Continuing Benefits During COVID-19-Related Leaves and Disability Policy Change

UC recently implemented Emergency Paid Sick Leave (EPSL) and Expanded Family and Medical Leave (EFML) policies related to COVID-19. Under these policies, employees may take leave for the six reasons listed below during the period April 1 through December 31, 2020:

  1. Quarantine or isolation order, including shelter-in-place/stay-at-home order
  2. Told by health-care provider to self-quarantine
  3. Experiencing COVID-19 symptoms and seeking diagnosis
  4. Caring for individual subject to quarantine/isolation order or who was told by health-care provider to self-quarantine
  5. Caring for child whose school/place of care is closed or child-care provider is unavailable because of COVID-19
  6. Other substantially similar condition specified by HHS Secretary

How are Disability Benefits Handled?

Leave reasons 1-3 and 6 are related to an employee’s own illness. When leave is for these reasons, the Disability plan provides a Waiver of Premium, and coverage continues for the duration of the leave. This is the standard process you are accustomed to seeing for medical leaves.  

Leave reasons 4 and 5 are not specific to an employee’s own illness, and there is no provision in the Disability plan that allows for a Waiver of Premium. Employees who take leave for reasons 4 and 5 are required to pay premiums for continuation of coverage.

What’s Changed?

If an employee is on leave for reasons 4 or 5 they can continue Disability coverage for the duration of their 12-week EFML entitlement and, if on leave without pay, can be direct-billed for premiums. This is a change from the current Direct Payment of Premiums policy as provided for in Admin Supplement II-C of the Group Insurance Regulations (GIRs), which prohibits employees from continuing Disability coverage while on a Leave Without Pay. This exception to policy has been made for disability coverage and COVID-related leave reasons 4 and 5 only, and does not apply to any other Leave without Pay situations. 

UCPath is being programmed to accommodate this change.  Going forward, when an employee on leave for reason 4 or 5 is coded as being on a EFML Leave, Disability coverage will continue. If the leave is without pay, UCPath will direct-bill them for premiums for the remainder of their 12-week EFML entitlement.  If the employee fails to pay premiums, their coverage will terminate.

Since this policy exception is effective retroactive to April 1, 2020,  there are some employees for whom disability benefits need to be reinstated, and missed premiums owed collected. In order to identify those employees, the UCPath team needs assistance from staff at UC locations. The process for collecting the necessary information is in Related Information. The UCPath team will reach out to locations as needed to initiate the process. 

A chart outlining how all benefits are handled during different types of leave is attached as a reference. The chart lists how long an employee remains eligible for benefits during leaves, and how long the UC contribution to premiums continues.