Short-Term Disability
What is Short-Term Disability?
Short-Term Disability (STD) insurance helps supplement your weekly earnings if you’re disabled and cannot work. STD benefits can continue for up to 26 weeks and are payable on the first day of a covered accident. When your claim is approved for an illness/sickness (including pregnancy), benefits are payable on the 8th day from the date of disability. For the first 12 months following the effective date of insurance coverage or an increase in insurance coverage, benefits are not payable for disabilities caused by, contributed to by, or resulting from a pre-existing condition. A pre-existing condition is one for which an insured has received medical treatment, consultation, care or services, including diagnostic measures or prescribed drugs or medicine within the 3 months prior to his or her effective date of insurance coverage or increase in insurance coverage. Please refer to your certificate for additional details.
What are the most common STD claims?
- Pregnancies
- Musculoskeletal disorders affecting the back and spine, knees, hips, shoulders, and other parts of the body
- Injuries such as fractures, sprains, and strains of muscles and ligaments, as well as digestive disorders, and mental health issues including depression and anxiety
Can I collect a Short-Term Disability benefit if I am receiving other benefits or income?
Yes, the STD plan helps replace weekly earnings if you are disabled and cannot work due to a disability. STD is not reduced by any other income, by sick leave pay, or if you have other insurance coverage or if you are collecting Workers’ Compensation.
If I collected on my Short-Term Disability, do I pay taxes on the funds I received?
Benefit payments are not subject to federal income tax.
How Does Paid Parental Leave (PPL) Impact Short-Term Disability?
Paid Parental Leave is a benefit available to PS&T unit employees and retroactive to April 1, 2023. Paid Parental Leave provides eligible employees job-protected, paid time off (up to 12 weeks of fully paid leave) without charge to accruals for parental leave completed within seven (7) months of the birth, adoption, or foster care placement of a child (“qualifying event”).
STD insurance serves as a supplement to PPL for anyone who is having a baby. STD, once applied for or if already enrolled, provides a payment above and beyond your income, PPL, or any other coverage you may have. Having a child can be very expensive and Sun Life’s STD provides the additional financial support you may need when your family is experiencing a life changing event
Can I collect on Short-Term Disability after I give birth? And for how long?
Yes, you can collect for 6 weeks for a normal delivery and 8 weeks for a C-section if you meet the definition of disability. For the first 12 months following the effective date of insurance coverage or an increase in insurance coverage, benefits are not payable for disabilities caused by, contributed to by, or resulting from a pre-existing condition. A pre-existing condition is one for which an insured has received medical treatment, consultation, care or services, including diagnostic measures or prescribed drugs or medicine within the 3 months prior to his or her effective date of insurance or increase in insurance.
Do I have to provide Evidence of Insurability when I apply?
If you are a new employee (on the job less than 240 days) in the PS&T (Professional, Scientific & Technical) unit, you may apply with no medical questions asked¹ if applying for coverage in increments of $100, $200, $300, and $400. If we do not receive your insurance application(s) within 240 days of your date of hire with the PS&T unit, or if you you want to elect coverage of $500, $600, or $700 when you first apply, you can still apply for insurance, but you will also need to complete an Evidence of Insurability (EOI) form, which must be approved by Sun Life before coverage can begin.
EOI form
How can I cancel my Short-Term Disability insurance benefits?
If you would like to discontinue your coverage for STD, you may do so at any time by sending the PEF Membership Benefits Program (PEF MBP) a written request with your name, date, PEF Membership Identification Number (MIN), and signature to: Insurance Department, PEF Membership Benefits Program, 10 Airline Drive, Suite 101, Albany, NY 12205. Please make sure you are specific about which type of insurance you wish to cancel. Cancellations are effective the day PEF MBP receives your request and deductions will be stopped on the next available payroll. PEF MBP will mail an acknowledgement letter that will include the effective date of your cancellation. The online insurance application is not an acceptable way to cancel coverage. If you have questions, please contact PEF MBP at (800) 767-1840, or (518) 785-1900, ext. 243, opt. 2. You may also email PEF MBP insurance.
Long-Term Disability
What is Long-Term Disability?
