Disability (Long-term)

Long-term disability insurance is a type of insurance that provides income replacement for a person who becomes disabled and is unable to work for an extended period. Here are some key features of long-term disability insurance:

• Long-term disability insurance is designed to provide income replacement for an extended period of time, typically until retirement age.

• To be eligible for long-term disability benefits, an individual must be unable to perform the duties of their occupation due to injury or illness.

• Disability benefits typically replace a percentage of the individual's pre-disability income, usually ranging from 50-80%.

• The waiting period for long-term disability benefits can range from 30 days to 180 days, during which time the individual must be unable to work due to their disability.

• The benefit period for long-term disability insurance is usually 2, 5, or 10 years or until the individual reaches retirement age.

• The definition of disability varies among insurance policies, but typically requires the individual to be unable to perform the duties of their occupation for a certain period of time.

For example, let's say that John is a surgeon who has a long-term disability insurance policy. He injures his hand in a car accident and is unable to perform surgeries for an extended period. Because he is unable to perform the duties of his occupation, he qualifies for long-term disability benefits. His policy has a waiting period of 90 days and a benefit period until age 65. The policy provides a benefit of 60% of his pre-disability income.

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According to Mployer Insights’ 2026 analysis of 76,000+ employer benefit plans, disability insurance remains a major market differentiator, with only 41% of U.S. employers offering short-term disability (STD) and 38% offering long-term disability (LTD). While 60% salary replacement serves as the national standard across both benefit types, standard plan designs disproportionately expose higher earners due to median benefit caps of $1,602/week for STD and $8,273/month for LTD. Furthermore, alignment between STD benefit durations (median 26 weeks) and LTD elimination periods (68% at 90 days) remains a critical area for plan structure optimization.
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According to Mployer Insights’ 2026 analysis of 50,000+ employer health plans, prescription drugs account for over 25% of total benefit expenses, with Tier 4 specialty drugs driving the majority of high-cost claims. While Tier 4 copays average $123 with coinsurance requirements in 31% of plans, individual oncology therapies like Darzalex Faspro ($170,800/yr) and Keytruda ($158,200/yr) frequently exceed average individual stop-loss deductibles ($141,938). To mitigate exposure, self-funded employers are increasingly turning to independent, transparent PBM models and biosimilar substitution—which yields up to a 73% net cost reduction per patient.