California State Disability Insurance 2016

EDD Administrative Branch Disability Insurance Branch Information Technology Branch Policy, Accountability and Compliance Branch Public Affairs Branch Unemployment Insurance Branch Workforce Services Branch

State Disability Insurance Paid Family Leave

State Disability Insurance Vision The State Disability Insurance program is a model of excellence, innovation, and integrity.

State Disability Insurance Mission We provide California’s eligible workers with timely benefits and deliver quality service to all our customers.

What is SDI? State Disability Insurance (SDI) is a partial, short-term, wage-replacement insurance plan for California workers.

Workers Covered by Two Benefits Disability Insurance (DI) provides partial wage replacement benefits for up to 52 weeks per claim. Paid Family Leave (PFL) provides partial wage replacement benefits for up to six weeks within a 12-month period.

Disability Insurance Which States Have It California is one of six U.S. locations with State Disability Insurance. Hawaii - DI New Jersey – DI, PFL New York - DI Rhode Island – DI, PFL The Commonwealth of Puerto Rico -DI

Key Points of SDI Covers approximately 17.9 million California workers. Replacement of approximately 55% of an employee’s income. Requires qualifying wages in the base period and attachment to the labor market when the DI or PFL claim begins.

Key Points of SDI 2 Requires a seven day, non-payable waiting period. Provides benefits starting on the 8th day. Must file a timely claim (no later than 49 days). Can apply without regard to length of employment. Does not provide entitlement to leave or job protection.

Can A Claimant Work Part-Time? Must be working less than their normal, regular and customary hours. The reduction of work hours must be a direct result of the disability or family leave claim. Must have a loss of wages.

How Is SDI Funded? Employees pay into SDI through state- mandated payroll deductions. 2016 withholding rate of 0.9% 2016 taxable wage limit = $106,742 2016 maximum yearly employee contribution = $960.68

Weekly Benefit Amounts (WBA) A base period of 12 months is used for calculating the maximum and weekly benefit amounts. Minimum Weekly Benefit Amount in 1946=$10 Minimum Weekly Benefit Amount in 2016=$50 Maximum Weekly Benefit Amount in 1946=$20 Maximum Weekly Benefit Amount in 2016=$1,129

Base Period for WBA CED 6/1/15 Base Period Quarters WBA = Weekly Benefit Amounts CED = Claim Effective Date $11,180 $15,657 $12,249 CED 6/1/15 1/15-3/15 4/15-6/15 7/15-9/15 10/15-12/15 1/16-3/16 4/16-6/16 (QTR 1) (QTR 2) (QTR 3) (QTR 4) (QTR 5) (QTR 6) Base Period Quarters

State Disability Insurance Data State Fiscal Year 2014-15 Stats Total DI claims filed: 697,485 Total PFL claims filed: 237,246 Average DI weekly benefit amount: $487 Average PFL weekly benefit amount: $543 Total DI benefits authorized: $4,991,992,497 Total PFL benefits authorized: $653,869,391

SDI - Employer Responsibilities 1 Post EDD Notice to Employees (DE 1857A).

Employer Responsibilities 2 Provide SDI brochures to new hires or employees who may need to file a claim: DE 2515 for DI

Employer Responsibilities 3 Provide SDI brochures to new hires or employees who may need to file a claim: DE 2511 for PFL

Employer Responsibilities 4 Complete and return the Notice to Employer (DE 2503/2503F) within two working days.

Key Points of Disability Insurance Provides benefits for employees who cannot work due to a non-work-related illness or injury. Includes: Elective surgery, alcoholism, drug addiction treatment and recovery, pregnancy, childbirth or other related conditions.

Key Points of Disability Insurance 2 Employees must be unable to perform their regular or customary work. Employees must be under the care of a physician/practitioner. Certification must be from the treating physician/practitioner of the illness, injury, or disability.

Key Points of Disability Insurance 3 Paid Family Leave (PFL) is a component of State Disability Insurance (SDI) and applies to all employees covered by SDI. PFL benefits are payable at the same rate as DI. Payments are limited to six weeks over a consecutive 12-month period for bonding or caregiving needs.

Key Points of Disability Insurance 4 Mothers transitioning from DI maternity leave to PFL for bonding benefits do not serve a second seven day waiting period. Employers may require employees to use up to two week of vacation before receiving PFL benefits.

Two Basic PFL Claim Types Bonding Requires written proof of the new child such as birth certificate, adoption papers, or foster care placement document. Must be claimed within 12 months of the child entering into family. Child must be under 18 years of age.

