Benefits - Ancillary Insurance

Voya & Aflac

Aflac Accident Insurance

Benefit Overview

The voluntary Accident Insurance plan offered through Aflac provides added protection for expenses related to an accident such as ER visits, hospitalization, physical therapy, or specific injuries are also eligible for benefits under this policy. This plan pays you a lump sum cash benefit when you experience a qualifying event. Coverage is available for you, your spouse and dependent children. Coverage is provided with no health questions and is paid in addition to your medical coverage. For more information about exclusions and other plan details click here.


Other Benefits Included:

  • Lump sum cash payments for qualified injuries or accidents
  • $50.00 annual wellness benefit for qualified health screenings for employees and covered dependents
  • Transportation and lodging benefit
  • Emergency room treatment benefit
  • Fast claims payment - most claims are processed in about four business days

Submitting a Claim

After you have experienced a qualifying event you may submit a claim online at aflacgroupinsurance.com or download and submit the claim form directly to Aflac via fax or mail using the related pages below.

Contact Information

Aflac- 1-800-433-3036
aflacgroupinsurance.com

Aflac Critical Illness Insurance

Benefits Overview

Critical Illness insurance pays you a lump sum benefit upon initial diagnosis of a covered illness such as cancer, heart attack or stroke. Employees may select between either a $15,000 or $30,000 benefit amount in coverage. Spouse and child(ren) coverage is 50% of employee selected amount. Voluntary Critical Illness Insurance through Aflac is a limited benefit policy and is not health insurance. This is an employee paid benefit. Premiums are based on age and tobacco utilization and will change over the duration of your coverage. See the plan document for more details. 
 
 

Covered Critical Illnesses and

Additional Benefits

Percentage of $15,000 or $30,000 Benefit Amount

Cancer (Internal or Invasive)

100%

Heart Attack

100%

Limited Benefit Major Organ Transplant

100%

Kidney Failure (End-Stage Renal Failure)

100%

Stroke

100%

Bone Marrow Transplant (Stem Cell Transplant)

100%

Sudden Cardiac Arrest

100%

Non-Invasive Cancer

25%

Coronary Artery Bypass Surgery

25%

Skin Cancer

$250 (once per calendar year/insured)

 

Additional Diagnosis – once benefits have been paid for a covered critical illness, Aflac will pay benefits for each different critical illness when the date of diagnosis is separated by at least 6 consecutive months. 
Reoccurrence – once benefits have been paid for a covered critical illness, benefits are payable for that same critical illness when the date of diagnosis is separated by at least 6 consecutive months.


Wellness Benefit - this policy also offers a Wellness Benefit, which provides a $50 reimbursement for covered annual health screenings per calendar year. Covered health screenings include chest x-ray, colonoscopy, fasting glucose test, blood test for triglycerides or serum cholesterol test, CA 125 test, CA 15-3 test, CEA, cervical cancer, PSA and other screenings.


Mammography Benefit – this policy includes a Mammography Benefit of $200. Benefit pays as follows: a) a baseline mammogram for women age 35 to 39, b) mammogram for women age 40 to 49, inclusive, every two years or more frequently based on physician’s recommendation, c) a yearly mammogram for age 50 and over.

Submitting a Claim 

After you have experienced a qualifying event you may submit a claim online at AlfacGroupInsurance.com or download and submit the claim form directly to Aflac via fax or mail using the related pages below.

Contact Information

Aflac- 1-800-433-3036
aflacgroupinsurance.com
Group Policy Number: C21000
 

Alfac Hospital Indemnity Insurance

Aflac Hospital Indemnity Plan

Benefits Overview

This is a voluntary plan that pays you a lump sum cash benefit when you are confined to a hospital, whether  for planned or unplanned reasons that can assist you with related out of pocket medical expenses or anything else you may need the cash for, like your mortgage. See the plan document for more details.

Voluntary Hospital Indemnity

Benefit Amount

$2,000

Issue Ages

Employee: 18+

Spouse: 18+

Children: Under the age 25

Guaranteed Issue

Guaranteed issue coverage is offered to all eligible applications during the initial enrollment and for new hires thereafter. At the group’s first anniversary, late enrollees are eligible to enroll on a guaranteed issue basis.

Waiting Period

No waiting period

Pre-Existing Condition Clause

None

Benefit Reduction

No reduction at any age

Waiver of Premium

After 90 days of total disability due to covered sickness or accidental injury for up to 12 months

Hospital Admission

$2,000

Hospital Confinement

$200 up to 31 days per accident

Hospital Intensive Care

(This benefit is payable in addition to the Hospital Confinement Benefit.)

$200 up to 10 days per accident

Intermediate Intensive Care Step-Down Unit

(This benefit is payable in addition to the Hospital Confinement Benefit.)

