STD, health benefits, unemployment benefits

[Orphic Seth]

Now that I got your attention:

I'm have some questions about Short Term Disability, COBRA, health insurance, and unemployment benefits. Sorry, not herpes.

I had some serious back problems early this year. I took a few months off with unpaid FMLA and did a long rigorous Physical Therapy program. With this time off, I ended up burning up all my FMLA for the year (12 wks). I went back to work, 100% and worked three months full time.

Then, on June 30th, my L5/S1 disc splattered its guts all over my spinal cord.

I've been out two months trying to get rehabilitated and avoid surgery.

I filed medical leave/hardship paperwork for medical leave since I don't have any FMLA left.

I filed STD paperwork in early August once the MRI results came through and my Dr. told me I wasn't going back anytime soon. HR initially "lost" the paperwork, and filed it a week ago after inquiries on my end.

On Friday the 27th, I got a voicemail from HR saying that on Tuesday, the 31st I would be losing my health insurance and I would go to COBRA.

Does any of this sound Kosher?

No payments yet from STD... will these be retro-active?

Can they push me to COBRA while on Short Term Disability? Who pays for this, it will be difficult for me, I'm now broke.

On a slightly different matter:

I have fears that my company could be going out of business... I don't know when, but I wonder if this is part of their scheme.

If I'm on disability OR when I'm on COBRA (and not collecting disability) can I collect unemployment benefits?

How does this all work?

My company is not teh funny. They is sinister.

Thanks.

[teletripper]

Hey thats false advertising!! I don't know anything about your insurance situation so I'm of no help there. But I can do this send me all your pain pills as you may get strung out on them which would create a whole new set of problems.

[splat]

You're probably about to be laid off due to a 'downsizing' when you return if they are the typical sinister corp. Evidently, you've outlived you're short term disability bennies and the only way you can keep insurance is to go back to work. Now that they know you cost money, they'll likely lose you as fast as they can.

[Orphic Seth]

I will not be laid off due to downsizing... employment is seniority based and I'm way up the list-- they are actually short of people in my position. There are strong indications that we may go belly up completely as an entity.

[DLD in UT]

I know a bit about COBRA but not your STD stuff. COBRA you pay for. Govt program that allows you to keep your coverage from previous employer, but you now pick up the full cost rather than them paying most of it. Not cheap. I can't imagine why you wouldn't be able to get unemployment if you are on COBRA, it would seem to actually be proof in and of itself that you don't have employment. Sorry to hear about all that, hope things work out and company stays afloat.

[Skidog]

^^^ yeah i thought you only got COBRA if you were NO LONGER WITH THE EMPLOYER?

[Conundrum]

Can't help you on the unemployment stuff-different laws in different states...you should check with your dept of labor.

But, I can give you info on COBRA/STD.

Short term disability-from what you described, you should be on short term disability. There will be a waiting period where they won't pay when you were not working. When the wait is up, they will start paying. It is retroactive. There is also a term of the policy that the benefit will last. If your company goes out of business, the policy should continue until the duration is up. But, there may or may not be a waiver of premium clause written into the policy so check on that. It means that if you are not able to work, they may waive your premium but it has to be in the policy contract.

COBRA-yes, they can take you off their employee health plan if you are not working. There might be a continuation of coverage that your employer offers but it doesn't sound like they do. So, make sure you sign up for COBRA by the date specified or you won't have insurance and your situation sounds like you need insurance. You will be responsible for the premium. It sucks but it's cheaper than paying for the care it sounds like you need. There is a gov subsidy that pays 65% of the COBRA premium if you qualify. Not knowing specifics of your situation, I can't tell you if you qualify.

If you company goes out of biz, there may or may not be COBRA available to you at that point. If they continue their health plan for employees as part of a severance, you would be eligible for COBRA. If they shut off the health plan when they shut their doors, your health insurance through them whether it is COBRA or not goes away.

Feel free to hit me with questions. I'm in ID so some of our laws might be different but for the most part, I should be able to point you in a direction.

[Garth Bimble]

A few things to consider regarding your "STD" coverage...

1. Your FMLA leave may have impacted your eligibility to receive an STD benefit. Most companies require an "initial period of employment" before you become eligible for this benefit. Even though you had probably already completed that period prior to your leave when you returned your company may have considered you to be re-hired and required you to complete another probationary period prior to receiving the benefit.

2. If your condition is considered pre-exisiting, it may not be covered under your STD plan.

3. Did the disc go out while you working? Was it a worker's comp situation? Your STD plan won't cover worker's comp issues.

4. If you are covered under STD, you may have to wait 7 working days for the coverage to kick in. The plan that my company offers does pay for your health insurance while you are disabled for a qualifying STD event, up to a total of 26 weeks.

[Conundrum]

If he was on FLMA, it wasn't a work comp issue. If it was work comp, he wouldn't have to dip into FLMA.

Good point on pre-x though. When did you start the STD policy? Why didn't you apply for STD on your FLMA period?

7 working days is policy specific. There could be any number of wait periods ie 0/7, 7/7, 30/30, etc. The company doesn't have to pay for insurance if an employee is on STD unless they want to.

[Garth Bimble]

^^^

He said he'd been back from the FMLA 3 months when the disc blew...that's why I asked.

