Disability Benefits Claims Procedures
Please follow these important instructions when submitting a Short-term and/or Supplemental Disability claim to Liberty Mutual. These procedures have been documented to provide those involved a clear outline of what transpires throughout the claim process.
Note for UCSF Medical Center employees: Please call 415-353-4545 for Medical Center Human Resources/Benefits claims procedures.
EMPLOYEE ACTIONS REQUIRED:
- Contact your HR Representative to request your FMLA packet, if applicable, and discuss your leave options
- Follow the instructions in the Disability Claims Procedures document to submit your claim to Liberty Mutual and note that Liberty will request a copy of job description from your dept. (No access to a computer - contact the UCSF HR/Benefits Office).
- Faculty members in the Health Sciences Compensation Plan (HSCP) may also be eligible for disability insurance on their ‘Y’ component of salary - contact the benefits office for more information
- Apply for State of California Disability Insurance if you have been employed at UC for less than 18 months
- Complete the DepCare/HCRA Enrollment, Change & Cancellation Form (UPAY 919) and submit to payroll prior to going off paystatus or within 31 days of a qualifying event if enrolled in a Flexible Spending Account
- Complete the Enrollment, Change, Cancellation form (UPAY 850), when returning from leave and/or to add newborn (if applicable) and submit to payroll*
Factsheets and summary plan descriptions that may apply to you:
- Disability Benefits Factsheet
- Partial Disability Factsheet (Stay-at-Work/Return-to-Work)
- Family Medical Leave Benefits Checklist
- Pregnancy And Newborn Child Factsheet
- Dependent Care Reimbursement Account Summary Plan Description
Liberty Mutual Reimbursement Agreement form
Resources and Contacts:
Liberty Mutual is generally able to process claims within 5 to 10 working days upon receipt of the employee claim, physician documentation and UC statement.
- UCSF Payroll Office/Insurance Section: 415-476-8428
- UCSF HR/Benefits: 415-476-1400
- Liberty Mutual: 1-800-838-4461
- State of California Employment Development Department (SDI): 1-800-480-3287
Compiles data pertaining to UC Statement for Liberty Mutual.
Certifies enrollment, eligibility, and salary data on UC statement.
Sends UC statement to employee’s department to verify payroll status (e.g., last day worked, date sick leave exhausted, last day on payroll status, etc.).
Electronically transmits all UC statement information to Liberty Mutual.
Sends instructions to employee regarding actions employee must take in order to continue insurance during, and upon return from, an approved Leave-Of-Absence*.
Department places employee on Leave-Of-Absence* (via appropriate OLPPS Entry/Update procedures). NOTE: LOA begins on the later of the following dates: The calendar day following the last day on pay status, OR, the date of disability.
Department provides information pertaining to UC statement (per instructions) and returns it to the Payroll Office.
NOTE: If/when an employee has been on leave-of-absence for six months, the home department may request that a Return-to-Work Review be conducted by Employee/Labor Relations and Disability Management Services.
It is important that all Leaves-Of-Absence Without Pay (LWOP) be documented and processed in order to provide for:
- System-generated notices regarding Basic (UC-Paid) Life Insurance conversion. Coverage ends following 4 calendar months while on approved LWOP. NOTE: Beginning with the end of coverage, there is a thirty-day window (only) to elect conversion. Contact UCSF HR/Benefits.
- Necessary documentation for purposes of establishing UCRP service credit (if desired) for the period on LWOP. NOTE: Upon the return from an approved LWOP an employee may elect to buyback/establish UCRP service credit which was not accrued while off of pay status. Generally, it is most cost-effective to initiate a Leave Buyback within a three-year window upon return to regular pay status—otherwise the cost escalates. Contact UCSF HR/Benefits for more details.
*Employees returning to pay status from a LWOP of more than one calendar month must reinstate all insurance. Enrollment forms must be received by the UCSF Payroll Office (Box 0812) or UCSF HR/Benefits Office (Box 0918) before the end of the last working day within a 31-day period upon return to pay status. Please be sure to notate: "Return from LOA [date]" on the Enrollment, Change, Cancellation form (UPAY 850) .