Benefits Administration Manual Training - PowerPoint Presentation

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BenefitsAdministrationManual Training

Benefits Program Analyst

Monica Hernandez

(916) 324-0533

(855)238-3276 Fax

m

onica.hernandez@calhr.ca.gov

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IntroductionWe will go over the following programs:Common Carrier Travel and Accident Insurance

Group Term Life Insurance

Long Term DisabilitySlide3

EligibilityThese programs are for designated excluded employees.

P

lease visit the BAM section for each program to find more information on eligibility.Slide4

COMMON CARRIER TRAVEL and ACCIDENT INSURANCESection 801.1Slide5

801.1 General InformationA state-paid benefit provided for managers, supervisors, confidential, and other specified excluded employees that are required to travel on state business away from the premises where he/she is permanently assigned.

STARR Indemnity & Liability is the current carrier for this program. Slide6

801.2 Eligibility Employees designated managerial, supervisory, confidential, and other specified excluded

employees.

Please visit the BAM Section for more

information.Slide7

801.5 Level of CoverageEligible employees are covered up to $150,000 for accidental death and dismemberment.

If an insured employee suffers more than one loss as a result of an injury and the loss occurred within one year after the date of the accident, only the larger of the sums will be paid.Slide8

801.6 ExclusionsBenefits will not be paid for a loss that is caused by or results from:

Intentionally self-inflicted injuries

Suicide or any attempted threat

More information found in the BAM.Slide9

801.7 EnrollmentEnrollment is automatic, once the employee’s PAR has been keyed and the information has been submitted to State Controller’s Office.

The effective date of coverage is the date the employee is appointed to an eligible classification.Slide10

801.8 Beneficiary DesignationBenefits payable under this program will be paid according to the standard order of beneficiary.

For additional information please contact:

Department of General Services

Office of Insurance and Risk Management (ORIM)

(916) 376-5278Slide11

Reporting a Covered LossDepartment personnel offices are responsible for immediately reporting the death or a covered loss of an insured employee to:

Department of General Services

Office of Insurance and Risk Management (ORIM)

(916) 376-5278Slide12

For more informationReview BAM Section 801.1

Common Carrier Travel & Accident Insurance

http://

www.calhr.ca.gov/state-hr-professionals

Contact DGS, Office of Risk Management (ORIM)

(916) 376-5278

CalHR

(916) 324-0533Slide13

BASIC GROUP TERM LIFE INSURANCESection 801Slide14

801 General InformationA state-paid benefit provided for managers, supervisors, confidential, and other eligible excluded employees.

Metropolitan Life Insurance Company (MetLife) is the carrier for this program.Slide15

802 EligibilityIs designated managerial, supervisory, confidential, and other eligible excluded employees.

M

ore information on the eligibility criteria is listed in the BAM.Slide16

803 Level of CoverageManagers:$50,000 policy

with Accidental Death and Dismemberment

Supervisors

,

Confidential,

and Specified

Excluded:

$25,000 policy

with Accidental Death and DismembermentSlide17

804 EnrollmentEnrollment is automatic, once the employee’s PAR has been keyed and the information has been submitted

to The

State Controller’s Office

.

To be effective the 1

st

of the following month, the PAR must be keyed by the 10

th

of the month.Slide18

Age 70The policy for active enrolled excluded employees, when they reach age 70, their employer-paid life insurance premium and benefit will be reduced by 50% on January 1 of the following year.

$50,000 will reduce to $25,000

$25,000 will reduce to $12,500Slide19

805 Supplemental CoverageEmployees may elect coverage amounts in increments of $10,000 up to eight (8) times their basic annual earnings, not to exceed $750,000, whichever is less.

Monthly premiums are based on an employee’s age and are adjusted annually on January 1 of each contract year. Slide20

805 Continuation of Supplemental CoverageEmployees can also purchase dependent coverage for their spouse or registered domestic partner and unmarried dependent child(ren) up to age 23, at a flat monthly rate based on employee’s age

Eligible dependent child(ren) from birth to six months are insured in the amount of $750.Slide21

Purchasing Supplemental InsuranceEmployees interested in purchasing supplemental life insurance coverage should contact:

MetLife

(800) 252-8524

An administrative fee of 50 cents is added to supplemental.Slide22

Cancellation of Supplemental CoverageEmployees may cancel their supplemental coverage at any time by submitting a written request to:

MetLife

Attn: Group Policy #74503

425 Market Street, Ste. 970

San Francisco, CA 94105Slide23

806 Accelerated Benefit OptionAllows an employee who suffers from a terminal illness to receive partial payment of the insurance benefit prior to death. Employees should contact:

MetLife

(800) 252-8524Slide24

807 AssignmentEligible employees are able to assign their Basic Life and Accidental Death and Dismemberment Policy. Employees should contact:

MetLife

(800) 252-8524Slide25

808 Beneficiary DesignationBenefits payable under this program are paid according to the standard order of beneficiary that the employee filed with MetLife.

If no beneficiary is on file, then benefits will be paid to the standard order of beneficiary.Slide26

Beneficiary FormNeed a beneficiary form?

Contact

MetLife at (800) 252-8524

Visit website

https

://

www.metlife.com/soc

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809 Reporting a DeathDepartment personnel offices are responsible for immediately reporting the death of a covered employee.

