Short Term Disability 8-11-2016 (updated 8-16-2016) Holly Nelson, - - PowerPoint PPT Presentation

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Short Term Disability 8-11-2016 (updated 8-16-2016) Holly Nelson, - - PowerPoint PPT Presentation

New Employee Benefit Short Term Disability 8-11-2016 (updated 8-16-2016) Holly Nelson, Sr. Account Specialist, Standard Insurance Company Becky Goins, Director of Employee Benefits, UAMS Human Resources Brad Loften, Senior Benefits Consultant,


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SLIDE 1

New Employee Benefit

Short Term Disability

8-11-2016 (updated 8-16-2016)

Holly Nelson, Sr. Account Specialist, Standard Insurance Company Becky Goins, Director of Employee Benefits, UAMS Human Resources Brad Loften, Senior Benefits Consultant, UAMS Human Resources

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SLIDE 2

How did we get here?

Over a year ago, began to explore ways to replace catastrophic leave program with a fully insured short term disability insurance plan. Goals:

– Provide a benefit to a larger number of employees than cat leave – Without increasing UAMS cost – And provide a benefit that employees have requested for years

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SLIDE 3

First, a review of Cat Leave

  • Rules are set by the State and are fairly stringent, subject to

decisions of campus committee

  • Eligible recipients must be off at least 6 weeks and have worked at

UAMS for at least 2 years

  • Cat leave is reserved for non-faculty employees for life threatening

illness

  • Employees “donate” unused sick time (primarily sick leave they

lose anyway when leaving UAMS)

  • Use of cat leave represents an added and unbudgeted cost to

departments since there are no real dollars attached to donations

  • Average of 100 employees are awarded cat leave annually at cost
  • f $1.2 mil.
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SLIDE 4

Transition from cat leave to STD

  • Current cat leave recipients as of Aug 31 will

continue, being phased out

  • No new cat leave applications for medical absences

beginning Sept 1 or later

  • Cat leave donations end
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SLIDE 5

NEW Short Term Disability

+ Projected to pay benefits to 500 employees per year, 5 x that of cat leave + Faculty are eligible + Will cover illnesses that don’t meet “catastrophic” criteria, including maternity + Makes us more competitive with local hospitals that offer short term disability

  • STD doesn’t replace 100% of salary that cat leave provided
  • STD only covers the employee’s illness. Loss of benefit for ~ 25 employees

each year who use cat leave for spouse/child’s serious illness

  • 12 weeks max STD benefit may not be enough to cover gap before Long

Term Disability kicks in

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SLIDE 6

Short Term Disability

  • Effective 9-1-2016
  • Fully insured group plan
  • Underwritten by The Standard Insurance

Company (same company that handles the UA life and disability plans)

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SLIDE 7

Short Term Disability

Who’s eligible?

Benefit-eligible employees covered in the group Basic Long Term Disability plan (for which UAMS pays the premium)

  • YES - Staff working 50% or more
  • YES - Faculty working 50% or more, including FGP
  • NO – Temps, student employees, grad assistants
  • NO – Housestaff/physician residents
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SLIDE 8

Protection from the Unexpected

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SLIDE 9

Disability Overview

9 August 11, 2016

  • What is your biggest asset?

(Hint: It’s you.)

  • Think of short term disability

insurance as insurance for a portion of your paycheck

  • It provides a monetary weekly

benefit if you’re unable to work because of a qualifying illness or injury

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SLIDE 10

Disability Statistics

10 August 11, 2016

One in four 20-year-olds will become disabled

Source: Social Security Basic Facts, April 2, 2014 Source: 8/9/16 Short-Term Disability claim data from University of Arkansas Fayetteville Campus.

Top 6 Causes of Short Term Disability Claims

Leading Disablers % of New Claims

1 2 3 4 5 6

Pregnancy 30 Musculoskeletal Condition 18 Circulatory/Heart 9 Back Condition 8 Mental Disorder 5 Reproductive/Urinary 4 & Respiratory (tied)

Average age of a STD Claim at the Fayetteville campus is 44.7 years

  • ld. Age range is 20-71 years old.
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SLIDE 11
  • Maternity
  • Musculoskeletal Conditions
  • Circulatory Problems/Heart Conditions
  • Back Conditions
  • Mental Disorders
  • Hysterectomy and other reproductive or urinary conditions
  • Respiratory Conditions
  • Fractures
  • Cancer
  • Diabetes
  • Digestive Conditions

Common STD Medical Conditions

11 Company Confidential August 11, 2016

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SLIDE 12
  • Workplace PossibilitiesSM

Program

  • Return To Work Incentive allowing

a part-time gradual RTW

  • Reasonable Accommodation

Expense Benefit

  • Telephonic Claim Submission

Disability Insurance Features

12 August 11, 2016

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SLIDE 13

Short Term Disability

What is the benefit?

