Frequently asked questions

We understand that the COVID-19 pandemic may require customers to unexpectedly furlough, temporarily lay off or provide leave of absence for employees. We will continue to cover employees who are not currently working for their employers or who experience a reduction in hours or earnings due to the pandemic, under these conditions: 

Group coverage:

• We will consider employees who are furloughed on or before September 30, 2020, to be on approved temporary layoff or leave of absence.

• Employees on a temporary layoff or leave of absence that began on or before May 31, 2020 will remain eligible for coverage for 90 days or the length of the temporary layoff/leave of absence provision in your policy, whichever is greater.

• Employees on a temporary layoff or leave of absence that begins after May 31, 2020, will remain eligible for coverage for the length of the temporary layoff/leave of absence provision in your policy.

• Unum is aware that our customers are facing extraordinary challenges at this time. If you have a unique situation that merits additional consideration, we encourage you to contact your Unum representative to discuss your specific needs.

• Premium payments should be based on the employee’s earnings, when applicable, prior to the change in hours or work status.

• During this furlough extension, we will not strictly apply minimum-hours-worked requirements for an employee to be considered actively employed.

Accident, Individual (including IDI) and Health benefits:

• Employees are eligible to keep their coverage as long as they pay their premiums.

• If premium payroll deductions are discontinued, we will send a conservation letter allowing the employee to be direct billed or the employee can port or convert their coverage, depending on the benefit.

Dental and Vision:

• Employees on temporary layoff or leave of absence may keep their coverage for up to a year, as long as the premiums are paid.

Statutory Plans Insured by Unum (NY DBL, NY PFL, NJ TDB, Hawaii TDI)

Unum’s interpretation of state law is that employees who have been furloughed are ineligible for benefits under New York’s Disability Benefits and Paid Family Leave laws, New Jersey’s Temporary Disability Benefits law, and Hawaii’s Temporary Disability Insurance law.

This is primarily because a furlough is akin to a temporary leave of absence — not a termination — and these state laws either stipulate or imply that employees on temporary leave of absence are not eligible for coverage. (New Jersey extends TDB coverage for two weeks after the temporary leave of absence or furlough begins.)

Given this, premiums are not required from employees while they are furloughed. After the employee returns to work and premiums restart, employees become eligible for benefits without having to satisfy a new waiting period.

It is important to note that furloughed employees might be eligible for unemployment benefits. The New York Attorney General’s Office indicates that employees may be entitled to unemployment insurance payments for 26 weeks if they are permanently or temporarily laid off through no fault of their own. Please check with your state’s unemployment office for benefits eligibility and requirements.

If an employee is quarantined based on a government order, or if the quarantine is an approved leave as defined by your policy’s leave provisions, the individual will be considered “actively employed.” They would thus be eligible to maintain their coverage, provided premiums are paid. People who self-quarantine will be considered to be actively employed for the length of time recommended by the Centers for Disease Control and Prevention (currently two weeks).

Our current process is flexible, allowing 90 days of continued coverage if your employment falls below the required number of insured people. To account for impacts to your business caused by COVID-19, we have temporarily paused policy terminations due solely to low participation until September 1, 2020.

We will allow inforce re-enrollments with an anniversary date from April 1 to July 1, 2020 to be delayed for up to 90 days.

If otherwise allowed by the policy, and premiums are paid, election changes may be made for a qualifying life event / status change as follows:

• If furloughed on or before May 31, 2020, an employee can change their elections for 90 days or the length of the temporary layoff/leave of absence provision in your policy, whichever is greater.

• If furloughed after May 31, 2020, an employee can change their elections for the length of the temporary layoff/leave of absence provision in your policy.

All other plan requirements, such as Evidence of Insurability, will apply.

Yes. Late entrants can apply for coverage while on a covered furlough, temporary layoff or leave of absence at an annual enrollment or at a time otherwise allowed by the policy. Coverage will take effect when Evidence of Insurability is received and approved by Unum, if required, and the employee returns to active employment. All policy provisions will apply.

