Help with disability insurance claims

Log in to your account and go to the “reports” section. Please note it can take two to three days from when the claim was submitted for it to show on these reports. You can find out claim status, the analyst name, and contact information. If a disability claim is approved, the payment information can be found under Resources/Tax Reports.

As the employer, you should:

• Provide the employee online form link or your telephonic claim submission number, if applicable. The employee should sign in and submit the employee section of the claim form.
• Sign in to submit the employer section of the online claim form. If the employee completes the online or telephonic claim form first and we haven't received the employer section, we'll contact the employer for their information.
• Emphasize the importance to your employee of providing the claim form to their physician as soon as possible. Medical information is needed to evaluate the claim.
• Keep communication lines open with employees while they’re out. This helps them feel that they will be welcomed back after recovery.  
• Be open to temporary or flexible work arrangements while employees are recovering. A gradual (or part-time) return to work allows employees to return to their job more quickly while easing back into their normal duties. Our work incentive benefit helps this work for everyone.
• Show concern and compassion while respecting the employee’s privacy. Avoid asking about specific private health matters. Feel free to ask when they’re coming back to work and if there are any schedule accommodations or special equipment needed for their return.
• Discuss appropriate actions with our claim analyst.

No, a separate claim form isn’t required. Our integrated claim process includes: single notification of claim, 1 claim form, transition from STD to LTD upon receipt of forms returned from the claimant, early intervention, and case management.

If the group has life coverage with us, communication will be sent to the employee explaining what’s needed if they want us to review for the waiver of life insurance premium benefit.

Yes, occasionally we’ll request more information—usually additional medical documentation we’re missing. If the employee completes the online claim form or the telephonic claim form, we’ll contact you for additional information.

• If your company benefits are based on W-2 earnings for the prior calendar years, you’ll need to provide copies of W-2s from those years. For those employed less than the specified policy calendar years, we’ll need gross earnings from date of hire through the last day worked.
• If you're a business owner, please specify this on the form. We’ll be in contact to get more information in these cases.
• Contributory coverage and self-accounting groups, we request a copy of the enrollment form. This helps us verify that an employee enrolled for coverage on a timely basis. It also shows us what coverages are elected.

• Short-term disability—Our goal is to make the STD claim decision 10 business days after we receive the claim. If we need more information after the claim is submitted, that can affect the timing for the decision. Quick responses helps keep the claim process moving.
• Long-term disability—LTD decisions are made 45 days from the receipt of the claim or by the completion of the elimination period, whichever is later.  If additional information is needed, this could affect timing of our decision.

Short-term disability

STD benefits are issued on a weekly basis, at the end of the payment period. Payments are issued on the same day of the week as when the Elimination Period (EP) was met. For example, if the EP is met on Wednesday, payments are issued every Wednesday. For routine maternity claims, benefits will be paid in a lump sum payout for the approved duration period.

Long-term disability

LTD benefits will be issued on a monthly basis, on the same day as the benefit start date, similar to STD.

We offer 2 monthly payment options for most STD and LTD:

1. Check—We’ll mail a check to the employee’s address.
2. Electronic Funds Transfer (EFT)—Employees can elect to transfer their STD or LTD benefit funds to a bank account they designate.

Please note: STD and LTD benefits are issued after the benefit payment period has been met. This means the benefits are issued after the week or month has ended.

It depends on whether the “salary continuance offset” is included in the “other income source” definition of the policy or not.

• Policy includes salary continuance offset—The disability benefit is directly reduced by any salary continuance, sick pay or PTO paid. This doesn’t allow the employer to supplement income with these types of pay.
• Policy doesn’t include salary continuance offset—The employer can supplement the claimant’s income with salary continuance, sick pay or PTO. However, the weekly payment limit will prevent the claimant from receiving more than 100% of their pre-disability earnings.

• Insured businesses–We don’t withhold state or federal taxes. However, these can be withheld at the claimant’s request. FICA tax is withheld for 6 months from the date last worked.
• ASO business-applicable states–Federal, state and FICA tax are automatically withheld. State income tax is withheld if allowed by the claimant’s state of residence.

Short-term disability

Premiums are not waived, so premium should be continued while a person is receiving STD unless employment is terminated or LTD is approved.

Long-term disability

Premiums are waived when the LTD claim is approved, which is based on the date LTD benefits begin.

Log in to your account and go to the “Resources Tax Services” section. This will show you which tax services were elected and what your responsibilities are. If you need additional assistance, contact our accounting department at 866-309-1625.

When you hear "accommodations," you may think of permanent job changes, but that’s not necessarily the case. An accommodation can mean several things and isn’t always permanent. Restrictions that need accommodations can include limited sitting/standing, limited walking or no repetitive hand use.

• Reduced work schedule–Allows the employee to return to work part-time, gradually increasing to full-time over a period of time.
• Flexible work schedules–Allows the employee to come in earlier or later, or to take longer breaks. This can give an employee time for medical or therapy appointments, or simply a resting period.
• Equipment/worksite modifications–May include items such as scooters, walkers or wheelchairs to assist with walking. Or, desks, chairs, keyboards or foot stools to help with sitting restrictions. In addition, adaptive computer software phone headsets, or an increase in email or texting processes, may help with a variety of restrictions. 
• Remote work site–Allows an employee to work from home or an office closer to home, reducing lengthy commutes that may cause stress on an employee’s recovery.
• Job duty changes–Adapts specific tasks, such as separating heavier items to be lifted into smaller, more manageable weights. Or, perhaps job duties that the returning employee can’t handle could be temporarily assigned to another employee.

A claim is potentially payable if it begins after the effective date of coverage. However, if the employee has had coverage for 3 months or less at the time of disability or death, we may need to request additional documentation showing the employee was actively working at the time they were eligible for coverage. 

Additional documentation could include, but is not limited to:

• Redacted emails
• Purchase orders
• Driving logs
• Signed and dated work documents
• Other documents may vary dependent on an employee’s job/occupation