$100 up to 10 days per accident

Rehab Benefit

Not covered

Wellness/Health Screening

$50, once per calendar year

Mammography Screening

$100, once per calendar year

Pregnancy Coverage

Covered

Mental and Emotional Disorder Coverage

Covered

 

Submitting a Claim

After you have experienced a qualifying event you may submit a claim online at AlfacGroupInsurance.com or download and submit the claim form directly to Aflac via fax or mail using the related pages below.

Contact Information

Aflac- 1-800-433-3036

aflacgroupinsurance.com

Group Policy Number: C8000

California State Disability Insurance (CA SDI)

The Employee Development Department (EDD) of the State of California fully administers  the California State Disability Insurance (CA SDI) program which consists of Disability Insurance (DI) and Paid Family Leave (PFL). This State run program is paid for by employees through payroll deductions. Reference Benefits At A Glance or you pay stub to see if your bargaining unit participates in this program. For any questions on this benefit, please refer to EDD.

Disability Insurance (DI)

  • DI provides 52 weeks of partially paid disability benefits at 60%  - 70% of employee weekly pay  for wages earned 5 to 18 months prior to your claim effective date.
  • The maximum weekly benefit is $1,300/week for a non-work related illness, injury, or pregnancy.
  • DI has a 7 day wait period for benefits.

Paid Family Leave (PFL)

  • PFL provides up to 8 weeks of paid benefits to individuals who need to take time off work to care for a seriously ill child, parent, parent-in-law, grandparent, grandchild, sibling, spouse, or registered domestic partner. Benefits are also available to new parents who need time to bond with a new child entering their life either by birth, adoption, or foster care placement.
  • PFL provides 60 – 70% of weekly wage replacement up to a maximum of $1,300/week for 8 weeks in a 12 month period. This is no wait period for this benefit.

General Information & Claims Submission

Contact

For the fastest service, access your claim information or file a claim online with SDI Online. You can also contact EDD representatives at 1-800-480-3287 for Disability Insurance or 1-877-238-4373 for Paid Family Leave, from 8 a.m. to 5 p.m., Monday through Friday.

EDD Disability Insurance

EDD Paid Family Leave

 

Voya Life and AD&D Insurance

Voya Life and AD&D Insurance

Benefits Overview

Life Insurance pays your beneficiary a lump sum if you die. AD&D provides another layer of benefits to either you or your beneficiary if you suffer from loss of a limb, speech, sight, or hearing, or if you die in an accident. Coverage is provided by Voya. Remeber to review your beneficiaries annually during Open Enrollment and update as needed. There are various life insurance policies dependent on your bargaining unit.

Voluntary Supplemental Life and AD&D Insurance

Voluntary Supplemental Life Insurance allows you to purchase additional life insurance to protect your family's financial security. This is an employee paid benefit. Coverage is available for your spouse and/or child(ren) if you purchase coverage for yourself. The employee must be approved for coverage to add dependents. Employees can apply for supplemental coverage in increments of $10,000, the minimum coverage amount is $20,000 with a maximum of $500,000. The benefit amount reduces to 65% at age 65, to 50% at age 70 and to 30% at age 75.


New employees can enroll within the first 31 days of employment with a guaranteed issue of up to $150,000 without submitting an Evidence of Insurability (EOI) form. An EOI form will be required for all other enrollees including during Open Enrollment. It is the employees responsibility to complete an EOI form which requires additional information about your health and the health of your dependents you want to cover. You must submit the EOI form to Voya for them to determine your eligibility. The coverage will not begin and no deductions will be taken from your paycheck until the EOI has been approved by Voya.

SUPPLEMENTAL LIFE & AD&D

 

Election Amounts

New Hire Guaranteed Issue

Employee amount

$20,000 up to a maximum of $500,000 in $10,000 increments

Up to $150,000

Spouse amount

$20,000 OR 50% of employee amount

Up to $50,000

Child(ren) amount

$10,000, not to exceed 100% of employee amount

Up to $10,000

 

Employer Paid Basic Life Insurance

The County provides Basic Term Life Insurance to employees in certain bargaining units at no cost. No action is needed to maintain these benefits. Employees also have option to purchase additional supplemental life insurance.On the policy anniversary after you attain age 65, the benefit amount is reduced by 35% of the original face amount. On the policy anniversary after you attain age 70, the benefit amount is reduced by 50% of the original face amount. This benefit is provided as follows:

 

Bargaining Unit

Amount of Life Insurance

08, 09, 10, 16, 17

$50,000

04, 06, 07, 11, 12

$30,000

 

 

 

 

Taxes: Due to IRS regulations, a life insurance benefit of $50,000 or more is considered a taxable benefit.  

