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UWHC,

Benefits,

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Pay & Benefits,Benefits,Disability,UW Hospitals and Clinics

Income Continuation Insurance (UWHC)

Income Continuation Insurance (UWHC) - Pay & Benefits, Benefits, Disability, UW Hospitals and Clinics

Focus

Benefit Summary

UW Hospitals and Clinics gives eligible employees the opportunity to enroll in an Income Continuation Insurance program to replace income if unable to work due to disability, illness, injury or impairment. The plan provides a benefit for medical conditions that are considered short term in nature, as well as those that may last for extended periods.

Employees may receive up to 75% of salary up to a maximum of $4,000 per month for any approved disability. Benefits are payable after an elimination period of 30 calendar days and the exhaustion of the employee’s sick leave (up to 130 working days), whichever is longer. A supplemental plan is available for employees with salaries exceeding $64,000 and up to $120,000.

Benefit Eligibility

All regular and temporary employees who are eligible or who become eligible for the Wisconsin Retirement System (WRS) are eligible to participate.

Premium/Rates

Premiums are based on earnings and sick leave balance and are deducted monthly through payroll deduction. Premiums may change annually or if there is a change in full-time equivalency (FTE).

Premiums are reviewed in January and adjusted based on the prior year’s gross earnings, sick leave accrued, and any changes to the standard premium rates. Notification of a change in premium will be communicated and updated for February coverage. Employees are responsible for monitoring the use of their sick leave time throughout the year. Requests to exchange sick leave for other paid time off will not be allowed retroactively so that the employee can qualify for a lower-cost premium category.

When an employee experiences a change in FTE, premiums will be determined based on the new projected annual rate. The new premium will be communicated to the employee and will be effective the first of the month following the change in FTE.

Per plan rules, premiums are only recalculated mid-year for FTE changes. If an employee experiences a pay increase or decrease that is not associated with an FTE change, their ICI premiums will not be recalculated until the annual review process.

Premium Categories

Categories 1, 2, 4, 5 and 6 are based on an employee’s year-end sick leave balance as of December 31. Category 3 is a special category based on sick leave accrual and usage during the annual evaluation period which consists of the full pay periods that fall within the calendar year.

Category

Sick Leave Balance/Usage during the annual evaluation period

1

Sick leave balance of 0 – 183

2

Sick leave balance of 184 - 519

3

Category 3 is a special category that employees have to qualify for each year based on sick leave accrual and usage during the full pay periods that fall within the calendar year. 


To qualify for Category 3 premiums, full time employees must have a net sick leave accrual of 80 hours or more at the end of the evaluation period.  This is calculated by taking the sick leave earned during the evaluation period and subtracting the sick leave used during the evaluation period - - if the result net accrual is 80 or more hours, the qualifications for Category 3 have been met.  The calculation is prorated for part-time employees.  For example, a 0.8 FTE would have to have a net accrual of 64 hours (80 hours x 0.8)


Generally speaking, full time employees accrue 96 hours of sick leave per year.  If 2 days (16 hours) of sick leave are used during the evaluation period, the net accrual would be equal 80 (96 – 16) and the employee would qualify for Category 3.

4

Sick leave balance of 520 – 727 or in Category 4 in previous year

5

Sick leave balance of 728 - 1039 or in Category 5 in previous year

6

Sick leave balance of 1040+ or in Category 6 in previous year

Categories 4, 5 and 6 are considered permanent plateau categories. This means that once an employee qualifies for that category during the annual update, they will not lose eligibility for that category even if their sick leave drops below the sick leave hours requirement.

For more information regarding the ICI premium categories, please review the ICI Brochure.

Enrollment

Initial Enrollment

Coverage will be effective the first of the month on or following the date of hire. Enrollment in the Income Continuation Insurance Plan requires the submission of the Income Continuation Insurance Application form to Human Resources within thirty (30) days of the date of hire.

Deferred Enrollment

Employees may also qualify for a deferred enrollment opportunity during the annual review process by accumulating certain amounts of sick leave. Employees can qualify to enroll during the annual deferred enrollment period without having to provide evidence of insurability under the following circumstances:

For more information on deferred enrollment or the ICI premium categories, please review the ICI Brochure.

Additionally, employees enrolled in Standard ICI but not enrolled in Supplemental ICI will be offered an annual opportunity to enroll in Supplemental ICI without having to provide evidence of insurability if their eligible earnings are greater or equal to $64,000 in the prior calendar year.

Human Resources will notify you if you are eligible for any of the enrollment opportunities above.

Late Enrollment

If your application is not received within the initial enrollment period, you may apply at any time by submitting an Evidence of Insurability Application directly to the Department of Employee Trust Funds. Your application will be subject to medical underwriting and may require medical records or documentation. Please contact Human Resources to obtain Evidence of Insurability. 

Cancelation

How to Cancel ICI Coverage

To cancel your ICI coverage, please complete an ICI application and submit it to Human Resources via attachment to an Ask HR case or faxing to (608) 263-5778. Your coverage will be canceled at the end of the month in which your application is received by Human Resources.

How to File a Claim

Contact Aetna directly at (800) 960-0052 to file a claim for Income Continuation Insurance benefits. Aetna will require the employee name, employer (University of Wisconsin Hospital and Clinics), the last day worked, the nature of the disability and the doctor that is providing care.

More information regarding the claim process can be found in the .

This document is a brief summary of benefits. Details of the plan(s) may be found in the official plan documents and plan descriptions. If a conflict exists between this document and the official plan document, the official plan document shall rule.

Resources

Enrollment Form

ICI Application

Premiums

2018 Employee Monthly Standard ICI Premiums

2018 Employee Monthly Supplemental ICI Premiums

Additional Information

Income Continuation Insurance (ICI)

ICI Brochure