Reporting Absences and Filing For Short Term Disability ...

1 Absence ManagementFrequently asked QuestionsCounty of SanBernardinoSI15064-7509971of3(6/15)Rep orting Absences and Filing For ShortTermDisabilityBenefitsIt feels good to be prepared. That's why we've developed the following guide to help you reportanabsence withStandardInsurance Company. Please use the steps outlined belowshould you become disabled or need to filefora leave of absence fromwork. They will enableyouto access our in-house Absence Management ServiceCenter (AMSC), online or via Should I Report An Absence?Contact The Standard if you are absent from work, or know you will be absent from work, for more than3calendar days due to the following.

2 Your own serious health condition (including pregnancy) To care for your newborn child The placement of your adopted or foster child To provide care for a qualifying family member with a serious health condition To carefor acovered service member injured in the line of duty For qualifyingmilitary exigency, allowingfamily members to take leave to prepare for or deal with issues thatarise as a result of a family member being called to serve in the militaryHow Do I Notify The Standard About An Absence? Call the AMSC at844-239-3560;or Report it online:oGo chooseI am an individualoOn the next page,selectReport an AbsenceoThe next page, select Log in toReport an AbsenceoYou will be asked to provide the following information:Company ID:County of San BernardinoUsername:This is yourlast name + the last 4 digits of your SSNP assword:If this is your first time reportingan absence, you will enter theword password as your will then be prompted to choose a personal Are The Absence Management Service CenterOperation Hours?

3 TheAMSC is available Monday through Friday, I Call ToRequest Leave OrReport My Absence, What Questions Will I Be asked ?You will be asked to provide the following information in addition to other questions about your absence: EmployerName:County of San Bernardino Last day you were at workor are expected to be at work Reason leave is requested If you are planning to filea Short term Disability claim, we will ask you to provide your Physician s contactinformation (name, address, phone, and fax number)When ShouldI Report an IntermittentAbsence?Your absence should be reported as soon as you are aware that you will miss scheduled time off from work.

4 Youmust report your intermittent absence within 48 hours of the start of the first shift you miss. Failure to do so mayjeopardize your jobprotection for those ManagementFrequently asked QuestionsCounty of San BernardinoStandard Insurance CompanyStandard Insurance Company|1100 SW Sixth Avenue|Portland OR 97204SI15064-7509972of3(6/15)Please note that the County of San Bernardino has a late Reporting provision which requires you to report yourrequest for intermittent Absences within 2 days of the Do I Report an Intermittent Absence?When you miss time associated with an approved, open intermittent leave, you can quickly and easily reportabsences through The Standard s self-service phone system.

5 When you call us, say report an absence whenasked, and you can report your time off without needing to speak to a representative. This service is available anytime of day or use the system you will need to provide: Your leave number. Your leave number is found on correspondence we sent you after we approved yourintermittent leave. Your date of birth. The date of the absence. You may report multiple Absences during one can be today, or in the pastor future, however each absence will be a separate entry during the same call. The type of will need to let the system know if your absence is related for your condition or is toattend a medical appointment.

6 The number of hours you were scheduled to work, and the number of hours of leave taken, for each day youare Reporting . A number where you can be reached. You will be asked to provide a call back number if we need to contact youfor further the automated intake is complete, you will receive a confirmation number to let you knowthat your absencereport has been successfully tforget to notify your manager and follow your department s usual call-in Is Responsible For NotifyingCounty of San BernardinoOf My Absence?It is your responsibility to followyour department s usual call-in I Receive Any Notification After I Initiate ALeave OrClaim?

7 After initiating arequestfor time off under Family Medical Leave and/orclaim forShort Term Disability (STD),The Standard will send you a letter confirming receipt of your leave request. If you are Filing for an STD claim,The Standard will fax an Attending Physician s Statement2to your physician to complete; an Authorization toObtain Information will be mailed to you to sign and return. If you called to request a leave but did not initiatean STD claim, you will receive a Certification of Health Care Provider form. These forms should be returned toThe Standard by the due date indicated in your will also receive letter about Your Benefits While onMedical Leave of Absence , including Continuation of Benefits Designation formfrom the County.

8 You areexpected to readthe informationand return the Benefits Designation form to the Do I Send The Completed Forms?If you are required to submit paperwork,please send the completed forms to:Standard Insurance CompanyEmployee Benefits DivisionPO Box 3877 Portland OR 97208Or you may fax completed forms to Long Does It Normally Take For An STD Claim Decision?It will take approximately one week to make a claim decision (once your completed claim application is received).If we have not made a decision within one week, you will be notified as to ManagementFrequently asked QuestionsCounty of San BernardinoStandard Insurance CompanyStandard Insurance Company|1100 SW Sixth Avenue|Portland OR 97204SI15064-7509973of3(6/15)If My Claim For Short Term Disability Benefits Is Approved, How Long Will It Take ToReceive My First Check?

9 After the Benefit Waiting Period of7days has been servedand yourSTDclaim has been approved, STD benefitpayments are paidin arrears on a weekly most cases, checks are mailed on Wednesday of each benefit payments that are payable for retroactive claims will be mailed following claim approval. STD checkswill be mailed directly to yourhome address listed in I ReceiveMy Benefit Payment via Direct Deposit?Electronic Funds Transfer (EFT) is an available option for receiving benefit payment. Information about initiatingthe EFT/direct deposit will be included in your approval FICAT axes BeDeductedFrom MyBenefitPayment?

10 FICAtax is composed of two parts, Social Security and a County employee, you will not contributeto Social Security tax, however,Medicarewill bewithheld under the following three the first six complete calendar months after the individual ceases work due to Disability when the claimant returns to work with the the first six complete calendar months after the employee ceases work Questions?Call The Standard s Absence Management Service Center the most current form is submitted. Refer to EMACS Forms/Procedures REQUEST FOR EXTENDED SICKAND SPECIAL LEAVE Employees must contact The Standard no later than the 4th day of leave to initiate the leave box if applying for STDMust print in Black or Blue ink ONLY Employee IDRcd Name, First Name Job TitleDepartment Department IDTo Be Completed By Employee (Supervisor may complete in employee's absence) Home AddressCityStateZip CodeMailing Address (if different than Home)CityStateZip CodeTelephoneHome WorkAlternateNumbers.