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New full-time employees are eligible to enroll in these plans during their 31-day enrollment period without Evidence of Insurability. If not enrolled during the enrollment period, the employee can apply through Evidence of Insurability during the annual summer enrollment period.
The Disability Income Plan is composed of two parts; Short-term Disability and Long-term Disability. Includes a 30 or 180-calendar day elimination period or for a pre-existing condition for newly enrolled employees, within the first six months of coverage.The employee must exhaust all paid sick leave (includes approved sick leave pool days).
A claim form is necessary to apply for benefits with a medical determination provided by a licensed practitioner.
Applying for DisabilityA covered employee may apply for disability benefits when they are unable to work as a result of a medical illness or injury.
Effective September 1, 2013, AON Hewitt will administer the disability plans for ERS via the Texas Income protection Plan (TIPP).
To file a claim please visit the TIPP website at: https://www.aontipp.com/start-file-claim.html and call TIPP Customer Care at AON Hewitt toll-free at (855) 604-6230 (TDD - 711) Monday - Friday, 7 a.m. - 7 p.m. CT. Carrier Review of the Claim FormThe insurance carrier will review the claim form in accordance to the attending practitioner statement. The attending practitioner defines the period of total disability and the degree of the disability. If the practitioner does not provide enough medical information for the insurance to make a decision concerning the approval of the claim, the physician is contacted for more medical information. Obtaining more medical information may include the employee, and all physicians and/or hospitals that have treated the employee for the disability related illness. This action may delay a determination for benefits and cause the employee to have a financial hardship. Employees are encouraged to notify their physicians when additional information is requested to speed the process.
The carrier will determine any other benefits amounts of entitlement such as social security, workers compensation, or retirement benefits.
If the claim is approved, the claim is paid as a monthly benefit. If the claim is denied, the carrier will notify the employee by mail.
AON Hewitt does not notify the DHR or location regarding disability claim status.
Approval of STD ClaimIf the claim is approved by the carrier, short-term disability benefits will be paid after the 30-calendar day elimination period and when all paid sick leave, extended sick leave and sick leave pool has been exhausted. Short-term disability benefits are paid for a maximum period of five (5) months.
The short-term disability benefit check is mailed directly to the employee's home address. Benefits end when you return to work or are no longer considered totally disabled under the plan.
Approval of LTD Claim
If the claim is approved by the Carrier, long-term disability benefits will be paid after the 180-calendar day elimination period and when all your sick leave, extended sick leave and sick leave pool has been exhausted. Long-term disability maximum benefits are paid to you up to the maximum benefit period, which depends on your age when you become totally disabled. Benefits end when you return to work or are no longer considered totally disabled under the plan.
*Benefits end the first day of the plan month after you reach this age.
The long-term disability check is forwarded to the employee’s home address. Coordination of STD and LTDAt a point defined by the carrier, long term disability benefits can be collected with short-term disability benefits. The same claim form will be used to determine short and long term disability benefits. These benefits may be combined for a period of two months or less, dependence upon your first day of total disability. When these benefits are combined, they pay at 70 percent.Appealing the Denial of a ClaimIf the claim is denied, the employee may appeal the decision by making a written request for reconsideration with additional medical information.
If the claim is denied a second time, the employee may file a grievance with the Employees Retirement System along with copies of the insurance’s correspondence. The request must be within 90 days of the denial. ERS will send the employee a decision in writing.
Upon approval this benefit can run concurrently with Vacation, Extenuating Circumstances leave, workers compensation and FMLA.STD Income benefitsA monthly income of 66 percent of your September 1 or first active duty date base salary (with a maximum covered salary of $10,000) or $6,600, whichever is less. For example, if your monthly salary is $3,200, your benefit would pay you up to $2,112 per month while you're unable to work because of disability.LTD Income benefitsA monthly income of 60 percent of your September 1 or first active duty date base salary (with a maximum covered salary of $10,000) or $6,000, whichever is less. For example, if your monthly salary is $3,200, your benefit would pay you up to $1,920 per month while you're unable to work.
The actual amount or STD and LTD can be reduced when an employee is receiving benefits from Workers Compensation, Teachers Retirement System of Texas, Social Security or any other group disability benefit. It will always be at least 10 percent of your insured monthly salary.
Short-term Disability - ERS
Long-term Disability - ERS