Yes, provided they remain covered during the furlough, temporary layoff or leave of absence. The date the increased amount goes into effect depends on the specific policy language. All policy provisions will apply.

If the employee falls out of a covered furlough, temporary layoff or leave of absence status before the increased coverage goes into effect, they will need to reapply when they return to active employment, as defined by the policy.

Different rules apply based on the type of benefit, when the furlough, temporary layoff or leave of absence began; how long the employee was away from work; and whether premiums continued to be paid during the time away from work.

Group benefits

Employees don’t need to re-enroll if premiums are paid during the furlough, temporary layoff or leave of absence AND:

If employees return to work outside of these time frames OR if premiums are not paid during the furlough, temporary layoff or leave of absence, they would need to re-enroll in coverage. They would be subject to any rehire provisions in the contract, which generally waive the employee waiting period if the employee is rehired within a specified period of time.

All provisions of the contract would apply, with the following administrative exceptions:

• Group Disability. If an employee was previously enrolled at the same coverage level and had already satisfied the pre-existing condition exclusion period, we won’t apply a new pre-existing period, as long as the employee is rehired within six months of their coverage end date, or within the rehire term in the policy, whichever is less. The coverage end date equals the date for which premium payments cease.

• Group Life. If an employee was previously enrolled at the same coverage level, we won’t require evidence of insurability for the re-enrolled coverage, as long as the employee is rehired within six months of their coverage end date or within the rehire term in the policy, whichever is less. The coverage end date equals the date for which premium payments cease.

Employees rehired at reduced hours can continue to be eligible for benefits subject to all provisions in the contract. Continued eligibility requires the employee to meet minimum hour requirements upon return and benefits would be based on current earnings as defined in the contract. Enrollment requirements are based on scenarios described in the two previous FAQs.

Voluntary benefits

Employees don’t need to re-enroll if premiums are paid during the furlough, temporary layoff or leave of absence and they return to work immediately after the furlough, temporary layoff or leave of absence, ends.

If premiums are not paid during the time away from work, coverage will lapse. For these benefits, however, they may not need to re-enroll. These conditions apply:

• For employees furloughed on or after March 1, 2020 due to COVID-19, and who had coverage before being furloughed, we will work with you to reinstate their coverage upon request once they return to active employment up through December 31, 2020.

  • Payment of past due premium is expected and required to keep coverage intact continuously.

  • We are willing to reinstate coverage with a new effective date and will not cover the gap period during which premiums weren’t paid. Please make sure your employees understand this.

  • If an employee reinstates with the same coverage level, we will not require Evidence of Insurability or apply a new pre-existing conditions exclusion period, provided the employee already satisfied the pre-ex period before their coverage lapsed.

• We can only reinstate certain voluntary benefits with a gap in coverage. Therefore, reinstatement may require the employee to pay any past due premiums. Employees who cannot make these payments will need to re-enroll.

• For any reinstatement requests after December 31, 2020, the employee will need to re-enroll for new coverage and will be subject to all policy rules. However, they would still have the advantage of any re-hire provisions stated in the underlying policy, as applicable.

Employees rehired at reduced hours will be considered actively at work and eligible to reinstate their coverage, as long as they are expected to return to full active employment and will meet the minimum hours requirement under the policy by December 31, 2020.

If an employee is temporarily laid off, on leave of absence, or furloughed, but remains an active employee, and if the employer is no long remitting the premium, an employee can convert their coverage to an individual policy, with guaranteed coverage and no requirement for evidence of insurability. Once the employee returns to work and is re-enrolled under the group policy, they can choose to cancel or keep this converted coverage.

If the employee does not return to active employment and is subsequently terminated, they can keep their converted individual policy. However, because premium was not remitted for the employee while they were on temporary leave or furloughed, they will not have the option to port their coverage. If premium is paid during the furloughed period, the employee is eligible to port or convert that coverage, effective on the date of termination.

If an employee:

• is temporarily laid off, on leave of absence, or furloughed

• remains an active employee

• has premiums paid for coverage during the permitted 90-day furlough/layoff period

• is then terminated from employment at the end of the furlough/layoff period

they would be able to port their coverage at that time only, because premiums have been paid.

