Attachment V - Hybrid STD Benefit Summary.pdf
PDF 202 KB Posted
- Attached to
- RFP 26-025-CJ GCPS- Employee Medical, Stop Loss, Dental, Vision, Disability & Voluntary Benefits Coverage
- Solicitation number
- RFP-115259
- Issued by
- Frederick County, Virginia
About this file
This is a Hybrid Short-Term Disability (STD) Benefit Summary document for Standard Insurance Company outlining group disability coverage for eligible employees of local public entities in Virginia participating in the state's hybrid retirement program. The document details the STD benefit program structure, which provides weekly income replacement for covered members experiencing disability. Eligibility requirements specify that members must be regular employees of participating employers actively working at least 10 hours per week and be U.S. or Canadian citizens or residents. Members become eligible for work-related disability coverage on their first day of employment or the program effective date, whichever is later, while non-work-related disability coverage requires 12 months of continuous participation. The benefit waiting period is seven calendar days of continuous disability before weekly benefits become payable, with a maximum benefit period of 125 work days.
The weekly benefit structure provides 60 percent income replacement of predisability earnings for work-related disabilities during the first 60 months of continuous participation, with varying replacement percentages thereafter based on tenure ranging from 60 to 120+ months of continuous participation. For non-work-related disabilities, the program provides similar replacement structures but with a 12-month employment requirement before coverage begins. The program is employer-funded with no minimum weekly benefit requirement, and Standard Insurance Company serves as the claims administrator responsible for receiving, processing, investigating, and making initial decisions on claims, while employers retain final review and appeal authority. Additional features include 24-hour coverage for work-related disabilities, assisted living benefits, return-to-work incentives, and temporary recovery provisions.
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Text version
Benefits at a Glance for Hybrid Disability Coverage
Standard Insurance Company 1100 SW Sixth Avenue Portland OR 97204
HDC
SI 14903 1 of 3 (5/19)
Group Short Term Disability Benefit Program Group Short Term Disability (STD) Benefit Program from Standard Insurance Company (The Standard) helps provide financial protection for covered members by promising to pay a weekly benefit in the event of a covered disability.
The cost of this benefit program is funded by your Employer.
Employer means any unit of local government or other local agency, public entity, school, jail, department, board, or authority in the Commonwealth of Virginia which a) is eligible for and is participating in the Virginia hybrid retirement program described in §51.1-169 of the Code of Virginia,
b) has signed a group application with The Standard, and c) whose participation under the Program has been approved in writing by The Standard.
Eligibility
Definition of a Member You are a member if you are:
• A regular employee of the Employer who is participating in the Virginia hybrid retirement program described in § 51.1-169 of the Code of Virginia;
• Actively At Work at least the minimum hours per week required by the Employer for coverage under the Program, but in no event less than 10 hours each week (for purposes of the Member definition, Actively At Work will include regularly scheduled days off, holidays, or vacation days, so long as the person is capable of Active Work on those days); and
• A citizen or resident of the United States or Canada.
You are not a member if you are a temporary or seasonal employee, full-time member of the armed forces, leased employee or an independent contractor.
Eligibility Waiting Period You are eligible on one of the following dates, but not before the effective date of your Employer’s participation under the Program:
• With respect to coverage for a disability arising out of or in the course of employment with the Employer, the later of i) your first day as a member, and ii) the Program Effective Date.
• With respect to coverage for any other disability, the first day after one year employment with the Employer.
