1. How do I know which coverage(s) I am currently enrolled for?
If you would like to confirm which coverage you are already enrolled for, you may call MGIS, Duke's plan record keeping administrator, at 1-800-969-6447 x 184. You may also email MGIS at firstname.lastname@example.org.
2. How do I enroll for coverage?
You can find an enrollment form here. If you are enrolling more than 30 days after your initial eligibility date, then you will need to submit the Personal Health Application with your enrollment form.
3. Can I enroll for coverage now if I am currently out of work due to a disabling condition?
You may attempt to enroll; however, any coverage for which you are approved will not become effective until you are actively at work for one full day. Please see FAQs regarding "Pre-existing Conditions" before submitting your enrollment form.
4. Does the STD plan cover job-related disabilities?
No. The voluntary STD plan only pays benefits for disabilities that are non-occupational (off-the-job). Job-related disabilities are covered by Workers' Compensation.
5. Are benefit payments taxable?
No. Benefit payments for which you have paid the premium with post-tax dollars are not subject to federal, state, or FICA taxes.
6. Does the STD or LTD plan cover pre-existing conditions?
A pre-existing condition is one for which you were diagnosed or received care during the 365 day period preceding the date your plan goes into effect (look-back period) will not be covered until you have received no further treatment for that particular condition for 365 consecutive days from the date coverage begins (treatment-free period); or you have been continuously insured under the plan for 365 days (insured period).
Under the STD plan, if approved for benefits, the disability administrator will pay 2 weeks of benefits even if your condition is determined to be a pre-existing condition. Under the LTD plan, the disability administrator will not pay benefits for a pre-existing condition that causes you to become disabled within the first 12 months of your being insured under the LTD plan. Once your disability coverage begins, there is no limitation on submitting a claim for a different, unrelated disability.
7. Is pregnancy covered?
Yes, if you are covered under the voluntary STD plan. Maternity claims are approved for 6 weeks from the date of delivery, regardless of whether the delivery is a C-section or normal delivery. The STD plan has a standard 6-week benefit period for pregnancy, where four weeks are non-payable due to the 4 week (28 day) elimination period; STD benefits will be paid for the remaining 2 weeks. An STD claim may be approved for longer than 6 weeks if your physician provides medical documentation that substantiates your inability to work.
Please note: If you do not elect STD coverage when first eligible, you are considered a late entrant and subject to medical underwriting. Your enrollment application could be declined. You are allowed to appeal a denial or reapply for coverage if/when your condition changes.
If the employee wants to receive income from both programs, then the approved voluntary short term benefit would pay first directly after the 4 week (28 day) waiting period for 2 weeks of benefit (normal delivery benefit). Then, the employee can request the 3 consecutive weeks of paid parental leave from Duke after the end of the voluntary STD claim and payments. Per HR policy, the 3 weeks of paid parental leave must be paid consecutively and cannot be split apart. If approved, both benefits should not be received at the same time; otherwise, the paid parental benefit will reduce the voluntary STD benefit. Please be advised that an approved voluntary STD benefit cannot be deferred to a later payment date while on leave of absence (FMLA). The employee is responsible for coordinating the timing and release of the paid parental leave benefit with their department and/or payroll clerk. Also, the voluntary disability administrator, Hartford, should be contacted by the employee directly to confirm approved STD benefit start and end dates as well as duration of benefit payments. Hartford's phone number is 866-945-4558; please provide the Duke group number (#043211) when calling.
9. Are there any other exclusions?
Yes. Benefits are not payable for disabilities resulting from commission or attempt to commit a felony, or to which a contributing cause was your being engaged in an illegal occupation; war or act of war (declared or not); or military service for any country engaged in war or other armed conflict; or by an intentionally self-inflicted injury.
No. Although the plan is flexible and gives you the option of using any accrued sick time or PTO before benefits are paid, STD benefits are offset for any days you elect to use sick time or PTO after the 28-day waiting period. Benefits are reduced by the amount of other income benefits you receive while disabled, such as sick/vacation leave, paid time off, or Kiel. For example, if an employee was paid $200 in PTO (or sick and vacation time) after the 28-day waiting period, then the voluntary disability carrier would reduce, or offset, the approved short-term disability benefit by the $200 PTO paid as "other income". If the short-term disability benefit payable was $500, then it would be reduced by $200 due to the PTO paid, thus resulting in a $300 STD benefit.
11. What should I do prior to my STD benefits expiring?
For benefit eligible employees with 3 years of full-time, continuous service, you may also be eligible for Duke Disability coverage. Please contact the HRIC at 919-684-5600 for details.
If you have less than 3 years of full-time, continuous service, you may be eligible for benefits under the voluntary Long Term Disability (LTD) plan, if you are enrolled for that coverage, subject to all terms and conditions of the LTD plan. For a voluntary long term disability claim, please file your claim within 60 days after your date of disability to allow for proper processing.
12. Can I continue my coverage if I leave my job?
Short Term disability insurance is not portable. When employment is terminated, the STD coverage ceases. LTD insurance is portable, given certain requirements are met. In addition, the LTD portable policy has different policy provisions and costs associated with it.
13. What other income benefits may reduce the amount of my STD or LTD Benefit?
Your STD and/or LTD benefit amount will be reduced by other income benefits you receive or are eligible to receive from: sick leave, vacation pay, PTO, parental leave and the Kiel Memorial Vacation/PTO Donation Program.
In addition to the specific work absence benefits provided by Duke, your STD benefit amount will also be reduced by Social Security Disability Income or similar plans (such as the Civil Service Retirement System, Railroad Retirement Act, the Jones Act, Canada Pension Plan or the Quebec Pension Plan); the Veteran's Administration or other foreign or domestic governmental agency for the same disability; Workers' Compensation or occupational disease laws, or similar laws; group, association, union or other organizational coverage; employer-related individual policies; governmental law or program that provides disability or unemployment benefits as a result of your job with your employer, disability coverage under your employer's retirement plan; and damages or settlements for income loss.
Your Long Term Disability benefit amount will be reduced by other income benefits you (or possibly your family) receive or are eligible to receive. Examples of such "other income benefits" are income from Social Security Disability Insurance, the Civil Service Retirement System, Railroad Retirement Act, the Jones Act, Canada Pension Plan, the Veteran's Administration, Workers' Compensation or occupational disease laws; group, association, union or other organizational coverage; employer-related individual policies; any disability or unemployment benefits; and damages or settlements for income loss.
For Long Term Disability benefits amounts, retirement benefits are another example of "other income benefits" if the retirement plan is wholly or partially funded by employer contributions, unless you were receiving them prior to becoming disabled, or you immediately transfer the payment to other plan qualified by the U.S. Internal Revenue Service for the funding of a future retirement.
Your Long Term Disability benefit payments will not be reduced by retirement benefits from Social Security Disability Insurance or similar plans, or by any portion of retirement benefits that you (or your family depending on your plan) receive that are funded by your after-tax contributions if you were receiving them prior to becoming disabled.
Your Long Term Disability benefit payments will not be reduced by your savings or investments, IRAs or Keoghs, profit-sharing, personal disability policies or Social Security Increases.