Quarantined employees

We will consider quarantined employees to be actively employed if they are quarantined pursuant to a government order or if their quarantine is an approved leave in accordance with the leave provisions of the applicable policy.

We will consider individuals who self-quarantine to be actively employed for a period of time consistent with the quarantine period recommended by the Centers for Disease Control (currently two weeks).

These periods of active employment will count toward satisfying the coverage waiting period.

Furloughed employees, including reduced-hour furloughs

• Group benefits

  • If an employee is furloughed on or before May 31, 2020 and before their effective date of coverage, we will allow up to 90 furlough days to count toward satisfying the waiting period.

  • If the waiting period is satisfied during the first 90 days while the employee is on furlough, then the effective date of coverage is the day after the waiting period is satisfied. Premium payments would need to begin as of the effective date, and be based on earnings prior to furlough or any reduction of hours. All other provisions apply.

  • If the waiting period is not satisfied during the first 90 days while on furlough, or if the employee is furloughed after May 31, 2020, the employee will need to enroll in new coverage when they return to active employment.

• Voluntary benefits

  • If a new hire is furloughed or laid off before their coverage becomes effective, they are not covered.

  • Coverage elected would go into effect as follows: If the employed is furloughed after the coverage effective date, and no premiums have been deducted or applied, we will review the claim. If payable, we would deduct the premium (either to the date of loss or to the end of the benefit payable period) to bring the policy up to date.

  • Voluntary benefits that require waiting periods may be able to be administered with the group furlough exception as described above. Please see your Unum service consultant for more information.

• GSI offers are available to all eligible full-time employees as defined in the offer letter.

• If an individual is furloughed at the time of eligibility, they can apply for coverage under the parameters of the GSI offer once they return to work full time and are performing their usual duties, provided they are asymptomatic and have no restrictions or limitations.

• If an individual is quarantined and/or working from home but asymptomatic they would be eligible for coverage.

• If an individual is quarantined and/or unable to perform their job at from home, they would be ineligible for coverage. However, an individual can reapply for coverage under the terms of the GSI offer once they have returned to work full time performing their usual duties, provided they are asymptomatic and have no restrictions or limitations.

Yes, provided they were covered and actively at work before the furlough, temporary layoff or leave of absence and the premium continues to be paid. Premiums must be based on the employee’s earnings prior to the temporary layoff, leave of absence or reduction in hours or salary.

Quarantined employees

We will consider quarantined employees to be actively employed if they are quarantined pursuant to a government order or if their quarantine is an approved leave in accordance with the leave provisions of the applicable policy.

We will consider individuals who self-quarantine to be actively employed for a period of time consistent with the quarantine period recommended by the Centers for Disease Control (currently two weeks).

These periods of active employment will count toward satisfying the coverage waiting period.

Furloughed employees, including reduced-hour furloughs

• Group benefits

  • If an employee is furloughed on or before May 31, 2020 and before their effective date of coverage, we will allow up to 90 furlough days to count toward satisfying the waiting period.

  • If the waiting period is satisfied during the first 90 days while the employee is on furlough, then the effective date of coverage is the day after the waiting period is satisfied. Premium payments would need to begin as of the effective date, and be based on earnings prior to furlough or any reduction of hours. All other provisions apply.

  • If the waiting period is not satisfied during the first 90 days while on furlough, or if the employee is furloughed after May 31, 2020, the employee will need to enroll in new coverage when they return to active employment.

• Voluntary benefits

  • If a new hire is furloughed or laid off before their coverage becomes effective, they are not covered.

  • If the employee is furloughed after the coverage effective date, and no premiums have been deducted or applied, we will review the claim. If payable, we would deduct the premium (either to the date of loss or to the end of the benefit payable period) to bring the policy up to date.

  • Voluntary benefits products that require waiting periods may be able to be administered with the group furlough exception as described above. Please see your Unum service consultant for more information.