Maybe I misunderstood.

[Orphic Seth]

Thank you guys. I have sent HR a polite email asking for some clarification, procedures, definitions, last week, and have yet to get a response.

It's not worker's comp.

My condition could be interpreted as pre-existing-- it used to be back pain, and then the disc really blew out in late June.

I did not take the STD route during my first FMLA because it was not offered-- FMLA was unpaid leave, but they told me I could get some pay by selling my sick days and vacations, which I did not do. STD didn't come up, and I didn't think about it. At this point, I was happy to be doing physical therapy and getting better. Money wasn't an issue, as I figured I'd be working the rest of year in good health-- instead I came back and worked 3 months before the disc went bad. The first time the STD came up when HR sent me the paperwork for "medical leave of absence/hardship leave" and sent me the STD paperwork subsequently.

I'll look into the gov't subsidy for COBRA, thanks.

Today is the first day I'm on COBRA-- even though I didn't get the filing paperwork yet. I know it's retroactive, do I still use my insurance card like normal for appts. and prescriptions and the like?

[Conundrum]

Yep. Cobra is the same policy only you are footing the bill.

[Orphic Seth]

Thank you bro, HR still hasn't answered that question.

Thank you.

Still no STD $ or COBRA paperwork, HR said the STD was filed and the COBRA sent. I got a letter from the STD company saying they were "reviewing" my file, we'll see where it goes from here.

[boarddad]

Resurrecting this thread to bitch about STD. I work for a large engineering firm that shall remain nameless that has STD coverage through CIGNA. I had back surgery last week and have been off this week. Yesterday I got a call from CIGNA. It started off la-de-da, how did they surgery go? Great? That’s great! Then the hits started coming;
How long will you be out? Surgeon said 2-3 weeks.
Oh, Cigna pays for 2, starting the first day you were off.
No big deal, this ain’t vacation and I’m bored, 2 weeks will be plenty. Surgery was on Friday, means I need to back to work on Friday - which is not great, but that’s the rules.
Oh, well we have a 7 day wait period.
Oh, so not getting paid this week. Sort of expected that. Retroactive? I hope so, but wouldn’t be surprised if it’s not.
Oh, well we pay 66.67% of your pay.
Again, that sucks, but expected that.
Oh, hang on. You’re in California. Yeah, the State STD pays 65%. We supplement to get you to 66.67%.

Wait...
Quick math...
66.67-65 = 1.67%
Simplifying to round numbers, say I make 100k, divide by 50, times 2%...
That’s $40/week (!!!!)
That’s terrible! And remember I simplified the numbers - it’s less than that. I’d make more on jury duty. Why are you calling me?
Oh, well let us know if you have any questions.
Yeah, I’ve got one; how much is my company paying for this “benefit”?

[old goat]

Resurrecting this thread to bitch about STD. I work for a large engineering firm that shall remain nameless that has STD coverage through CIGNA. I had back surgery last week and have been off this week. Yesterday I got a call from CIGNA. It started off la-de-da, how did they surgery go? Great? That’s great! Then the hits started coming;
How long will you be out? Surgeon said 2-3 weeks.
Oh, Cigna pays for 2, starting the first day you were off.
No big deal, this ain’t vacation and I’m bored, 2 weeks will be plenty. Surgery was on Friday, means I need to back to work on Friday - which is not great, but that’s the rules.
Oh, well we have a 7 day wait period.
Oh, so not getting paid this week. Sort of expected that. Retroactive? I hope so, but wouldn’t be surprised if it’s not.
Oh, well we pay 66.67% of your pay.
Again, that sucks, but expected that.
Oh, hang on. You’re in California. Yeah, the State STD pays 65%. We supplement to get you to 66.67%.

Wait...
Quick math...
66.67-65 = 1.67%
Simplifying to round numbers, say I make 100k, divide by 50, times 2%...
That’s $40/week (!!!!)
That’s terrible! And remember I simplified the numbers - it’s less than that. I’d make more on jury duty. Why are you calling me?
Oh, well let us know if you have any questions.
Yeah, I’ve got one; how much is my company paying for this “benefit”?

Maybe I misunderstand but it sounds like state pays you 65%, CIGNA the $40/week extra--so you get paid your 2/3 or 67,000 roughly--that's a lot more than jury duty.

[boarddad]

The state SDI we all pay for regardless of who you work for or what insurance you have - just check your W2. Believe me, I’ve put in far more than I am getting out of that account. The paltry amount my CIGNA is paying me leaves me pretty unmotivated to follow their 2-week max rule. Chances are pretty good I’m not going back to work the Friday before Memorial Day W/E on their account. I’m pretty bored at home though so will see.

[old goat]

I get it--if you stay out longer than 2 weeks you don't get the extra $40 Cigna is paying you for the first 2. Hard to see why your employer even bothers. Probably cheaper to self insure for the extra 1.7%.

The disability insurers have their charts that tell them how long you get off work for what operation, no allowance for individual variation. I had my own chart--private employer 2 weeks, self-employed 2 days, state employee 2 months.

Most of us pay more into CA SDI then we will ever get out of it. That's so a few of our fellow employees can go on extended disability. You meet them on the ski slopes from time to time. But I would prefer to be healthy and working to being hurt and collecting lots of disability.