Long-Term Disability (LTD) insurance provides a monthly benefit to someone who, due to a covered on-the-job or off-the-job illness or injury, is unable to work for an extended period of time. All active, dues-paying members of PEF who work at least 17.5 hours per week on a regularly scheduled basis are eligible for this plan. The LTD plan offers two (2) levels of coverage: 50% or 60% of your monthly income, up to $7,500 a month. The LTD plan begins to pay benefits after a 6-month Elimination (waiting) Period. The LTD benefit is based on your base salary (excluding items like hazard pay and overtime) and does not take into account earnings from investments or savings plans. Once the Elimination Period ends and your claim is approved, you are eligible for monthly income for as long as you’re disabled, up to age 65. (Disabilities that start between the ages of 62 and 69 are covered from 1 to 3.5 years. Disabilities that start at or after age 69 are covered for 12 months. Consult your insurance certificate for details.)
What are the most common Long-Term Disability claims
- Musculoskeletal disorders
- Cancer
- Injuries such as fractures, sprains, and strains of muscles and ligaments
- Mental health issues
- Circulatory issues such as a heart attack or a stroke
Are there offsets for Long-Term Disability insurance coverage?
The LTD benefit is reduced or offset by benefit payments from other sources of income for which you may be eligible, such as:
• Workers’ compensation
• Social Security (Primary and Family source)
• Disability pension or any New York state retirement payments
• Any other group benefits for disability, retirement, or unemployment
• Benefits from your sick pay program (these will offset benefits payable under this LTD program only when the combined benefits exceed 85% of income)
However, your LTD benefit payments will not be reduced if Social Security benefits increase for general cost-of-living adjustments. Regardless of how much in other benefits you may be eligible for, your LTD benefit will not be less than $200 a month. For a complete list of other income benefits, please refer to the plan certificate.
For more information on LTD and offsets, contact PEF MBP at (800) 767-1840, or (518) 785-1900, ext. 243, opt. 2.
Do I have to provide Evidence of Insurability when I enroll?
If you are a new employee (on the job less than 240 days) in the PS&T (Professional, Scientific & Technical) unit, you may apply with no medical questions asked¹. If we do not receive your insurance application(s) within 240 days of your date of hire with the PS&T unit, you can still apply for the insurances, but you will also need to complete a Evidence of Insurability (EOI) form, which must be approved by Sun Life before coverage can begin.
EOI formIf I become disabled, how long will I have to wait before receiving Long-Term Disability benefits?
Payments start after you have been disabled for 6 months and your claim is approved by Sun Life.
What if I go back to work after being disabled, and then get sick again?
If during the Elimination Period, you return to work for less than 15 consecutive days and become disabled from the same cause, there will be no interruption in calculating the Elimination Period. You can be partially disabled during the elimination period and still be working; however, benefits still will not be paid until after the Elimination Period. If after receiving benefits, you return to work for less than 6 months only to become disabled again from the same cause, you will not have to go through another Elimination Period to resume benefit payments.
Does this plan cover illnesses that occur before the insurance goes into effect?
If you received treatment or took medication for a condition in the 6 months before your effective date, benefits will not be payable for the first 12 months. This applies only to the first 12 months after your effective date.
Does this plan cover mental and nervous illnesses?
Yes, but those benefits are limited to 24 months. This limitation does not apply to periods of confinement in a hospital, or another qualified institution, for treating mental and nervous disorders, alcoholism, and drug addiction.
What happens if I leave my present job and I am no longer a PEF member?
If you are no longer in a PEF-represented position or have left state service, you have the option to convert to an individual policy and keep your current coverage. (Only applicable to past PEF members with 12 consecutive months of employment before termination.)
How can I cancel my Long-Term Disability insurance benefits?
If you would like to discontinue your coverage for LTD, you may do so at any time by sending the PEF Membership Benefits Program (PEF MBP) a written request with your name, date, PEF Membership Identification Number (MIN), and signature to: Insurance Department, PEF Membership Benefits Program, 10 Airline Drive, Suite 101, Albany, NY 12205. Please make sure you are specific about which type of insurance you wish to cancel. Cancellations are effective the day PEF MBP receives your request and deductions will be stopped on the next available payroll. PEF MBP will mail an acknowledgement letter that will include the effective date of your cancellation. The online insurance application is not an acceptable way to cancel coverage. If you have questions, please contact PEF MBP at (800) 767-1840, or (518) 785-1900, ext. 243, opt. 2. You may also email PEF MBP insurance.
Group Term Life Insurance
Do I have to provide Evidence of Insurability when I apply?
If you are a new employee (on the job less than 240 days) in the PS&T (Professional, Scientific & Technical) unit, you may apply with, no medical questions asked¹, for up to three times your Basic Annual Earnings. In addition, you may elect $20,000 of spouse/domestic partner coverage and $15,000 of coverage for each eligible dependent child. Coverage that does not require proof of good health will begin the day your enrollment form is received by the PEF MBP. If we do not receive your insurance application(s) within 240 days of your date of hire with the PS&T unit, you can still apply for insurance, but you will also need to complete a Evidence of Insurability (EOI) form, which must be approved by Sun Life before coverage can begin.