Some states are now requiring non-essential employees to stay at home and may require employers to prioritize responsibilities. If an enrollment just started or can no longer be supported, we will work closely with you to determine if an open enrollment can be supported later this year or in 2021.

We understand this is a challenging time for all. We will work closely with you to determine when another open enrollment can be supported later this year or in 2021.

Yes, provided premium continues to be paid. Premiums must be based on earnings prior to the temporary layoff, leave of absence or reduction in hours or earnings. We will not strictly enforce the minimum hours requirement during this pandemic.

We understand this is a challenging time for your business. We’re committed to delivering dependable service as you navigate the effect on your workforce. We also remain committed to ensuring you and your employees are supported during this time, including helping employees keep their valuable coverage. We will continue to perform billing services as normal, and subject to any state-mandated requirements about premium grace periods (see grace period question below). However, if you anticipate having any issues with remitting your premiums due to the circumstances surrounding COVID-19, please contact AskUnum at askunum@unum.com or connect with your Billing Coordinator.

If you do not make arrangements to pay premiums, the coverage will be terminated. Termination dates will depend on the type of coverage you have:

• Group Disability Insurance. Coverage will end on the day the employee is furloughed or laid off.

• Dental and Vision. Coverage will end the day the employee is furloughed or laid off. If you employ more than 20 people, you’re required to offer COBRA insurance to the employee.

• Voluntary benefits and Individual Disability Insurance (IDI). The coverage will end on the furlough or layoff date. Unum will mail a letter directly to the employee with options for maintaining their coverage directly with Unum.

• Individual Disability Insurance (IDI).We will work with employers to discuss payment options. If the employer chooses not to pay the premium, then individual policyholders will be sent premium notices to continue their coverage. For specific questions, please reach out to your billing contact or call us at 1-800-633-7490.

We understand that COVID-19 presents a very unique challenge, and we want to help you maintain coverage for your employees. Your contract of benefits contains a premium grace period that allows coverage to continue for a period of time. Please refer to your contract to review the provisions and administration of the grace period.

As your grace period nears expiration, we will communicate with you before your coverage lapses, to work through your situation and better understand your ability to remit payment. Any dental or vision service rendered after the grace period expiration will pend (neither deny nor process) until the premium is paid to date; or the policy is terminated. Additionally, we are closely monitoring any state directives on premium grace periods and will update our guidelines and processes with state notices as appropriate.

If your policy does terminate, we will work closely with you through the reinstatement process.

If you would like to discuss your specific issue and request, please contact Ask Unum at askunum@unum.com or connect with your Billing Coordinator.

If you can’t get to your office to pay your bill, we will honor the bill-payment grace period in your contract. We can help by providing an electronic copy of your bill or setting you up for online self-serve access and payment. Please contact AskUnum at askunum@unum.com for assistance. For Individual Disability Insurance (IDI), please reach out to your billing contact or call us at 1-800-633-7490.

Unum offers ACH electronic payment for all our Group, Voluntary Benefits and Individual Disability benefits. Contact Ask Unum at 1-800-275-8686 or at askunum@unum.com for further information on how to set up ACH payment for your policy.

Group benefits customers can make a one-time premium payment via phone. Please contact Ask Unum at 1-800-275-8686. For prompt processing, please have your group policy number, business checking account and routing number ready.

Some of our benefits and services would cover COVID-19-related claims, and we will follow the provisions in our policies and service agreements to determine coverage, as we would for any other diagnosis.

Here’s a brief description of how we would approach COVID-19-related claims, assuming all other policy provisions have been met.

• Short Term Disability Insurance (individual and group)

  Fully insured: If a person is diagnosed with COVID-19 and becomes disabled as defined in the policy, a claim for Short Term Disability benefits would likely be payable after the elimination period. Individuals who are quarantined without a diagnosis and not sick generally would not have a payable claim.

  Administrative Services Only (ASO): We are continuing to administer self-insured Short Term Disability customers per their contract, and we recommend employers adhere to the initial intent of the disability plan, which is to ensure that all employees and conditions are handled consistently. View more ASO guidance below.

