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UC Disability (Maternity) Benefits
Has anyone out there with a newborn and who has worked as a GSI applied for the new Paid Family Leave allowance?
I last worked as a GSI Fall 03 and had worked continuously as a GSI for years up to that point. I haven't worked this year (husband works full-time) because of my pregnancy (baby was born in September) and surgery in March that had me on bed-rest for 6 weeks.
I will be able to apply again for work with my department for Spring 05, but in the meantime will have no income...
Has anyone been in a similar position and received PDI coverage? Are GSIs even eligible for this? I've found little detailed information on the CA gov website and nothing on the UCB HR site. Any suggestions for how to go about applying or pointers for where to look next would be welcome as well. Thanks! --Curious PDI
Also, the goal of the PFL program is to help make up for lost income from taking time off from work to be with your baby. But since it appears you weren't officially employed when you had your baby, you might not be eligible after all.
I'd say call the PFL people at the State to clarify. I've had to talk to them a few times about my claim and everyone has been very helpful and friendly.
Apparently, because UC does not participate in the State SDI program, UC employees are not eligible to take advantage of California's new Paid Family Leave law. Nor can we take advantage of it through the supplemental disability plan offered via UC. The EDD site states: ''If a Voluntary Plan Insurer provides your company's disability insurance coverage, then it must also provide Paid Family Leave insurance coverage.'' Does anyone know what a Voluntary Plan Insurer is??? More importantly, can individuals pay into the state disability system in order to qualify for this wonderful new benefit? Or is it just the luck of the draw...if you work for a company that chooses to participate you win, and if you don't, you lose? Thanks!
[no replies received]
Any UC employees who have recently filed a disability claim form for maternity through Liberty Mutual? I'm a bit stumped at how I'm supposed to fill the claim form out.(And what's supposed to happen with the Attending Physician's statement.) The person I talked to in the Benefits office--covering for Lupe Vanderberg who's out for several weeks--was very nice and helpful, but didn't seem 100% sure of how one answers these questions, and I'm a bit nervous about doing it wrong and having the claim rejected. My understanding is that I need to send these forms in now (I'm due in about 5 weeks), but alot of the questions don't make sense "in advance". When do folks normally send these in? For the space for "Date Injury/Illness Began", do I just put the approximate date I became pregnant? For "Date First Treated", is that my first prenatal appointment? For "Date Last Worked", do I put down two weeks before my due date? For "Date Returned to Work", do I put down my estimate of when I plan to return (even if that's later than what I know disability will cover?) For "Describe how and where injury ocurred or describe the onset and nature of your illness", is it enough to just write "Pregnancy"? These are how I guessed they should be answered, and the benefits person said they seemed right, but they weren't sure because they didn't specialize in maternity. (It's just all so weird, having pregnancy framed as an illness, and having to answer the questions as if I've already stopped working.) Also, for this Attending Physician's Statement, any advice on what to tell my practitioner when I give it to her? (I'm a Kaiser member, actually; any Kaiser members know if the form goes to my practitioner or to the business office? )
I just did all this in January. Here we go: q)When do folks normally send these in? a) You can't have the forms completed until the dr signs you out as disabled. q)For the space for "Date Injury/Illness Began", do I just put the approximate date I became pregnant? a) That is what I used. q)For "Date First Treated", is that my first prenatal appointment? a) It is the date of the first time you saw the dr./np. q)For "Date Last Worked", do I put down two weeks before my due date? a) That is the last day you work before the dr signs you out on disability q)For "Date Returned to Work", do I put down my estimate of when I plan to return (even if that's later than what I know disability will cover?) a)That is what I put. q)For "Describe how and where injury ocurred or describe the onset and nature of your illness", is it enough to just write "Pregnancy"? a) I put something like pregnancy and child childbirth. q)Also, for this Attending Physician's Statement, any advice on what to tell my practitioner when I give it to her? (I'm a Kaiser member, actually; any Kaiser members know if the form goes to my practitioner or to the business office? ) a) I am a Kaiser member too. The business office fills it out. The NP will give you a pink disabled slip that says why you are going out on disability. The business office will take a copy to fill out the form. You will keep the other copies to give your DPA here on campus. **Please note that Kaiser is VERY SLOW sending these out. ** They told me that it is standard for it to take 14 working days. ( and there were 2 holiday weekends after I turned my form in so mine took a