Pre-Disability Earnings is defined as your monthly rate of earnings from the County that were in effect on your last full day of active work, but does not include bonuses, commissions, shift differential pay, overtime pay, your employer’s contributions to any deferred compensation arrangement or pension plan or any other “extra” compensation. Note: Pay increases during your disability will not increase your LTD benefit payment.
Deductible Income is defined as sick pay, annual or personal leave pay, severance pay, or other salary continuation, including donated amounts, (but not vacation pay) which exceeds 100% of your Pre-Disability Earnings.
The payment of the minimum LTD benefit plus your County pay for your leave accruals may result in more than 100% of your pre-disability earnings. When an employee receives payment for leave accruals, the LTD benefit will be reduced so that the leave accruals paid plus the LTD benefit will not exceed 100% of the employee’s Pre-Disability Earnings. In essence, this means that the LTD benefit will be LESS than it could be. Typically, this occurs when an employee has full leave accruals instead of only coding the 33.3% required to coordinate leave balances. If you have deductible income that is reducing your LTD payments, please contact your Department Representative and ask that your time sheet be changed to reduce the number of leave bank hours reported.
Minimum LTD Benefit – You will receive a minimum payment of $100 or 15% of your LTD Benefit before reduction by deductible Income, whichever is greater. This benefit is paid when you are using full leave accruals (see Deductible Income above).
If you mistakenly code leave hours for a full County pay warrant, you will need to request a time sheet correction from your Human Resources Department Representative. You will then notify Standard Life about the change in your leave hours. Standard Life will request verification of your earnings after the change. In this case, you should be prepared to:
- Repay your leave hours to the County; and
- Repay the any minimum LTD benefit paid as you may not receive more than 100% if you are fully integrating your leave hours with your LTD benefit. (A minimum LTD benefit is only paid when you are fully using your leave hours and no LTD benefit can be made without exceeding 100% of your pre-disability earnings.)
Determining Your Weekly Benefit – The following rules apply to computing your monthly rate of earnings:
- Annual Pay – if you are paid on an annual contract basis, your monthly rate of earnings is one-twelfth (1/12th) of your annual contract salary.
- Hourly Pay – If you are paid hourly, your monthly rate of earnings is based on your hourly pay rate multiplied by the number of hours you are regularly scheduled to work per month, but not more than 173 hours.
- Variable Hours – If you do not have regular work hours, your monthly rate of earnings is based on the average number of hours you worked per month during the preceding 12 calendar months (or during your period of employment if less than 12 months), but not more than 173 hours.
When to File a Claim – You should initiate your claim for benefits as soon as you are hospitalized or when you believe your disability will last beyond the waiting period. To avoid payment delay, you should file your claim as soon as possible. You must file the claim within 90 days from the date of disability or as soon thereafter as reasonably possible.
How to File a Claim – Obtain a LTD claim application (SI 3379), under the "Forms" tab on this benefits website.
The LTD application (SI 3379) consists of four parts:
- The Employee’s Statement – You need to complete this portion of the application and immediately send it to Standard Insurance Company.
- The Authorization to Obtain Information – You need to complete this portion of the application and send it with the Employee’s Statement to Standard Insurance Company. This permits Standard Insurance Company to request information necessary to determine your eligibility for benefits.
- The Attending Physician’s Statement – You provide this portion of the application to your physician to complete. The Physician must mail this portion of the form directly to Standard Insurance Company. Any expenses charged by your physician’s office to complete this paperwork is your responsibility.
- The Employer’s Statement – This portion is completed by Human Resources, Employee Services Division. The Employee Services Division will mail this portion of the application directly to Standard Insurance Company.
Standard Insurance Company will be unable to process your claim until all forms are received. Standard Insurance will require written proof of your disability to determine benefits. If this proof is not provided within 60 days after Standard Insurance requests information, your claim may be denied.
Deadline to File a Claim – No claims will be accepted after one year from the end of the 90 day claim filing period. Claims not filed timely will be denied and benefits will not be paid. These time limits will not apply during any period when you lacked the legal capacity to file a claim.
Where to File a Claim – Your LTD benefits are insured by Standard Insurance Company. Your application for benefits is submitted to:
Group LTD Benefits
Standard Insurance Company
P.O. Box 2800
Portland, Oregon 97208-9929
Claim Payment – Benefits will be paid within 60 days after receiving all documentation required to establish the eligibility of your claim. To check the status of your claim, please call Standard Insurance’s Long-Term Disability Insurance Department at (800) 368-1135.
Maximum Duration of LTD Benefits – Your LTD benefit payments will continue until one of the following occurs:
- For disabilities which prevent you from performing the duties of your own occupation, benefits will be paid for up to 24 months.
- For disabilities which prevent you from performing any occupation, benefits will be paid for up to the Maximum Benefit Period.