Standard Insurance Company 1100 SW Sixth Avenue Portland OR 97204
HDC
SI 14903 2 of 3 (5/19)
Benefits
Weekly Benefit
For a disability arising out of or in the course of employment with the Employer:
The STD Benefit provides income replacement for (i) 60 percent of a member’s predisability earnings for the first 60 months of continuous participation in the Virginia hybrid retirement program described in § 51.1-169 of the Code of Virginia and (ii) thereafter, a percentage of a Member’s predisability earnings during the periods specified below, based on the number of months of continuous participation in the Virginia hybrid retirement program attained by an employee who is disabled, on maternity leave, or takes periodic absences due to a major chronic condition, as determined by the Board or its designee, as follows:
Months of Continuous Participation
Work days of 100 percent Replacement of Creditable Compensation
Work days of 80 percent Replacement of Creditable Compensation
Work days of 60 percent Replacement of Creditable Compensation
Fewer than 60 0 0 125
60-119 85 25 15
120 or more 85 40 0
For any other disability:
The STD Benefit provides income replacement for (i) 60 percent of a member’s predisability earnings after 12 months of continuous participation through the first 60 months of continuous participation in the Virginia hybrid retirement program described in § 51.1-169 of the Code of Virginia and (ii) thereafter, a percentage of a Member’s predisability earnings during the periods specified below, based on the number of months of continuous participation in the Virginia hybrid retirement program attained by an employee who is disabled, on maternity leave, or takes periodic absences due to a major chronic condition, as follows:
Months of Continuous Participation
Work days of 100 percent Replacement of Creditable Compensation
Work days of 80 percent Replacement of Creditable Compensation
Work days of 60 percent Replacement of Creditable Compensation
Fewer than 12 0 0 0
12-59 0 0 125
60-119 25 25 75
120-179 25 50 50
180 or more 25 75 25
Minimum Weekly Benefit None
Benefit Waiting Period Your weekly benefit becomes payable after you have been continuously disabled for 7 calendar days.
Standard Insurance Company 1100 SW Sixth Avenue Portland OR 97204
HDC
SI 14903 3 of 3 (5/19)
Definition of Disability For the benefit waiting period and while the STD benefits are payable, you are considered disabled if you:
• Are unable, as a result of physical disease, injury, pregnancy or mental disorder, to perform with reasonable continuity the material duties of your own occupation; or
• You are working but, as a result of physical disease, injury, pregnancy or mental disorder, you are unable to earn 80 percent or more of your predisability earnings
You will no longer be considered disabled when your earnings from any occupation meet or exceed 80 percent of your predisability earnings.
Maximum Benefit Period 125 work days
Other Features and Services
• 24 hour coverage, including coverage for work-related disabilities
• Assisted Living Benefit
• Return to Work Incentive
• Temporary Recovery Provision
This is an employer-funded short term disability income benefit (Program) for certain employees of local public entities whose participation under the Program has been approved in writing by The Standard. Employers are solely responsible for payment of all risks, liabilities, benefits and claims under this Program.
The Standard acts as Claims Administrator for the Program with respect to all claims for benefits submitted to The Standard for administration and management. The Standard shall receive, process, investigate and evaluate claims for benefits. The Standard has authority to make initial decisions to approve, deny or close claims for benefits. The Standard is also authorized to review and decide appeals of denied or closed claims, if requested by claimants as provided in the appeal provision of the Program. Thereafter, the Employer may elect to hear and decide any further appeals by claimants. In each case, the Employer retains the right of final review and decision on all claims and appeals.
The Standard will also perform certain administrative services for the Program, including advising and assisting Program Sponsor with preparation and revision of the Program. The Standard and Program Sponsor has no authority or obligation with respect to management or investment of the assets of the Program or Employer’s right of subrogation under the Program.
This information is only a brief description of the STD benefit program administered by The Standard. The controlling provisions will be in the Program Document. The Program Document contains a detailed description of the limitations, reductions in benefits, and exclusions. The Program Document that describes the terms and conditions of the coverage is available for those who become covered according to its terms.
For more complete details of coverage, contact your human resources representative.
| Group Short Term Disability Benefit Program |
| Eligibility |
| Definition of a Member |
| Eligibility Waiting Period |
| Benefits |
| Weekly Benefit |
| Minimum Weekly Benefit |
| Benefit Waiting Period |
| Definition of Disability |
| Maximum Benefit Period |
Other Features and Services
File details come from the government source that posted it. Updated .