Two Basic PFL Claim Types 2 Care To care for seriously ill child, parent, parent- in-law, grandparent, grandchild, sibling, spouse, or registered domestic partner. Requires physician/practitioner certification of a serious illness and a need for care. Requires the signature of the person receiving care or their authorized representative.

Differences Between DI and PFL Disability Insurance Up to 52 weeks per claim Employee’s personal illness, injury, or disability Not required to use vacation benefits Vacation pay is not in conflict with DI Benefits are not reportable to IRS (unless in lieu of UI)

Differences Between DI and PFL 2 Paid Family Leave Up to six weeks per 12-months Caring for a seriously ill family member or to bond with a new child Employers may require employees to use up to two weeks of vacation Vacation pay conflicts with PFL when employer requires employee to use Benefits are reportable to IRS

SDI Fraud Prevention To deter fraud, please respond immediately to the Notice to Employer if you are not the employer shown or if the claimant: Is not your employee. Has quit their job. Is receiving wages. Has not stopped or has started back to work.

SDI Fraud Prevention 2 To deter fraud, please respond immediately to the Notice to Employer if you are not the employer shown or if the claimant: Is known to be working for another employer. Has filed for workers’ compensation or is believed to be planning to do so. Is using a Social Security number incorrectly. Is working under another name.

To Report Fraud To report Disability Insurance, Paid Family Leave or Unemployment Insurance fraud: Call the EDD Fraud Tip Hotline at 1-800-229-6297

To Report Payroll Fraud Submit an online Fraud Reporting Form at www.edd.ca.gov Call 1-800-528-1783 Email ueo@edd.ca.gov Fax 1-916-227-2772

What is SDI Online? SDI Online: Is an online claim filing system. Allows online submission of SDI claims and other claim documents by claimants, physicians/practitioners, employers, and voluntary plan administrators.

What is SDI Online? 2 Provides the best method to file a DI or PFL claim and for employers and physician/practitioners to submit their paperwork. Is the faster and easier alternative to filing by mail.

SDI Online - Security Claimants can securely submit: Disability Insurance (DI) claims. Paid Family Leave (PFL) claims. Required documentation related to their claim.

SDI Online – Security 2 Physicians/Practitioners and physician/practitioner representatives can: View a patient’s initial claim for benefits Submit DI and PFL claim certifications. View claim certification history.

SDI Online - Convenience Employers, designated representatives, and Voluntary Plan Administrators can use an SDI Online account to: File the Notice to Employer of Disability Insurance Claim Filed (DE 2503) File the Disability Insurance Eligibility – Workers’ Compensation (DE 2578A) File the Employer’s Statement of Job Duties (DE 2546PE) Update contact information.

SDI Online - Benefits Benefits of SDI Online: Improved access to services, claim status, and payment history. Reduced claim processing time. Improved detection and management of fraud and abuse. Reduced paperwork and postage costs. Health Insurance Portability and Accountability Act compliant.

SDI Online Access Visit www.edd.ca.gov/disability to register or login to SDI Online.

SDI Online Access 2 Select Register for SDI Online to register for an SDI Online account. Existing users may go directly to the Log in to SDI Online.

SDI Online Access 3 Select Employers to view tips, FAQs, videos, and tutorials.

SDI Online Access 4 SDI Online page showing available Employer tips, FAQs and tutorials.

Paper Claim Form - DI DE 2501, Optical Character Recognition (OCR) form for Disability Insurance which can be scanned and interfaces with the SDI Online system. Part A (pages 1-4): Claimant’s Statement Part B (pages 5-7): Physician/Practitioner’s Certification

Paper Claim Form - PFL DE 2501F, Optical Character Recognition (OCR) form for Paid Family Leave Part A (page 1): Claimant’s Statement

Paper Claim Form – PFL 2 Page 2: Care Recipient’s Authorization

Paper Claim Form – PFL 3 Parts B and C (page 3): Bonding Certification (B) and Statement of Care Recipient (C)

Paper Claim Form – PFL 4 Part D (page 4): Doctor’s Certification

SDI Contact Information Disability Insurance English: 800-480-3287 Disability Insurance Español: 866-658-8846 Paid Family Leave English: 877-238-4373 Paid Family Leave Español: 877-379-3819

SDI Contact Information 2 For Employers Only: SDI Online Services Help Desk 855-342-3645

In Conclusion Visit www.edd.ca.gov/disability for more information about State Disability Insurance and SDI Online. DIBOutreach@edd.ca.gov

Questions?

The EDD is an equal opportunity employer/program The EDD is an equal opportunity employer/program. Auxiliary aids and services are available upon requests to individuals with disabilities.