month to be sent out the first time!) And when they did send mine out Liberty Mutual never got it so they had to resend the forms... but they didnt' have a complete copy of what they had sent and liberty mutual couldn't accept them! So I had to hike over to the business office with my 5 day old to throw a fit. Fortunately I had a second copy of the forms and they did complete the forms over again on the spot and fax them to liberty mutual! (By the way, the guy who handles the UC claims at Liberty Mutual is pretty nice.) I went out on disability a month before my due date and didn't start getting checks until the baby was already a month old. But the liberty mutual rep said that this was an uncommon situation. Lupe is back! I spoke with her Monday, 6/28. If you get simple answers to your specific questions, and have the time, would you would you mind posting them here for the benefit of those of us who will be going through the same procedure fairly soon? The system is obviously nuts in its own way, but it's all we've got. Thanks!!! I am due Aug. 15 and have just filled out the claim forms for Liberty Mutual. I called them to see if I was doing it right, since, like you, I found it confusing. I have already sent in the forms - you don't have to wait until the baby's born, but you do have to notify Liberty Mutual of the date of birth. Since the forms are designed for any type of injury/illness, most of the questions don't apply to pregnancy. I left all questions that didn't apply blank. I just wrote "Pregnancy" and the date of my LMP for the reason and date of onset questions. The Attending Physician's statement asks for a bunch of stuff that, according to the Liberty Mutual person I spoke to, you don't have to send in. No chart notes are needed. Just have your doctor write in that you are indeed pregnant, your due date, and sign the form. Most of the other questions don't apply to pregnancy. I have found all of the disability/leave rules and paperwork thoroughly confusing. And the amount of disability payments that one gets for pregnancy leave is pathetic. It isn't one of those "great benefits" of working for the University we're always hearing about! Good luck with your new baby!
I just did the maternity-disability thing about 8 months ago, and it is really confusing. Lupe Vanderburg is the only person I found who seems to really understand it all, everyone else just knows bits and pieces. The "date that the injury began" is the date you gave birth. The "last date worked" is the day you decided you shouldn't work anymore, for me it was three days before I had the baby. Don't put any dates down in advance. For the "date returned to work," I figured that out after I had the baby. I stayed out twelve weeks on the FMLA plan (even though only six weeks was covered by disability). You do not fill in any dates until after the child is born, they are very fussy about this. I filled out everything that I could in advance, so that I just had to do a few things after the birth. Under "describe the injury," just write pregnancy. If you take the attending physician forms to the business office at Kaiser, they will take care of it, and they will send you a postcard when it has been completed and mailed. I turned it in at the "three days after birth" appointment. Liberty Mutual was very prompt in processing my claim after the birth of my daughter. It took about two weeks. There was one thing that they were unsure about, and they just called me at home. Be sure to notify your personnel representative in your department after the birth, because they have to verify the info to Liberty Mutual once they receive your your claim, as well as other things. Good luck with everything.
In response to the person wondering how to handle the maternity leave forms with Liberty Mutual, I went through the same thing last year, except that I had to take early disability (because I was carrying twins) and then maternity leave. I'm also a Kaiser member. The forms are indeed frustrating, mostly because they are designed to cover all possible disabilities, and I found it hard to get adequate information from UC/LBNL about how to fill them out. However, the Liberty Mutual folks are very helpful, and you can also call the Office of the President benefits department at (800) 239-4002, ext. 7-0123, for information that your own person may not have. But basically, you just put down that you are pregnant, your due date, etc., and ignore anything that doesn't apply (such as date of accident, etc.). As for the doctor's statement, I had my OB fill that out -- he knew what to do -- and I sent it in with the other form to the benefits office. The benefits office sent it on to Liberty Mutual, which sent me a confirmation letter. Somehow it all worked out, although it was pretty hairy towards the end of my leave because I took additional LWOP and it was very confusing determining what, when and who to pay to ensure that my benefits premiums were paid. I remember being very upset that something so common as maternity leave could be made so so complicated. At times I felt like the first person who had ever had a baby! In retrospect, I think I worried too much because everything came out all right. If your form is missing some information, they'll contact you to get it. Just enjoy your pregnancy and remember that all too soon this will be a distant memory. Good luck!