• Long Term Disability

  Fully insured: If a person is diagnosed with COVID-19 and becomes disabled as defined in the policy, a claim for Long Term Disability benefits would likely be payable after the elimination period. As with Short Term Disability, individuals who are quarantined but not sick generally would not have a payable claim.

  Administrative Services Only (ASO): We follow the same approach we use with fully insured Long Term Disability customers.

• Individual Disability Insurance (IDI)

  We would likely approve a claim for IDI filed by someone with a COVID-19 diagnosis after the elimination period, if the definition of disability has been met. As with other products, individuals who are quarantined but not sick generally would not have a payable claim.

• Accident Insurance

  Accident Insurance does not provide benefits for the diagnosis or treatment of COVID-19, except where it includes a Sickness Hospital Confinement Rider, which may provide benefits if the individual is hospitalized for a covered sickness.

• Critical Illness Insurance

  COVID-19 is not considered a covered condition under our Critical Illness products except where the contract includes “Infectious Disease.” In that case, the requirements specified in the contract must be met — generally that the individual must have a positive diagnosis and be confined to a hospital (not to home) for a minimum of 14 consecutive days.

• Hospital Indemnity Insurance

  Individuals who are admitted or confined to the hospital after a COVID-19 diagnosis may be eligible for benefits, provided all other provisions of the policy are met, including facility definition.

• Life Insurance

  COVID-19 is a covered illness for our group and voluntary Life Insurance benefits. Benefits would be paid according to policy provisions.

• Accidental Death & Dismemberment

  Accidental Death & Dismemberment coverage does not apply to COVID-19.

• Long-Term Care Insurance

  A Long-Term Care claim filed by an individual diagnosed with COVID-19 would likely be payable if they meet the policy definition and are receiving covered services. If a claimant is quarantined and not receiving covered services, no benefits would likely be payable.

• Wellness Benefit

  Tests for exposure to the novel coronavirus, which causes the COVID-19 illness, are not currently covered under the Wellness Benefit. Screening tests under this benefit are encouraged for prevention of disease, not diagnosis. In addition, as test kits are currently limited, we do not want to encourage unnecessary testing. We will continue to closely monitor the legislative actions around testing, which may diminish any out-of-pocket costs for coronavirus tests.

• Work-life balance employee assistance program (EAP)

  This service can help employees with managing anxiety about the pandemic. It can also provide guidance for management teams on issues like ensuring employee productivity or managing a remote workforce. It's included with group Long Term Disability and is available with group Life Insurance.

• Worldwide emergency travel assistance

  When traveling, one phone call can connect employees and their family members to medical, legal and other services 24/7, and can provide custom travel support during the pandemic. It's available with group Long Term and Short Term Disability Insurance.

Basic benefits can be calculated based on the earnings, when applicable, that the employee was receiving before any COVID-19-related change in work hours or earnings, using the policy’s definition of earnings. Premiums must have been paid on the pre-reduction earnings.

For earnings definitions with components averaged over a specified period of time (e.g., bonuses or commissions averaged over 12 months), we can prorate those components to exclude up to 90 days of any COVID-related furlough, temporary layoff or leave of absence.

This accommodation will end after 8/31/20 and we will follow our policy provisions thereafter.

Probably not. Generally, we do not consider quarantined workers to be disabled unless they have a medical condition that results in restrictions and limitations that satisfy a policy’s definition of disability.

The FFCRA chiefly affects public employers and private employers with fewer than 500 employees. Under the law, these employers are required to provide paid leave to employees impacted by the pandemic. The cost of this leave can be offset by a fully refundable tax credit. See our COVID-19 legislative updates page for more information.

FFCRA payments issued for care of a family member will not affect a disability benefit payment.

FFCRA payments issued for the employee may affect a disability benefit payment under the following conditions:

• When specific offset language applies.

• Where there is no specific offset language, there will be no impact on the payment.

If the payment is issued for care of a family member, it will not affect a disability benefit payment.

If the payment is issued for the employee, it may affect a disability benefit payment under the following conditions:

• When specific offset language applies.

