Short Term Disability and Maternity Leave

CPAnotHR

I have numerous pregnant women in the office, all of whom purchased supplemental STD that the company offered, at their own expense . They were under the impression that a maternity leave of 3 months would be covered since that is how long the STD is for. But, the broker recently stated that it is federally mandated that only 4 weeks for a vaginal and 6 weeks for a c-section is covered. Is this true? Any help would be greatly appreciated.

Parabeagle

I'm not aware of any federal laws that limit the length of a leave of absence based on the type of delivery. It almost sounds like the guidelines you mentioned are guidelines for how long the insurance company will PAY for a pregnancy leave, not mandating the length of the leave itself. Am I missing something?

LindaS

I haven't heard of anything like this. In fact when talking with our TPA regarding this issue I was informed that it is illegal to have a specific timeframe for maternity leave pay. It was explained to me that it is up to the physician to determine how long the female is unable to work and treating this any different than any other disability is discriminatory.

Pearce

There is a difference between the period of time that is considered leave and the period of time that the person is considered disabled. Under FMLA a person could take up to 12 weeks because of the birth of a child; however, the salary continuation or short term disability would not automatically consider that person disabled for that period of time. 6-8 weeks of disability would be normal. Complications, substantiated by a physician, might certify a disability that is longer and thus increase the period of time applicable to salary continuation or short term disability.

Whatever

This sounds discriminatory therefore illegal. I never heard of such a thing.

Human Resources Manager

We have two different STD carriers, one for non-union and one for union employees. Both carriers will consider a woman with a "normal" delivery, vaginal or c-section, disabled for 6 weeks. Benefits will be extended if a doctor certifies the need. It was my understanding that this was standard practice for STD insurers; however, I don't think that there is any federal mandate.

CAL

I would ask your broker to cite the reference to the Federal mandate -- betcha he/she can't do it.

A pregnant employee is entitled under federal law to the entire 12 weeks, if requested, for pregnancy, childbirth and child bonding (and in some states, like mine, there are additional considerations -- up to 16 weeks for pregnancy and then 12 more weeks for baby bonding). However, neither the federal law, nor most states, will require an employer to pay the employee for this leave time. The STD plan is a benefit; however, it should be consistently applied to all medically certified leaves - if it is not, here is where the discrimination lies.

For example, if the cap is 12 weeks for the STD payout, and you have one employee out with back surgery for 6 weeks, and a pregnant employee out with a cesaerean for 10 weeks (say the MD takes her off 2 weeks before due to hypertension, and then says she needs 8 weeks to recover), then they BOTH qualify under the STD, because they are BOTH medically certified. Similarly, if the back surgery was certified by the MD to be out for 10 weeks, and the new mom only 4, then that's what logically the STD should pay for (but in the case the mom would still be entitled to 8 more weeks off for baby bonding - just not covered by STD). What STD shouldn't pay for, is someone who has been released medically and still hasn't returned to work -- this would normally be unpaid time off.

Whew - is that clear as mud?

cthr

Most STD policies cover 6 weeks for vaginal and 8 weeks for c section. This is the amount of time that the woman is considered to be "disabled". If there are complications either before or after the delivery and the doctor certifies this the carrier, in my experience, has always provided coverage. Once the woman is released by her doctor to return to work she is no longer considered "disabled". She still has the option to use her remaining FMLA if any as UNPAID time. It is not discriminatory as STD stands for Short Term DISABILITY.

HRQ

This is my understanding as well - up to 12 weeks Leave, generally 6-8 weeks STD based on approval of insurance company.

Unfortunately, employees tend to get Disability insurance confused with FMLA, and think they are the same thing. (Meaning by requesting FMLA, it will automatically be paid by STD, or vice versa)

I just automatically assume from the start that the employee doesn't understand and I explain the separate issues and the employee's responsiblities.

Didn't someone say something about hand holding and mind reading in another post? It is a part of our daily life. x0:)

E Wart

E Wart
Sounds to me as if the employees (and perhaps you) are confusing several different things. 1)The STD policy that your employees were able to purchase(Voluntary STD) is designed to cover an employee who is DISABLED AND UNABLE TO PERFORM THEIR JOB (or any job depending upon the wording of the policy) up to a maximum of "so many" weeks. From your comments, your "so many" weeks must be 12. In order to qualify for this the employee would have to have their doctor complete a disability form (which the insurance company should supply) which they return to the insurance company. Then the insurance company decides when the employee qualifies for disaiblity and how long the disability should continue. (Additional forms may need to be completed.) Also there may be a 7 day "waiting"/elimination period for illness, which means they wouldn't be covered for the first seven consecutive days. Then they are paid a percentage (usually 60%) of their salary while they are totally disabled. This could be for one day or for six years, depending upon their situation and the insurance company's approval. (Even if it was for six years, the coverage only pays up to the first 12 weeks.)
I too have never heard any federal law mandates on how long a person receives for disaiblity. Each case is different. (I have had a person who worked all day, delivered that night, had a c-section, and returned to work in 4 weeks and another who was out about 20+ weeks due to complications (and complete bed rest) before the child was even born.
The second issue is the FMLA, if you qualify. Depending upon which state you are from, there could be a state mandate as well. I think the others have explained this so I won't bore you further. This is just "approving" a leave and agreeing to hold job open, continue with group insurance, etc. for up to 12 weeks (for birth of a child). This doesn't have anything to do with any compensation that a person would receive during these 12 weeks.
Sounds as if you need to talk with your broker that sold you the insurance and get all the details of the coverage and explain it to all of your employees (or take a fee minutes and read the SPD that your employees should have been provided.) Good luck.