Can I apply for Group Term Life insurance coverage on my dependents only?
No, you must have coverage on yourself to be eligible to apply for dependent coverage.
How much will my premiums be for my dependent coverage?
Premiums are based on the member’s current age and are a flat bi-weekly rate. Spouse/domestic partner level of coverage cannot exceed the member’s coverage.
I’m retiring. Can I maintain my current benefits?
Yes, but you must join PEF Retirees in order to maintain your current benefits . Failure to join PEF Retirees will result in you being in an ineligible class for this insurance, resulting in cancellation of your policy. PEF Retiree dues can be paid by either a flat rate of $41.00 per year, or by Pension Deduction at $3 per month ($36.00 per year). For further information, you may contact the PEF Retirees directly at: (800) 342-4306, ext. 288, or (518) 785-1900, ext. 288.
Who is my beneficiary(ies)?
For privacy reasons, PEF MBP is unable to tell you over the phone who is listed as your beneficiary(ies). PEF MBP will mail a letter to the address on file stating who your current beneficiary(ies) is on your policy and PEF MBP will also include a Change of Beneficiary form that you can send back to PEF MBP if you would like to change your beneficiary(ies). Once PEF MBP receives the form, PEF MBP will send you a written confirmation of the change.
What is the Accidental Death & Dismemberment benefit with Group Term Life insurance?
If you apply for Group Term Life insurance coverage for yourself or your dependents, you and your dependents are automatically covered for Accidental Death and Dismemberment (AD&D) coverage. Accidental Death coverage provides an additional benefit equal to the amount of your life insurance coverage and is payable if your death occurs as a direct result of a covered accidental bodily injury sustained while insured, provided death occurs within 365 days of the accident.
What is the Group Term Life Insurance “Accelerated Death Benefits” (ADB)?
Should you or your spouse/domestic partner become diagnosed as terminally ill (certified with a 12-month-or-less life expectancy, the Accelerated Death Benefit (ADB) provides an accelerated payment of a portion of the terminally ill person’s life insurance proceeds. Your request cannot exceed 80% of the amount of their Group Term Life insurance in force.
How can I cancel my Group Term Life insurance benefits?
If you would like to discontinue your coverage for GTL, you may do so at any time by sending the PEF Membership Benefits Program (PEF MBP) a written request with your name, date, PEF Membership Identification Number (MIN), and signature to: Insurance Department, PEF Membership Benefits Program, 10 Airline Drive, Suite 101, Albany, NY 12205. Please make sure you are specific about which type of insurance you wish to cancel. Cancellations are effective the day PEF MBP receives your request and deductions will be stopped on the next available payroll. PEF MBP will mail an acknowledgement letter that will include the effective date of your cancellation. The online insurance application is not an acceptable way to cancel coverage. If you have questions, please contact PEF MBP at (800) 767-1840, or (518) 785-1900, ext. 243, opt. 2. You may also email PEF MBP insurance.
Military Leave
I’m going on Military leave. What happens to my benefits?
Group Term Life
Group Term Life insurance coverage can be continued for up to 12 months at no charge to you for your approved military leave. A death claim would be eligible for payment if death occurs while covered under this policy. No benefits would be paid under the Accidental Death and Dismemberment (AD&D) feature of your policy for a loss caused, or contributed to, by war or any act of war whether war is declared or not.
Short-Term Disability
Coverage cannot be maintained while on an approved leave of absence. The current contract specifically excludes disability caused by “war or act of war” and states that coverage will be terminated on the date you cease to be in an eligible class including leave for military service. When you return to active employment, you must notify PEF to initiate reinstatement of your coverage. You must request reinstatement of your policy within 240 days of your return to active work.
Long-Term Disability
You may continue your coverage for 6 months while on an approved leave of absence. When you return to active employment with NYS, you must notify PEF MBP and request to reinstate your group LTD policy. You may contact PEF MBP at: (800) 767-1840, or (518) 785-1900, ext. 243, opt. 2. To maintain your voluntary insurance benefits while on Military Leave, complete the application.
Have additional questions?
For additional questions, please contact PEF MBP at (800) 767-1840, or (518) 785-1900, ext. 243, opt. 2. You may also email PEF MBP insurance.