60% salary replacement (same as Long Term Disability) when: – Your doctor states you will be unable to work for more than 2 weeks – And after you have exhausted your personal leave and are in LWOP (leave without pay) status (Maternity

exception: per state law, women on maternity leave can begin LWOP without first exhausting all accrued leave)

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SLIDE 14

Difference between STD and LTD

Long Term Disability Short Term Disability

6 month waiting period 2 week waiting period Paid for duration of disability, up to age 65 Paid for 12 weeks maximum Benefits paid monthly Benefits paid weekly

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SLIDE 15

Two Short Term Disability Plans

  • Basic STD: UAMS will cover first $45,000 of salary.

You pay zero. Max weekly benefit is $519.

How benefit is calculated: $45,000/52 = weekly salary of $863.38 x .60 = $519.23

  • Optional STD: Employees who make over $45,000

and up to $216,000 can buy-up additional coverage in a special open enrollment. Raises max weekly benefit to $2,492.

How benefit is calculated: $216,000 - $45,000 = $171,000/52 = weekly salary of $3,288.46 x .60 = additional $1,973.08 max weekly benefit. Added to $519.23 Basic = $2,492.31 total max weekly benefit.

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SLIDE 16

Premium Cost

  • Basic STD: .00348 x salary
  • Max premium UAMS (your department) will pay per

employee is $13.05/mo

  • Optional STD: .00802 x salary above $45,000
  • Cost to employee making $55,000 = $6.68/mo
  • Cost to employee making $100,000 = $36.76/mo
  • Cost to employee making $216,000+ = $114.29/mo
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SLIDE 17

How do I enroll?

  • HR will automatically enroll you in Basic STD. You don’t

have to do anything.

  • If you make over $45,000, you may enroll in Optional STD

during the special open enrollment period, Aug 1-19. Coverage will take effect Sept 1, 2016.

– Enroll on-line via ESS, Employee Self Service

  • TIP: Enroll now. If you wait and enroll in November when we

have annual open enrollment, you run the risk of pre-existing exclusion

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SLIDE 18

How is pre-existing treated?

  • Only applies to claims filed in the first 12 months of coverage
  • If you file a claim in the first 12 months, Standard will look

back 3 months to see if your condition already existed. This “look back” period means the 90 days before your coverage began.

  • Any condition already existing in that 90 day look back period

will be excluded.

  • But, current employees will be treated differently than new

employees

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SLIDE 19

For current “grandfathered” employees – those already working before Sept 1

Salary under $45,000 Salary over $45,000  No exclusion for pre-existing conditions

Remember, you will automatically be enrolled in Basic STD effective 9-1-2016.

 If you enroll in Optional STD effective 9-1-2016, no exclusion for pre-existing conditions  But if you wait until later to enroll in Optional STD, pre-existing conditions will be excluded in the first year of coverage

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SLIDE 20

For NEW employees who start work Sept 1 or later

Salary under $45,000 Salary over $45,000 Pre-existing condition exclusion will apply to all new employees, whether enrolled in Basic STD only, or Basic + Optional STD. Again, this only applies during their first year of coverage.

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SLIDE 21

Let’s look at some examples

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SLIDE 22

Mary

Mary has worked at UAMS since 2012. Her salary is $26,000. She has a baby on Sept 15. She has 3 weeks + 2 days leave time saved up and will off for 6 weeks, Sept 15-Oct 27. She wants to save 2 days sick leave for when she comes back to work.

  • What is Mary’s benefit for weeks 1-3?

– Paid leave

  • What happens weeks 4-6?

– Placed on LWOP in SAP – Receives Basic STD benefit of $300 per week (60% of $26,000)

Mary receives the full 60% STD benefit because she was actively at work on Sept 1 when the Basic STD policy took effect… and because her salary is under $45,000.

