to employees paying income tax in the Netherlands and provides worldwide coverage.
Let us know if an employee is incapacitated for work within 42 weeks of their first day of illness. Also register new employees with us as soon as possible.
You and your sick employee must do everything possible to ensure that the employee can return to work. You and your employee must comply with the policy conditions and the obligations imposed by the UWV.
All information required to implement this insurance must be made available to us. This includes income data and changes in the degree of incapacity for work.
Health
If you request this insurance, we will not ask about your employees’ health.
You pay the premium each year. The premium must be paid within thirty days of the invoice being sent. If the premium is not paid after a reminder and a final payment deadline, the cover lapses.
Premium
Your premium percentage depends on the type of business you run and factors such as your employees’ salaries and ages, and the number of employees who have been previously incapacitated for work.
The insurance starts on the date specified in the policy. The standard policy term is three years. At the end of those three years, we will make you a proposal to renew your insurance.
Your employee’s cover ends at their state pension (AOW) age, when they leave their employment, on their death or ontermination of the insurance. The benefit runs until their state pension age at the latest.
If you fail to pay the premium on time, we can terminate the insurance.
Give us written notice of termination no later than two months before the end of the first contract term. After the first contract term, you can give notice of termination of the insurance on any day in writing subject to a one-month notice period.