MetLife

(800) 252-8524

Or

CalHR

(916) 324-0533Slide28

810 Involuntary Re-designation Upon an employee’s involuntary change from an excluded designation to a represented designation, the employing department must pay for 12 months of basic life insurance premiums in the amount of:

$100.20 for managerial coverage of $50,000

$52.80 for supervisory/confidential of $25,000Slide29

810 Involuntary Re-designation continuedSubmit a cover memo and mail check to

MetLife

Attn: State of California Policy Administrator Policy #74503

425 Market Street, Suite 970

San Francisco, CA 94105Slide30

810 Leave of Absence/Disability Department personnel offices are responsible to provide information to employees who will be going out on a leave of absence or disability.

It is the employees responsibility to contact MetLife, 30 days prior or within 30 days of their leave of absence, should they want to continue coverage.Slide31

810 SeparationDepartment personnel offices are responsible for providing information to employees, upon separation.

Employees have 30 days to convert the basic and/or supplemental insurance to an individual plan.

E

mployee must contact:

MetLife

(800) 252-8524Slide32

810 Retirement Department personnel offices are responsible for providing information to retiring employees.

Employees who wish to continue their basic and/or supplemental life insurance coverage into retirement, must contact MetLife

30 days prior or within 30 days

of retirement.

MetLife

(800) 252-8524Slide33

For more information

Review BAM Section 801

Basic Group Term Life Insurance

www.calhr.ca.gov/state-hr-professionals

Contact CalHR Benefits Division

(916) 324-0533

Contact MetLife

(800

)

252-8524

www.metlife.com/soc/index.html

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LONG TERM DISBILITY (LTD)SECTION 901Slide35

901 General Information This benefit is intended to provide income protection in the event an employee becomes disabled due to an illness or injury and is unable to work for six months or longer.

The Standard Insurance is the carrier for this program.Slide36

902 EligibilityEmployees designated managerial, supervisory, confidential, and eligible excluded employees.

Limited Term appointments who otherwise meet this eligibility criteria may enroll in LTD only if they have a mandatory right of return to a position and status that also meets this criteria.Slide37

902 Eligibility ContinuationPermanent Intermittent employees are not eligible.

If an employee has a reduction in time base/salary, it is the employee’s responsibility to submit a new form to reduce monthly premiums.

Please visit the BAM Section for

eligibility information.Slide38

904 Level of BenefitsThe program offers two monthly benefit plan options:

55% of the first $18,182 or

65% of the first $15,385

o

f the employee’s pre-disability earnings (monthly base salary), reduced by other deductible income benefits. Slide39

905 Disability Claim Elimination PeriodAll claimants must complete an elimination period, which is the first six months of disability.

The employee must be under the continuous care of a physician during the elimination period.Slide40

905 Disability Claim Elimination Continued During the elimination period, the employee is responsible for paying the monthly LTD premiums directly to Standard Insurance.

Therefore, it is the responsibility of the department personnel office to inform the employee to pay the premium when the deductions is not paid from the pay warrant.Slide41

906 Pre-Existing LimitationsThere are pre-existing limitations.

Please use the BAM for details.

Standard Insurance will determine this on a case by case situation. Slide42

911 Annual Premium UpdateOn January 1 of each year, an annual age/salary update is conducted for all enrolled employees in the LTD Program.

Therefore, the LTD premium will change, for employees who move into a different age bracket or who has a salary change in the previous year.Slide43

912 Enrollment Newly eligible employees have 60 days from date of eligibility to enroll.

The department personnel office is responsible to notify and provide the LTD form to their newly eligible employees. Slide44

912 Open EnrollmentIt is the department personnel office’s responsibility to notify their eligible employees of open enrollment. Which is conducted annually April 1-30.Slide45

913 Ordering Forms CalHR does not maintain a supply of forms for distribution to departments.

You can order supplies by contacting

Standard Insurance

(855) 641-7193

Emailing:

socltdforms@standard.com

Website:

www.standard.com/mybenefits/california

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915 Claims Process/ProceduresIt is the department personnel office’s responsibility to notify CalHR when the enrolled employee files a worker’s compensation claim or before the 6 month elimination period is completed.

CalHR, Benefits Division; LTD Program

(916) 324-0533Slide47

915 Waiver of PremiumsDuring the 6 month waiting period, employees must continue to pay their LTD premiums.

If the claim is approved, the premium deduction will be administratively cancelled by CalHR.

Upon return to work (if still eligible) the employee must re-enroll. Department personnel offices are responsible to notify employee.Slide48

916 Loss of EligibilityTransfer to Rank and FileEmployee may enroll in the 24 month direct pay program.

Separation/Leave of Absence

Employee has 30 days to convert their group LTD coverage to a limited individual disability plan.Slide49

916 Loss of Eligibility ContinuedRetirementThere is NO conversion privilege when the employee retires.

It is the department

p

ersonnel office’s responsibility to provide this information to the employee.Slide50

917 Changing Plan CategoriesEmployees who change categories from

Miscellaneous/Non-Safety to

Peace Officer/Firefighter/Safety/Non-OASDI or

Vice versa

n

eed to complete another enrollment form and check the box “Changing Plan Option” and submit to their personnel office. Slide51

918 Cancellation of CoverageEmployees may cancel LTD coverage at any time.

By

c

ompleting

an LTD Enrollment form, indicating “

cancellation

” of

coverage and submitting

to their personnel office.Slide52

918 Cancellation of CoverageSubmit a written request

to:

State Controller’s Office

Attn: Miscellaneous Deductions Unit

300 Capitol Mall, 10

th

Floor

Sacramento, CA 95814Slide53

For more information…Review Bam Section 901 Long Term Disability

www.calhr.ca.gov/state-hr-professionals

Standard Insurance

(888) 641-7193

www.standard.com/mybenefits/california

CalHR

(916) 324-0533