8.24 – Group Long-Term Disability Insurance

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Details

Scope: NMSU System

Source: ARP Chapter 8 | HR-Benefits

Rule Administrator:

Last Updated: 06/27/2016

Related

Cross-Reference:

Revision History:

2017 Recompilation, formerly Rule 7.15.25
06/27/16 Change in Benefits approved by Board of Regents
06/21/16 Change in Benefits approved by Chancellor
10/21/15 Policy 7.15.05 approved as initial Rule 7.15.05 approved by Board of Regents
06/20/13 Amendment to policy 7.15.25 approved by Board of Regents

A. Eligibility


The university offers group long-term disability insurance for all eligible employees.  Effective July 1, 2016, eligible employees are defined as those employees working at least .75 FTE in a regular, nine-month, or term appointment position.  Nine -month regular employees will receive full benefits, except for unemployment compensation, during the off employment period provided they return to employment the following academic year.  Eligible employees also include any employee continuously enrolled in this benefit from June 30, 2016.

Employees working in a position less than a .75 FTE; temporary employees; graduate assistants; other student employees; and Cooperative Extension Service employees with federal appointments are not eligible to participate in the group policy.

 

B. Effective Date of Coverage


Coverage is optional and is available from the date of eligible employment.  Coverage is effective the first pay period after 30 days of employment. Coverage may begin on the first or sixteenth day of the month. Employees must complete and return an enrollment form to the Office of Human Resource Services department within 31 calendar days of their regular date of employment to receive this benefit without late enrollment provisions.

 

C. Enrollment Procedures


At the time of eligible employment new employees will be required to complete an enrollment form to either enroll in or waive coverage within the first 31 days of employment.  If an employee does not complete an enrollment or waiver form within 31 days of eligible employment, then the employee will automatically waive his/her right to long-term disability coverage and will be subject to approval by the long-term disability carrier for coverage to begin.

 

D. Premium Payments


Premium payments are made by payroll deduction, and the university pays a percent of the premium.  Premium payments begin the pay period in which coverage begins. Note: A full fiscal year of premiums (July-June) will be deducted over 18 paychecks (August-May) for 9 month faculty/staff.

 

E. Application for Benefits


When an employee is disabled, it is the employee’s responsibility to notify the Office of Human Resource Services. The Application for Disability and a Physician’s Statement of Disability must be completed and returned directly to the insurance carrier for processing to request benefits to be paid under this program, along with the Employer Statement. The Employer Statement can be requested from the Office of Human Resource Services. The long term disability carrier will not process incomplete applications.

 

F. Pending Approval for Claims


The employee can request to be placed on paid leave if sick leave or annual leave are available or request to be placed on leave without pay while the carrier processes the application.  If the application is denied, then employment may be terminated if the employee is unable to return to work.

 

G. Employees on Long-term Disability


Employees who qualify and receive a long-term disability benefits will:

  1. Use all remaining sick and annual leave to offset long-term disability benefits. Total compensation, to include annual/sick leave and long-term disability benefits, may not exceed the employee’s regular rate of pay unless a minimum disability benefit is being paid by the carrier.
  2. If still employed at the time of approval for disability payments, be placed on extended leave without pay for up to one year from the date the disability benefits are effective. If the employee is able to return to work within one year from the date disability benefits are effective, when possible, the university will assist the employee in finding an appropriate position for which they are qualified during the first 90 days after becoming eligible for employment. If an appropriate position is not available or the employee refuses the offered position, the employee may be terminated.
  3. Be required to submit a copy of their certificate of continued disability to the insurance company as required by the policy.
  4. Retire or terminate at the end of one year, and in order to retain other applicable insurance benefits during that year, the employee must pay premiums like any other employee on LWOP.
  5. If the employee qualifies and decides to retire, the employee may continue medical insurance the same as any other retiree, provided the medical benefits remained in effect during the leave of absence.

 

H. Coverage After Retirement or Termination


Coverage is not available after retirement or termination.  Coverage ceases at midnight on the 15th day of the month if employment terminates between the 1st and 15th day of the month, provided the applicable premium for the pay period has been paid. If an employee terminates employment between the 16th and last day of the month, coverage ceases at midnight on the last day of the month, provided the applicable premium for the pay period has been paid.

 

I. Coverage During Leave Without Pay


During periods of leave without pay employees have limited access to continue long term disability coverage and should consult with the Office of Human Resources for details.

 

J. Discontinuing Coverage


An employee who discontinues coverage and then wishes to re-enroll in the future will be required to submit evidence of insurability as specified by the carrier and may include a medical examination at the employee’s expense.  Reinstatement of coverage is not automatic and is subject to approval or disapproval by the university’s insurance carrier.