Presented By: Tammy Usher Chief Executive Office Risk Management Branch Long-Term Disability LONG-TERM DISABILITY AND SURVIVOR BENEFIT PLAN County of Los Angeles “To Enrich Lives Through Effective and Caring Service”

2 Long-Term Disability The Long-Term Disability (LTD) Benefit provides a monthly income replacement to eligible participants when they are sick or disabled from work for more than six months.

3 Long-Term Disability An eligible County employee must be a General Member of Retirement Plan A, B, C, D, or E of the County of Los Angeles Employees Retirement Association (LACERA), and appointed to a County item as follows: “A,” “L,” “N,” or “D (with restrictions),” and “M (with restrictions)”.

4 Authority, Eligibility & Benefit Non-MegaFlex Choices, Options and Flex (excluding Safety Retirement members) The Non-MegaFlex LTD Plan is governed by section 5.38 of the County Code. Employees must have five years of continuous County service or have an admitted worker’s compensation claim. Employees are offered LTD benefits at 60% of their average basic monthly compensation (for the 12 months prior to the qualifying disability).

5 Authority, Eligibility & Benefit MegaFlex Non-Represented and certain Management level Safety Classification Employees  The MegaFlex LTD Plan is governed by sections 5.27and 5.28 of the County Code.  Before the qualifying disability begins, a MegaFlex employee must have purchased LTD benefits at 40% or 60% of their average basic monthly compensation for the 12 months prior to the qualifying disability. MegaFlex employees in Retirement Plan E with five years of continuous County service or an admitted worker’s compensation claim qualify for a 40% LTD core benefit.

6 LTD Waiting Period An eligible employee must be disabled for six months or more with the qualifying disability approved by the County’s third-party administrator (Sedgwick) for LTD benefits. During the six month waiting period there are no LTD benefits paid, but the waiting period is not extended if the employee attempts to return to work for a total of 29 days or less. If the employee returns to work for 30 days or more, the six month waiting period will start over.

7 LTD Application Process Employees absent from work for more than four months should ask Sedgwick for an LTD Application Form, if not already received. (It is employee’s responsibility to receive LTD Application Form.) An employee must complete the “Employee’s Statement of Claim” form, and their physician must complete the “Attending Physician’s Statement” form. The completed LTD application forms must be returned to Sedgwick within one year from the first day of absence due to disability. Otherwise, a penalty is assessed for each day the claim is filed late.

8 LTD Application Process Within 30 days of filing an LTD application for benefits, employees must also apply for Social Security Disability (SSD) benefits under the Federal Social Security Act (FSSA), to complete the application process. LTD Plan requires that employees provide Sedgwick with proof of their application for SSD benefits under the FSSA, regardless of whether or not they were found eligible to receive FSSA benefits.

9 Duration of LTD Benefits The first 24 months of benefit eligibility, an employee must be disabled and unable to perform the duties of their County position. After 24 months of eligibility, an employee must be deemed totally disabled according to Social Security guidelines, and unable to perform the duties of any occupation.

10 Coordination of LTD Benefits If an employee is entitled to other income replacement benefits from a government entity as a result of their disability, i.e. worker’s compensation benefits, their LTD benefit will be coordinated with these other benefits. If an employee elects to use sick leave, vacation, annual leave, or other accrued time in lieu of LTD benefits, LTD benefits will be substituted on a day-for-day basis, resulting in one day’s loss of LTD benefits for each day of substituted time. Note: Employees on LTD cannot use paid leave or donated leave on a once-a-month frequency to maintain health care contributions or other cafeteria benefits.

11 Long-Term Disability Health Eligibility & Benefit An employee must be approved for LTD benefits, and also be enrolled in a County-sponsored medical plan to participate in the LTDH Plan. The County LTDH Plan provides a “core” coverage of 75% County-sponsored medical premium while receiving LTD benefits. The employee will pay 25% of the monthly premium. If an employee elects to “buy-up” with LTDH prior to the start of their disability, they will be covered for 100% of their health benefit while receiving LTD benefits.

12 Long-Term Disability Health Eligibility & Benefit The LTDH program is provided by the Department of Human Resources (DHR), Employee Benefits Division. Please contact DHR directly at (213) if you have questions about LTDH.

13 Survivor Benefit & Eligibility Non-MegaFlex Choices, Options and Flex (excluding Safety Retirement members) Survivors of Non-MegaFlex deceased employees who meet the LTD qualifications, may be eligible for Survivor Benefits (SB). For the life of the surviving spouse or domestic partner, SB pays 55% of the 60% LTD benefit, whether or not the employee was receiving LTD on the date of death.

14 Survivor Benefit & Eligibility MegaFlex Non-Represented and certain Management level Safety Classification Employees MegaFlex employees do not receive SB benefits, but MegaFlex Retirement Plan E employees may elect a separate Survivor Income Benefit (SIB) Plan. More information about SIB coverage may be found in the MegaFlex Summary Plan Description from the Department of Human Resources, Employee Benefits Division.

15 Other Resources Additional LTD information is available on the County Medical Provider Network website at: (click on the Return-To-Work Unit) At the website you will find: The LTD Booklet The LTD Pamphlet Excerpt from the County Code that relates to LTD

16 Other Resources Contact (800) Fax – (818) Sedgwick CMS PO Box 9830 Calabasas, CA

17 LTD & Survivor Benefits This is intended only as an overview of the LTD Plan. In the event that there are any discrepancies or inconsistencies between the information provided in this presentation and the provisions of the County Code, the County Code shall govern.