1st Trimester

Short Term Disability Question

I recently applied for short term disability during open enrollment at my workplace (I work for a hospital system) This was back in Mid-November. I elected to have short term disability insurance. I found out I was pregnant at the end of December. The short term disability is not deducted from my paycheck until January. I am concerned I won't be able to use this wafted I deliver. I plan to use FMLA. Has anyone had a similar experience with STD or have any knowledge of how this works? Thanks so much!

Re: Short Term Disability Question

  • When you applied for STD during open enrollment it's for your new benefit year 2013. So it wasn't supposed to start until January. You can only change benefits mid year with a qualifying event marriage and child birth typically.
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  • Without knowing the specifics of your plan, generally you have to have the coverage prior to being diagnosed with the medical condition you hope to use it for.  So if your plan follows the general rules, no, you wouldn't be able to make a claim for your maternity leave.
    Formerly known as elmoali :)

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  • image elmoali:
    Without knowing the specifics of your plan, generally you have to have the coverage prior to being diagnosed with the medical condition you hope to use it for.  So if your plan follows the general rules, no, you wouldn't be able to make a claim for your maternity leave.

    That might depend on if "found out I was pregnant" means, got a positive on a pee stick, or was confirmed by a doctor. If OP didn't see a doctor until Jan to confirm pregnancy, the argument can be made that she wasn't "diagnosed" as pregnant until then.

    Talk to your HR people - they can tell you what the requirements of your specific plan are, and they are not allowed to talk to your boss or anyone about anything medical.

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  • image msspeedymarie:

    image elmoali:
    Without knowing the specifics of your plan, generally you have to have the coverage prior to being diagnosed with the medical condition you hope to use it for.  So if your plan follows the general rules, no, you wouldn't be able to make a claim for your maternity leave.

    That might depend on if "found out I was pregnant" means, got a positive on a pee stick, or was confirmed by a doctor. If OP didn't see a doctor until Jan to confirm pregnancy, the argument can be made that she wasn't "diagnosed" as pregnant until then.

    Talk to your HR people - they can tell you what the requirements of your specific plan are, and they are not allowed to talk to your boss or anyone about anything medical.

    I'm not saying it's not possible but unlike a lot of other medical conditions, it's fairly easy to determine if a person was pregnant on a certain date.  Like, you can't say "This person definitely had cancer last month."  But a doctor can say "You are 9 weeks along, therefore were pregnant in December." kwim?  But I agree, she needs to check because there isn't 1 definite answer. 

    Formerly known as elmoali :)

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  • Do we work at the same place?! lol I'm in the same situation. However, I looked into a lot of the small print as I was evaluating different STD options, since we were already TTC.

    For the plan I ended up going with, any condition that "starts" in the 12 months prior to plan start (Jan 1 for us, too) is considered pre-existing, and only pays out at 50%. I also believe maternity benefits for pre-existing pregnancies have a max pay out of 6 weeks, instead of 8 for full coverage (depending on delivery type). 

    I'd check with your HR. I know I'll still have SOME coverage, which is better than nothing. But damn our timing! lol

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  • I enrolled in STD in October, the same month as our BFP. My plans states that pregnancy won't be covered if I I give birth within 10 months of obtaining coverage. My coverage started the day I signed on the line. So, if I carry my baby around for an extra 3 weeks, I can use my benefits.
    Best best is ask HR if your STD is trough your company, or like my case contact the company directly. Good luck! Also, FMLA is unpaid leave. Not sure if you knew that.

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  • image kpahl:
    When you applied for STD during open enrollment it's for your new benefit year 2013. So it wasn't supposed to start until January. You can only change benefits mid year with a qualifying event marriage and child birth typically.

    this and depending on the stipulations of the plan will depend on if your pg is covered or considered a prexisting condition.   Call HR.

