Long-term disability

What is long-term disability insurance?

Long-term disability (LTD) insurance protects a portion of an employee’s salary if they are unable to work due to sickness, injury, or pregnancy. When an employee enrolls in LTD coverage, it pays a percentage of their monthly earnings if they become disabled.

The PEBB Program offers two kinds of LTD insurance:

• Employer-paid LTD has a 90-day benefit waiting period and pays a minimum benefit of $100 and a maximum benefit of $240 per month.
• Employee-paid LTD also has a 90-day benefit waiting period and pays a minimum benefit of $100 per month. The maximum benefit is determined by the coverage level the employee is enrolled in:
  • The 50-percent coverage level pays up to a maximum benefit of $8,333 per month.
  • The 60-percent coverage level pays up to a maximum benefit of $10,000 per month.

To learn more, see the LTD Plan Booklet and visit the Long-term disability insurance page on the public employees website.

Who is eligible?

Employer-paid and employee-paid LTD insurance is available to eligible employees of:

• State agencies
• Higher-education institutions (including community and technical colleges)
• PEBB participating employer groups

Enrolling employees in LTD insurance

Employees eligible for long-term disability insurance are automatically enrolled in employer-paid and employee-paid LTD at the 60-percent coverage level when eligibility for PEBB benefits is entered into Benefits 24/7.

LTD coverage begins the first day of the month following the day the employee becomes eligible for PEBB benefits. However, if the employee becomes eligible on the first working day of the month, coverage begins that day.

If the employee elects to reduce, decline, or make changes to their employee-paid LTD coverage, the effective date of coverage remains the same if the LTD Enrollment/Change form is received by the employer within the employee's 31-day eligibility window (WAC 182-12-114).

Evidence of insurability approval is not required for changes made within an employee's 31-day eligibility window.

Making changes after the 31-day eligibility window

At any time, employees may reduce to the 50-percent coverage level or decline employee-paid LTD coverage by completing and submitting the LTD Enrollment/Change form to their BA for processing.

Employees who later decide to enroll in or increase coverage after the 31-day eligibility window must submit the LTD Enrollment/Change form to their BA for processing and the Evidence of Insurability form to Standard for approval.

When are changes effective?

The effective date of coverage will depend on the change requested and whether evidence of insurability (EOI) approval is required (WAC 182-08-197):

Reducing employee-paid LTD to the 50-percent coverage level:

• Requests to reduce coverage are effective the first day of the month following the date the employer receives the completed LTD Enrollment/Change form.

Declining employee-paid LTD coverage:

• Requests to decline coverage are effective the last day of the month following the date the employer receives the completed LTD Enrollment/Change form.

Enrolling in or increasing employee-paid LTD coverage:

• Requests to enroll in or increase coverage require EOI and are effective the day of the month Standard approves the request. The new LTD premium deduction will begin the first of the month following the effective date of the coverage.

To learn more, see the LTD Administration Manual.

Rates and premiums

The monthly employer-paid LTD rate is $2.10. The employer-paid rate is included in the employer contribution, paid by the employer for each eligible employee.

The monthly employee-paid LTD premium is based on the employee’s:

• Coverage level the employee is enrolled in (either 60-percent or 50-percent), and
• Retirement plan (Higher-education employees retirement plan, or TRS, PERS, and other retirement plans), and
• Monthly base pay (gross earnings before tax and other deductions, not to exceed $16,667).

Learn more about employee-paid LTD premiums.

Calculating employee-paid LTD rates in Benefits 24/7

Employee-paid LTD premiums are calculated based on the employee's monthly salary entered in Benefits 24/7 for all employers, except some higher-education institutions who do not use Benefits 24/7 for LTD.

• The maximum monthly benefit for employee-paid LTD is based on a monthly salary of up to $16,667. If an employee's monthly salary is higher than $16,667, Benefits 24/7 will calculate the premium based on a $16,667 salary.
  • Employee monthly salaries must be kept current in Benefits 24/7 to ensure that employee-paid premium calculations are correct. Incorrect salaries may negatively impact an employee’s benefit claim.

Higher-education institutions

• Ensure that you are not calculating the premium on a monthly salary that is more than $16,667.
• If you have faculty employed at more than one institution who are enrolled in employee-paid LTD:
  • Employee-paid LTD premiums are calculated based on income from all state higher-education institutions when the faculty makes you aware of their faculty employment at other institutions.
    • By calculating premiums from all income, the faculty’s benefit, should they go out on a claim, will reflect their full income and the Standard will not reduce their claim payment to collect back premiums for premiums not collected.
    • It is understood that this practice may cause some challenges with the diverse payroll systems between institutions.

Filing a claim

LTD claims should be filed as soon as the employee's last day (physically) on the job is known. Do not wait for the 90-day waiting period or for their period of leave to be exhausted before filing the claim. Standard does not require that the employee exhaust their leave; however, leave balances are verified for purposes of determining when the benefit payment period begins.

To file a claim, the LTD Claim Packet must be completed by the employee and employer. Standard provides the following options for claims submissions:

• Utilize Web Intake
  • This allows you to submit claims via Standard's website. You will need to create an account with a login and submit the claim. Instructions will be provided through the entire claim submission process.
• By telephone, contact The Standard’s Claim Intake Service Center at 800-368-2860
• Mail to Standard Insurance Company at PO Box 2800, Portland OR, 97208-2800, or
• Fax the forms to 1-888-878-3686.

Learn more about the employer process for filing an LTD claim in the LTD Administration Manual.

Related rules

• WAC 182-08-187 Correcting Enrollment Errors
• WAC 182-08-197 When must newly eligible employees select PEBB benefits and complete enrollment forms?
• WAC 182-12-133 What options for continuation coverage are available to employees on certain types of leave or whose work ends due to a layoff?
• WAC 182-12-136 May an employee on approved educational leave waive continuation coverage?
• WAC 182-12-138 What options are available if an employee is approved for the federal Family and Medical Leave Act (FMLA)?
• WAC 182-12-141 If I revert from an eligible position to another position, what happens to my insurance coverage?
• WAC 182-12-142 What options for continuation of coverage are available to faculty and seasonal employees who are between periods of eligibility?
• WAC 182-12-148 What options for continuation coverage are available to employees during their appeal of dismissal?