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SLIDE 23

Joan

Joan has worked at UAMS since 2014. Her salary is $52,000. She finds out she is pregnant in Oct 2016. She waits to enroll in Optional STD during November open enrollment for additional coverage effective Jan 1, 2017. She has a baby on April 5 and will take off a full 12 weeks FMLA (6 weeks of which are medical leave, rest are for bonding with the baby). She has 3 weeks leave time and she wants to use all of it.

  • What is Joan’s benefit for weeks 1-3?

– Paid leave

  • What happens week 4?

– Placed on LWOP in SAP – Starts to receive Basic STD benefit of $516 per week (60% of $45,000)

If Joan had enrolled in Optional STD in August, so it would be in effect 9-1-2016, her weekly benefit would have increased to $600 (60% of $52,000).

  • What happens after week 6?

– Not eligible for STD benefits because she is taking off 6 additional weeks to be with baby; she is not disabled any longer. No pay because did not have enough leave to cover FMLA protected absence of 12 weeks.

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SLIDE 24

John

John was hired in Jan 2016. He makes $80,000. He enrolls in Optional STD by Aug 19, for coverage effective Sept 1. He breaks his leg on Oct 3 while playing soccer and will be out for 12 weeks. He has 1 week leave saved up.

  • What is John’s benefit for week 1?

– Paid leave

  • Week 2?

– Placed on LWOP in SAP. Not eligible for STD yet, 2 week waiting period.

  • Weeks 3-12?

– Receives Basic STD benefit of $519 per week (60% of $45,000) PLUS Optional STD benefit of $404 (60% of salary above $45,000) for a total weekly benefit of $923.

John receives the maximum STD benefit because he was actively at work on Sept 1 and had enrolled in the Optional STD effective Sept 1.

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SLIDE 25

Harvey

Harvey is hired Sept 1. He makes $170,000. He is in a car accident 2 weeks later and will be on indefinite medical leave, perhaps permanently disabled. He enrolled in Optional STD and Optional LTD on his first day.

  • What is John’s benefit for weeks 1-2?

– No pay (2-week waiting period and he has no leave). Placed on LWOP in SAP.

  • Weeks 3-14?

– Receives Basic STD benefit of $519 per week (60% of $45,000) PLUS Optional STD benefit of $1,442 (60% of salary above $45,000) for a total weekly benefit of $1,961.

  • Weeks 15-26?

– STD ends, reached 12 weeks maximum benefit

  • Week 27 forward?

– LTD kicks in, same $1,961 benefit, for as long as he is disabled or reaches age 65

Pre-existing exclusion does not apply to accidents. And STD pays out even if Harvey’s department ends his employment rather than placing him on LWOP.

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SLIDE 26

Susan

Susan was also hired on Sept 1, at $70,000 salary. She was in the car with Harvey and will also be on medical leave indefinitely. But she did not enroll in Optional STD or Optional LTD.

  • What is Susan’s benefit weeks 1-2?

– No pay (2-week waiting period and she has no leave). Placed on LWOP in SAP.

  • Weeks 3-14?

– Receives Basic STD benefit for 12 weeks, $519 per week (60% of $45,000).

Her benefit would have been $807 if she had enrolled in Optional STD.

  • Weeks 15-26?

– STD ends. Reached 12 weeks maximum benefit.

  • Week 27 forward?

– LTD benefit kicks in, but reduced to weekly benefit of $230 because she only had the first $20,000 of her salary covered under the Basic LTD plan.

If Susan had enrolled in Optional LTD, her weekly benefit would have been $807 per week.

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SLIDE 27

Tips for smooth STD claim process

  • Employees: bank your leave time, particularly sick leave, so

that it will be there when needed. 100% salary replacement is always better than 60% under STD or LTD. File a claim as soon as you know you will be out more than 2 weeks – don’t wait until you think disability benefits would begin.

  • Managers: do not spread out an employee’s leave time.

Charge employee’s accrued leave based on their normal work schedule (no change from current policy). When employee runs out of leave, immediately place them on LWOP in SAP.

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SLIDE 28

Questions?

Contact: UAMS Office of Human Resources/Employee Services (501) 686-5650 AskHR@uams.edu 4th floor Central Building, wing 4C