Source: http://regulations.delaware.gov/register/december2011/proposed/15%20DE%20Reg%20799%2012-01-11.htm
Timestamp: 2018-07-23 13:51:33
Document Index: 686062716

Matched Legal Cases: ['§5210', '§9602', '§5255', '§5253', '§5253', '§5253', '§5254', '§5933', '§5933', '§5933', '§5933']

Any person who wishes to submit written suggestions, compilations of data, briefs or other written materials concerning the proposed rules and regulations must submit same to Brenda Lakeman, Director, at Statewide Benefits Office, 500 W. Loockerman Street, Suite 320, Dover, DE 19904 or by email at brenda.lakeman@state.de.us or by fax at (302) 739-8339 by January 20, 2012. A public hearing to consider the adoption of the Disability Insurance Program Rules and Regulations will be held during the State Employee Benefits Committee meeting scheduled on January 30, 2012 at 2:00 pm at the Tatnall Building, 150 William Penn Street, Dover, DE 19901.
The action concerning the adoption of the proposed rules and regulations will be based upon the results of the State Employee Benefits Committee staff analysis and consideration of any comments and written materials submitted by any person.
The purpose of the proposed Disability Insurance Program Rules and Regulations is to provide State employees and administrative staff with access to policies currently in force and in practice with respect to the Disability Insurance Program. The proposed Rules and Regulations encompass and combine processes that have been developed since inception of the Disability Insurance Program and over the past five (5) years.
“Base Rate of Compensation” means the employee’s usual rate of pay, not including commissions, bonuses, shift differential pay, overtime pay or any other fringe benefit or extra compensation.
“RTW Coordinator” means the person selected by the Office of Management and Budget to assist individuals enrolled or previously enrolled in the DIP who expect to be out of work due to a disability in their transition back to work. Return To Work assistance may be requested by an employee, previously employed individual and/or by an employing organization. The RTW Coordinator may also consult with the individual’s health care provider(s) to acquire and/or clarify a claimant’s restrictions and/or limitations if applicable, to facilitate a safe return to the workplace.
3.1	Pursuant to the authority vested in the State Employee Benefits Committee (SEBC) by 29 Del.C. §5210(4), §9602(b) (4) and §5255, the SEBC adopts these eligibility and coverage rules for the State of Delaware’s Disability Insurance Program (DIP). In the event of conflict between these rules and the Delaware Code, the Delaware Code takes precedence over these rules. DIP is comprised of a Short Term Disability (STD) program and a Long Term Disability (LTD) program.
4.1	Pursuant to 29 Del.C. §5253(b)(1), STD benefits for participating employees shall commence upon the exhaustion of the calendar day elimination period. The elimination period shall begin on the first day following the onset of the participating employee’s physical or mental incapacity. The calendar day elimination period does not have to be satisfied consecutively however, if an employee returns to work for one day or less during the calendar day elimination period, but cannot continue to work thereafter, the period worked shall not be considered to have interrupted the calendar day elimination period.
4.2	Pursuant to 29 Del.C. §5253(b)(1), the calendar day elimination period must commence and conclude within normal working periods for employees who work less than 12 months per calendar year. “Normal working periods” are the scheduled working days of the participating employee.
4.3	Pursuant to 29 Del.C. §5253(b)(5), if a participating employee returns to the employee’s position on a full time basis for 15 consecutive calendar days or longer, any succeeding period of disability for which the participating employee shall become eligible shall constitute a new period of STD with a corresponding calendar day elimination period.
4.4	There is no pre-existing conditions limitation in the STD program.
5.2	All employees enrolled in DIP who expect to be out of work for the length of the calendar day elimination period are required to file a STD claim, even if the employee applied for and/or is receiving Workers’ Compensation (WC) benefits or Other Income Benefits defined in the STD benefits booklet per Delaware Code.
5.4	Employees must contact their physician(s) to authorize the release of medical information required by the Return to Work (RTW) Coordinator and/or the DIP insurance carrier and/or third party administrator (Administrator) selected to administer and/or insure the program by the SEBC pursuant to 29 Del.C. §5254. It is the employee’s responsibility to be sure that his or her medical documentation is submitted to the DIP insurance carrier and/or Administrator and the RTW Coordinator as requested.
5.6	Medical documentation by the employee’s physician(s) must be submitted to determine benefit payment. A physician’s return to work note will not be sufficient.
6.3.1	IMPORTANT NOTE: Weekly earnings means the employee’s usual rate of pay, not including commissions, bonuses, shift differential pay, overtime pay or any other fringe benefit or extra compensation. If disabled, weekly earnings will be the rate in effect on the last day as an active full-time employee before becoming totally disabled.
8.3	STD benefits shall be payable at a rate of up to 75% of the participating employee’s creditable compensation during the period the employee has a disability.
8.17	It is the employee’s responsibility to promptly notify and repay the State of Delaware for all overpayments including income paid as an offset during the STD and/or LTD benefit period.
9.10	Upon the exhaustion of the maximum STD benefit period, any employee, except those entitled to hazardous duty pay as defined in 29 Del.C.. §5933(c), shall no longer be an employee of the State or any of its political subdivisions provided the employee has exhausted their FMLA entitlement and/or is not FMLA eligible. Employees entitled to hazardous duty pay as defined in 29 Del.C.. §5933(c) who exhaust the maximum short term disability benefit period shall no longer be an employee of the State or any of its political subdivisions at the end of their entitlement to hazardous duty pay provided the employee has exhausted their FMLA entitlement and/or is not FMLA eligible. The employee has two options with respect to remaining accrued leave.
10.1.5	Upon the exhaustion of the maximum STD benefit period, any employee, except those entitled to hazardous duty pay as defined in 29 Del.C.. §5933(c), shall no longer be an employee of the State or any of its political subdivisions provided the employee has exhausted their FMLA entitlement and/or is not FMLA eligible. Employees entitled to hazardous duty pay as defined in 29 Del.C.. §5933(c) who exhaust the maximum short term disability benefit period shall no longer be an employee of the State or any of its political subdivisions at the end of their entitlement to hazardous duty pay provided the employee has exhausted their FMLA entitlement and/or is not FMLA eligible.
17.1.3	The date premium payment is due but not paid, if applicable ;
19.4.2	Employees previously employed in a Merit position, must contact the RTW Coordinator at the Statewide Benefits Office within 15 days of their release to return to work and/or the termination of their LTD benefit.
19.4.6	Employees formerly employed by a school district, charter school, institution of higher education or other nonmerit employing organization, should contact their former Human Resource department for assistance in placement.
15 DE Reg. 799 (12/01/11) (Prop.)