Contact Information

1-800-955-7736
www.voya.com
Group Name: PRISM Health
Group Number:316407
Account: 37 – County of San Luis Obispo

 

Voya Long Term Disability Insurance

Voya Long Term Disability Insurance

Benefits Overview

Long term disability (LTD) coverage pays you a percentage of your income if you cannot work due to an injury or illness preventing you from performing your job functions over a long time. The County offers voluntary long term disability insurance to any employee that does not receive employer paid long term disability insurance.

  • Long term disability benefits typically begin after short term disability benefits end
  • Vocational rehabilitation services are available to assist you in returning to work when possible
  • While you are receiving benefits from Voya, they may waive some insurance premiums
  • It is important to know that benefits are reduced by income from other sources like workers' compensation and Social Security.
  •  If you leave your job, you may be eligible to convert your long-term disability coverage and take the policy with you

Voluntary LTD

All County employees are eligible to participate except for employees that are covered by another long term disability policy. Eligibility varies by bargaining unit. This is an employee paid benefit. Disability premiums are calculated based on your age and salary and will change throughout your coverage.

This benefit will only be displayed for enrollment if you are eligible. Employees can enroll without providing an evidence of insurability (EOI) form if they apply within 31 days of first becoming eligible. An EOI form will be required for all other enrollees.

When you become disabled, you must complete a waiting period meaning that you are absent from work due to the same disability for 360 consecutive days before benefits are payable. Any days that you are able to work after the start of your disability will not count towards your elimination period. See the plan document for all details.

LONG TERM DISABILITY (LTD)

 

 

Monthly Benefit Amount

Plan pays 60% covered monthly earnings

 

Maximum Monthly Benefit

$10,000

 

Minimum Monthly Benefit

$100 / 10%

 

Waiting Period: Accident or Sickness

360 days of disability

 

Maximum Payment Period

Social Security Normal Retirement Age

 

Survivor Benefit

3 months gross monthly benefit

 

Employer Paid LTD

The County provides employees in select Bargaining Units with employer paid Long Term Disability insurance. When you become disabled, you must complete a waiting period meaning that you are absent from work due to the same disability for 90 consecutive days before benefits are payable. Any days that you are able to work after the start of your disability will not count towards your elimination period. You may be eligible for Short Term Disability payments during this time if you enroll in Voya’s Voluntary Short Term Disability plan, which is employee paid. See the plan document for all details.

EMPLOYER PAID LONG TERM DISABILITY (LTD)

Monthly Benefit Amount

Plan pays 66 2/3% of monthly earnings

Maximum Monthly Income Benefit

$10,000

Minimum Monthly Income Benefit

$50

Waiting Period

90 days of disability

Contact Information

1-800-955-7736
www.voya.com
Group Name: PRISM Health
Group Number:316407
Account: 37 – County of San Luis Obispo

Voya Short Term Disability Insurance

Voya Short Term Disability Insurance

Benefits Overview

Voya Short Term Disability insurance provides you with benefits to replace part of your paycheck when you cannot work because of a sickness or injury. Short-Term Disability benefits are paid for up to 12 weeks. There is a 7-day waiting period before you are paid. See the plan document for more details.

Short Term Disability (STD)

Weekly Benefit Amount

Plan pays 60% covered weekly earnings

Maximum Weekly Benefit

$1,325

Minimum Weekly Benefit

$50

Waiting Period

7 days

Maximum Payment Period

12 weeks

Coverage Type

Non-occupational coverage (off the job)

 

Cost of Coverage: Rates will change with salary and age throughout the life of your plan. See plan brochure or BenXcel.net for your personalized premium.

Eligibility & Enrollment

Employees in select bargaining units that do not participate in CA SDI or PORAC are eligible to enroll in this plan. This benefit will only be displayed for enrollment in BenXcel if you are eligible to enroll.

  • New Hires are offered a guaranteed issue for this plan and will not need to provide an Evidence of Insurability (EOI) form if they apply within 31 days of employment.
  • An EOI form will be required for all other enrollees.

Submitting a Claim

It is recommended to start the paperwork process 2 – 4 weeks in advance of your disability date. County internal processing takes about 1 - 2 weeks to complete the employer form and cannot be completed until date of disability. All claims are submitted directly to Voya. View the  How to Sumit a Claim to Voya webpage below for instructions.

Contact Information

1-800-955-7736
www.voya.com
Group Name: PRISM Health
Group Number:    31640-7
Account: 37 – County of San Luis Obispo
 
Voya does not keep individual records of employee enrollment, to discuss questions related to an individual situation, you must submit a claim to Voya.

 

VOYA

This service allows County employees the option to purchase voluntary insurance plans to enhance their benefit package.

AFLAC

This service allows County employees the option to purchase voluntary insurance plans to enhance their benefit package.