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According to recent studies disability income is a rising star in the employee benefits market. This is due to a variety of factors. Most poignantly insurance company attempts to court and educate employee benefit advisers about the product, historically low national unemployment and financial impact of the recent tax reforms.

In discussions with successful financial and employee benefits professionals across the country, one of the common traits observed is their ability to adapt their business in the midst of market change.  To accomplish this, professionals must not only pay attention to industry trends, but also anticipate how to shift an organizational process to maximize positive outcomes.  Of equal importance is optimizing the client experience.  Executed successfully, this type of innovation will result in phenomenal business rewards.

Is this disability income protection trend an opportunity wave you should ride?

When reviewed more closely, Disability Income Protection placements within the context of employee benefits programs is a triple-win scenario for today’s economic environment.

The employer wins because it enhances the ability to attract, retain and recruit employees.

The employee wins as they are provided easy and efficient access to more adequately protect their most valuable asset, the ability to earn income.

The advisor wins because these new product placements drive new revenue and deepen the engagement with the customer.

If your clients believe in providing traditional group long term disability coverage to their employees, they will likely engage in a discussion pertaining to enhanced disability income protection for executives and key contributors.

In an April 2018 article featured in Think Advisor titled, “Maybe Employers Are Ready to Be Aware of Disability Insurance”, Allison Bell cites comments on two major disability insurance companies’ recent earnings calls that securities analysts see increased employer interest in adding to disability benefits. This is thought to be attributed to the current state of the U.S. economy where near full employment levels have convinced employers that they have to do more to attract and retain good workers.

How can you position this opportunity?

  1. Focus On Incentive-Based Compensation – Most group long term disability insurance programs insure only base salary. However, most executives, sales professionals and other key contributors within an organization are compensated beyond base salary alone. Bonus, ownership distributions, stock bonus plans, and other fringe benefits add up to a significant portion of income uninsured by the group disability insurance program. When disability occurs without any other form of planning beyond a group program, these valuable employees are left in a devastating financial state, drastically disrupting their lifestyles.
  2. C-Suite Engagement. Although disability income programs are often implemented by an HR Team, they may not always have influence to make company decisions or recommendations for benefit programs. These programs are most successful when the executive team is engaged in the initial discussions for development. Focus on your clients where you have a strong relationship with the C-Suite to gauge their interest. After all, they are the most likely to benefit from this type of disability income protection program.

A Life Happensr ecent study called “What Do You Know About Disability Insurance?” concluded 7 in 10 employed Americans would have trouble in a month or less if they couldn’t earn a paycheck. This statistic emphasizes the importance of disability income protection insurance and why advisers need to be talking to clients about their options.

By Nicole Blodgett

Originally published by www.UBABenefits.com

No one foresees needing disability benefits. But, should a problem arise, the educated and informed employee can plan for the future by purchasing disability insurance to help cover expenses when needed.
Watch this short video to learn more!

The Department of Labor’s new claim rules for disability benefits took effect April 2, 2018. The changes were announced over a year ago, but the effective date was delayed to give insurers, employers, and plan administrators adequate time for implementation. Although we’ve reported on the key issues in this blog previously, now seems like a good time for a refresher on how the new rules affect employer plans.

Affected Plans

The new claim rules apply to disability benefits provided under plans covered by the Employee Retirement Income Security Act (ERISA); that is, plans sponsored by private-sector employers. Then the new rules apply if the ERISA plan must make a determination of disability in order for the claimant to obtain the benefit. Group short- and long-term disability plans are the most common examples, but pension, 401(k), and deferred compensation plans also may be affected.

Many plans do not make their own determination of disability, but instead condition the plan’s benefit on another party’s determination. For instance, employer plans that base the benefit on a disability determination made by the Social Security Administration (SSA) are not affected by the new rules.

New Rules

For ERISA plans affected by the new rules, the following additional requirements apply to disability claims filed on or after April 2, 2018:

  • Disclosure Requirements: Benefit denial notices must explain why the plan denied a claim and the standards used in making the decision. For example, the notices must explain the basis for disagreeing with a disability determination made by the SSA if presented by the claimant in support of his or her claim.
  • Claim Files and Internal Protocols: Benefit denial notices must include a statement that the claimant is entitled to request and receive the entire claim file and other relevant documents. (Previously this statement was required only in notices denying benefits on appeal, not on initial claim denials.) The notice also must include the internal rules, guidelines, protocols, standards or other similar criteria of the plan that were used in denying a claim or a statement that none were used. (Previously it was optional to include a statement that such rules and protocols were used in denying the claim and that the claimant could request a copy.)
  • Right to Review and Respond to New Information Before Final Decision: Plans are prohibited from denying benefits on appeal based on new or additional evidence or rationales that were not included when the benefit was denied at the claims stage, unless the claimant is given notice and a fair opportunity to respond.
  • Conflicts of Interest: Claims and appeals must be adjudicated in a manner designed to ensure the independence and impartiality of the persons involved in making the decision. For example, a claims adjudicator or medical or vocational expert could not be hired, promoted, terminated or compensated based on the likelihood of the person denying benefit claims.
  • Deemed Exhaustion of Claims and Appeal Processes: If plans do not adhere to all claims processing rules, the claimant is deemed to have exhausted the administrative remedies available under the plan (unless exceptions for minor errors or other conditions apply). In that case, the claimant may immediately pursue his or her claim in court. Plans also must treat a claim as re-filed on appeal upon the plan’s receipt of a court’s decision rejecting the claimant’s request for review.
  • Coverage Rescissions: Rescissions of coverage, including retroactive terminations due to alleged misrepresentations or errors in applying for coverage, must be treated as adverse benefit determinations that trigger the plan’s appeals procedures.
  • Notices Written in a Culturally and Linguistically Appropriate Manner: Benefit denial notices must be provided in a culturally and linguistically appropriate manner in certain situations. Specifically, if the claimant’s address is in a county where 10 percent or more of the population is literate only in the same non-English language, the notices must include a prominent statement in the relevant non-English language about the availability of language services. The plan would also be required to provide a verbal customer assistance process in the non-English language and provide written notices in the non-English language upon request.

Action Steps for Employers

Employers are reminded to work with their carriers, third-party administrators, and advisors to make sure their plans comply with the new requirements. Consider these steps:

  • Identify all plans that are subject to ERISA. (Plans sponsored by governmental employers, such as cities and public school districts, and certain church plans, are exempt from ERISA.)
  • Does the ERISA plan provide any benefit based on disability? If so, is the benefit conditioned on a determination of disability made by the plan or by another party, such as Social Security?
  • For insured plans, such as group STD and LTD insurance plans, the carrier generally is responsible for compliance with ERISA’s claim rules. The employer, however, does have a duty to make reasonable efforts to ensure the carrier is complying.
  • For self-funded plans, the employer is responsible for compliance. Although the employer may engage the services of a third-party claims administrator, the employer remains responsible for the plan’s compliance with all rules.

Originally Published By ThinkHR.com

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