To: UCB Parents Network
From: the Benefits Office
Date: Feb 22, 1998
The three people in the office who handle day-to-day disability counseling are:
Feel free to publish their names and numbers.
I'm trying to figure out whether it makes sense to apply for the employee paid disability plan, and am hoping somebody on this list may have some insights and answers to some questions. I'm not pregnant yet (haven't even started trying), but we're thinking about having a second child. First time around I was completely oblivious to the fact that there was such a thing as employee paid disability, but it turned out ok since I had plenty of sick leave and needed disability pay for only one week. Now I'd like to make a more informed decision.
The booklet says "due to the complexities of disability and FMLA situations, the options available to you are not discussed here. Please see your local Benefits Representative." In the past I've found my Benefits Rep to not be very helpful; can any of you enlighten me as to the "complexities"? For example, does it matter if I become pregnant shortly after becoming approved?
In general, I get the sense that most UC-employed women make sure that they're on employee paid disability if they're going to have a child. Is this an accurate observation? Have folks found that it's really worth it?
Complicating matters is the fact that I'm currently a part-time employee, and if I understand the booklet correctly, and I remain part-time, my monthly payments will be the same as if I was full-time, but my benefits will be reduced. Any other part-timers out there that have used employee paid disability for family leave?
If you have any thoughts, I'd love to hear them. Thanks.
Personally, I've only found one person at UC in the benefits area who knows anything, or is willing to find out the answer. I suggest calling other than your benefits person until you find someone who can help you.
And BTW, under the FMLA you continue to get your benefits, without having to make COBRA payments, but it doesn't provide for any salary payments.
Disability insurance is arguably MORE important than life insurance. Consider the two situations: (a) if you're disabled then your family potentially needs money both to replace your lost income AND to support you in your disabled state [transiently if the disability will allow you to return to work; permanently if the disability will not allow you to work]; vs. (b) if you're dead, then your family loses your income and your role as a family leader but also is spared the cost of supporting you. Craig
And my two cents about using the disability for pregnancy: While I think having disability coverage is important in general in case of accident/injury, etc. I didn't think it was worth it for maternity for myself. What with the waiting period, technicalities, and haviing a lot of sick leave and vacaton accumulated I received a fairly small amount, which covered less than 2 week's worth of pay. That was my experience in May of '96. The university has also changed disability carriers since then, so some people might have different experiences, but this was mine. Good luck in your decision! Suzanne
A co-worker of mine hired 8 to 10 years ago and swears she was counseled by the dept. rep. to decline the Employee paid disability plan. Told her she wouldn't need it! Well, she is diabetic and has been off of work many times over the past years. This last time was 10 months. Because Employer paid disability only pays 55% of your salary and lasts no more than 6 months, once your through with that, there is no MONEY coming in at all!!! For 4 months, I think she has had to rely on relatives for support.
The bottom line is you never know if you are going to be very ill or have an accident of some kind or what have you! I think it is better to be safe than sorry.
That's my 2 cents! Oh yeah... the other part of this is that she (my co-worker) cannot ever get EPD benefits by doing a Statement of Health form to the company, because once you have a condition such as diabetes, cancer, etc. they will not allow you to sign up and be covered under this plan. If you are perfectly healthy and all else is fine, you may get lucky and they'll enroll you.
For specific questions that you are not getting answers for, I would call the Campus Benefits Office. - Concerned Mom & UCB employee
The advantages of employee-paid disability: While you are on approved disability leave you will receive 70% of your normal pay (as opposed to 55% with just UC-paid disability); I think the 55% from the UC-paid plan is not taxable, but the additional 15% from the employee-paid plan is. Your disability checks come out to be close to the same amount as your regular payroll checks.