• Where there is no specific offset language, there will be no impact on the payment.

EAP services typically extend for 30 days after an employee’s termination date. As a result of the COVID-19 pandemic, terminated employees can access the EAP program 90 days post-termination.

Under the original Family and Medical Leave Act (FMLA), quarantined employees are generally not entitled to job-protected leave unless they meet the definition of a serious health condition. However, if a serious health condition develops, FMLA might apply. This remains true for employees working for employers with 500 employees or more.

However, the Families First Coronavirus Response Act (FFCRA), which went into effect April 1, temporarily expands FMLA like this:

• Employees can be eligible for job-protected and paid leave if, due to this public health emergency, they are unable to work or telework and must care for their child under 18 because the child’s school or childcare facility is closed, or their childcare provider is unavailable.

• The expansion applies to all private employers with fewer than 500 employees and most public employers.

• Employees must have worked for their employer for at least 30 days to be eligible.

• This expansion applies through December 31, 2020.

If we are administering your leave program, we would also consider applicable state leave laws and corporate leave policies in determining whether the employee is entitled to leave.

For more information on laws passed to deal with the pandemic, see our COVID-19 legislative updates page.

We will manage paid or unpaid corporate leave policies related to COVID-19 if the employee or family member has a serious health condition. We will not manage paid or unpaid corporate leave policies for COVID-19-related absences that are not related to a serious health condition.

If a person is diagnosed with COVID-19, ADA Services will request and evaluate medical information to determine if the severity of illness rises to the level of disability under ADA or any equivalent state laws. Individuals who are quarantined without a diagnosis and not sick generally would not be considered disabled. The Equal Employment Opportunity Commission (EEOC) has published guidance for employers on specific workplace practices and inquiries related to COVID-19.

April 9 EEOC guidance expands the right of individuals at higher risk for severe illness from COVID-19 to request ADA accommodations to lower the risk of contracting the disease. We have incorporated the expanded “high risk” definitions into our service and put a work flow in place to handle these requests and ensure compliance.

Here are just a few of the steps we’re taking to address our customers’ needs:

People

• We established a dedicated team to process leaves related to the FMLA expansion program.

• We are engaging with our employees to ensure they are taken care of so they can take care of our customers.

• We continue to monitor customer satisfaction and service levels to ensure best-in-class service delivery.

• We are redoubling our volume forecasting and capacity management to identify and deploy additional team members to areas with expected volume increases.

Process

• We are streamlining and simplifying our internal processes where possible to aid our ability to maintain quality and deliver timely decisions as we navigate this ever-changing environment.

Technology

• We are continuing to focus on enhancing the web and mobile experience for our customers — something that is even more critical today as a result of social distancing.

We’re in this together and we ask for your understanding as we focus on delivering benefits to your employees as rapidly as possible. Please remember to encourage your employees to submit claims through our website, which will help them get assistance quickly.

On May 4, 2020, the Department of Labor (DOL) and the Internal Revenue Service (IRS) announced the extension of certain timeframes under ERISA and the Internal Revenue Code for group health plans, disability and other welfare plans, and pension plans during the COVID-19 National Emergency. The relief announced was retroactively effective back to March 1, 2020.

On February 26, 2021, the DOL provided updated guidance about the relief available to plan participants and beneficiaries.

There are two deadline extensions that apply to life, accident, long term care, and disability claims governed by ERISA:

• The deadline to file a benefit claim under the plan’s claims procedures; and
• the deadline to file an appeal of an adverse benefit determination under the plan’s claims procedures.

Pursuant to the February 26, 2021 DOL guidance, extended claim filing and appeal filing deadlines will end on the earlier of:

• 1 year from the date the deadline would have ended on or after March 1, 2020, absent the previously announced extension; or
• The end of the “Outbreak Period.”

The “Outbreak Period” ends 60 days after the declared end of the National Emergency.  To date, no end to the National Emergency has been declared.  As the end of the “Outbreak Period” is currently unknown, it is not be possible to provide specific claim filing and appeal deadline dates for every claim.