    LilySlim - (VMOr)

  • If you signed up during open enrollment but the benefit doesn't go into a effect until January, you will likely not qualify to use it during your pregnancy because it's now a pre-existing condition.  The best thing you can do is call your plan administrator and find out the exact terms.  I do, however, know that's how my STD works ....
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  • My workplace did an open enrollment for STD for the first time this year.  It's always an apply whenever and then you can collect down the road if you were enrolled before the condition (aka I enrolled a month before getting pregnant last time, so I was able to collect after the birth).  But this year was different and ours negates if you were pregnant before the enrollment, as long as it was before January 1st.  Make sense?  Perhaps yours is the same and it's something relating to the new federal standards?
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  • It totally depends on your plan-talk to your HR department. Some STD plans require you to have the coverage for a minimum time frame before being able to utilize the benefits. Good luck!
  • image elmoali:
    image msspeedymarie:

    image elmoali:
    Without knowing the specifics of your plan, generally you have to have the coverage prior to being diagnosed with the medical condition you hope to use it for.  So if your plan follows the general rules, no, you wouldn't be able to make a claim for your maternity leave.

    That might depend on if "found out I was pregnant" means, got a positive on a pee stick, or was confirmed by a doctor. If OP didn't see a doctor until Jan to confirm pregnancy, the argument can be made that she wasn't "diagnosed" as pregnant until then.

    Talk to your HR people - they can tell you what the requirements of your specific plan are, and they are not allowed to talk to your boss or anyone about anything medical.

    I'm not saying it's not possible but unlike a lot of other medical conditions, it's fairly easy to determine if a person was pregnant on a certain date.  Like, you can't say "This person definitely had cancer last month."  But a doctor can say "You are 9 weeks along, therefore were pregnant in December." kwim?  But I agree, she needs to check because there isn't 1 definite answer. 

    And most will do this because they aren't completely stupid and can figure out how to back date a pregnancy just like your doctor can. 

    You need to check your policy and check with your HR department.

     

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  • My plan requires that coverage be effective for 10 months prior to delivery.  I believe there are exceptions for preterm labor which also includes nicu coverage.
  • I agree with everyone else it depends on the plan. I'm pretty sure the Aflac plan I looked at with my old employer had an 18 or 24 month restriction until it could be used as in, I couldn't draw from it until I had it for 18 or 24 months. But I'm sure it depends on the plan.
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  • Also, FMLA just guarantees you a set amount of time off and that your job will be held. It isn't a paycheck, though. If I recall correctly, it guarantees a minimum of 6 weeks off for a vaginal delivery and 8 weeks for csection. You can take off more time if your employer is amiable to you doing so.
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  • image anvloveskme:
    My plan requires that coverage be effective for 10 months prior to delivery. nbsp;I believe there are exceptions for preterm labor which also includes nicu coverage.


    Colonial ? That's my terms too

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  • image lynn97:
    Also, FMLA just guarantees you a set amount of time off and that your job will be held. It isn't a paycheck, though. If I recall correctly, it guarantees a minimum of 6 weeks off for a vaginal delivery and 8 weeks for csection. You can take off more time if your employer is amiable to you doing so.

    No. You can take 12 weeks if your employer likes it or not. I was still at 6 weeks with a c-section.

     

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  • image GhostMonkey:

    image lynn97:
    Also, FMLA just guarantees you a set amount of time off and that your job will be held. It isn't a paycheck, though. If I recall correctly, it guarantees a minimum of 6 weeks off for a vaginal delivery and 8 weeks for csection. You can take off more time if your employer is amiable to you doing so.

    No. You can take 12 weeks if your employer likes it or not. I was still at 6 weeks with a c-section.

     



    Gotcha.
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  • image Alicia0817:
    image anvloveskme:
    My plan requires that coverage be effective for 10 months prior to delivery. nbsp;I believe there are exceptions for preterm labor which also includes nicu coverage.

    AFLAC
    Colonial ? That's my terms too
  • FMLA applies only if you have worked full time for at least a year at a company with 50 employees or less.

    With outside STD plans like aflac, they usually put maternity benefits on hold for 10 months from the policy effective date. I get STD through my company and it's effective immediately which is usually the way internally offered STD benefits are.
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