In addition, the employee-paid plan has a long-term disability feature that the UC-paid plan does not have.
Cost: The cost is computed at your full-time salary rate, while benefits are paid based your actual percentage of time worked (eg if you work 50% time, you will receive %70 of your actual rate, not 70% of the full-time rate). The Bencom website will calculate the monthly cost for you (http://www.ucop.edu/bencom/hw/ygip/ygipdisa.html). The person who submitted the posting said only that she worked part-time; it shouldn't be difficult to calculate the difference between 55% and 70% of the salary she receives monthly to see if this is worthwile for her. When I moved from 100% to 75%, it was still worth it for me to keep the plan since I knew I would be using it.
If you decide to apply for the employee-paid plan, definately do it before you become pregnant. Once you've been approved, then you can become pregnant immediately.
The "complexities" they talk about in some of the literature relate more to FMLA leave than disability. Whether or not you have employee- paid disability has little bearing on the FMLA side of the equation. As long as you worked at least 1250 hours in the past 12 months, you are eligible for FMLA leave which covers your health insurance premiums for up to 12 weeks from the start of your leave (concurrent with disability).
The Bencom website is an excellent source of information on UC staff benefits plans. If you feel that the DBC in your office is unable to provide you with accurate information, you can always call the Benefits office yourself (for info on FMLA leave, call the Employee Relations Specialist assigned to your department). Lee
UC Bencom Maternity Leave - Maternity Leave Overview http://www.ucop.edu/bencom/life/maternity/maternity.html
Also, you can order the Maternity Leave Checklist form # E6101 from campus supply or ask your benefits person to get it for you.
It's the portion of the distribution that is from the UC-paid plan that is taxable; the portion from the employee-paid plan is not taxable.
The benefit paid from the UC-paid plan is up to 55% but not to exceed a maximum of $800/month.
As I said, we learn by doing, and you should all feel free to contact the Benefits unit directly for answers to these more complex questions! Lee
I agree with Leah's posting about how valuable Employee-Paid Disability can be. However, I would add one fine point. IF the issue is anticipating possible problems during pregnancy, AND you are someone who has accrued a lot of sick leave, it may not be worth it to pay the extra money for the 7-day Waiting Period type (versus the 30-day Waiting Period type). Here's why:
At the time I had my little girl, I had about 200 hours of sick leave built up. I was told that I must use at least one month's sick leave (about 20 working days) prior to drawing disability. This made the 7-day waiting period benefit null and void for me. A friend of mine here at UCB also had the exact same experience.
Since returning to work, I have switched to the 30-day Waiting Period type, as I tend to maintain a fairly large sick leave "balance."
(I know I'm not expressing this in a very sophisticated way. Please forgive me. I find this part of UC life totally overwhelming.)
I'm sure there are others out there who can add more... My two cents. Catherine
Which brings me to my real point: Self insurance. Insurance is there to make sure that you can take care of yourself in an emergency. It was never intended to take the place of planning your own financial future (although much of America seems to view it that way these days). In many cases, you could do a lot better by taking the money you would have paid into the insurance plan, and investing it in higher-yield propositions. This is called self-insurance, because the idea is you fall back on your own savings and investments in an emergency. It is not for everybody. If you would never actually DO it, and would spend the money on a new TV instead, then you should definitely stick with the formal insurance plan. But recommending that EVERYONE blindly sign up for this insurance is not responsible, either, IMHO. Unfortunately, no one can (or should!) take away the responsibility (burden and priviledge) of making your own financial decisions. But depending on your own temperament, and financial situation, you might do much better on your own. If you sign up for the disability insurance, and that emergency never materializes, then you have thrown all that money away all those years. If, on the other hand, you invest in some other plan, then you are free to spend the money however you wish later on. And if you invest wisely, and the emergency does happen, then you are no worse off than with the disability insurance. It *IS* a risk, though. No doubt about it. Dawn
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