All WRS Employers
Vol. 18, No. 4
February 16, 2001
Income Continuation Insurance and Long Term Disability
Insurance Claim Process Changes Effective March 1, 2001
Effective March 1, 2001 the process for filing an Income Continuation
Insurance (ICI) or Long Term Disability Insurance (LTDI) claim will
no longer require a paper claim form from the employee. If your
employee becomes ill or injured and is expected to meet the filing
requirements (ICI elimination period, service requirements, etc.)
for ICI or LTDI, instruct them to call CORE, INC. at 1-800-960-0052
to file a claim.
An employee who is applying for LTDI benefits should still contact
Employee Trust Funds (ETF) toll free at 1-877-533-5020 for an LTDI
estimate or claim form if the employee wishes to file a paper claim
instead of an electronic one.
Here's how the claim process works:
- The employee contacts CORE, INC. at 1-800-960-0052.
- The CORE customer service representative will collect basic
information including name, Social Security Number, date of birth,
and current mailing address.
- CORE will ask questions that relate to the employee's absence,
such as: the nature of the disability, last day worked, the name,
address and telephone number of their attending and/or treating
physician, and any additional work-related information.
- CORE mails the following to the employee: an introductory letter,
a medical release form, and a letter to be given to the physician.
It is important for CORE to have the employee's current mailing
address in order to send correspondence relating to the employee's
- The employee introductory letter explains how the program
works and what to expect while the claim is pending.
- The employee must sign the medical release form and return
it to CORE or the employee's attending and/or treating
physician immediately. Note: The attending and/or treating
physician, clinic or medical records departments will not
release confidential medical information to CORE without the
employee's consent. Until that release is given, the claim
cannot be processed.
For ICI Claims:
- A registered nurse, hired by CORE, will call the attending and/or
treating physician to obtain clinical information concerning the
- The nurse may call the physician to arrange a return to work
plan for the employee. The plan may include modified hours or
restricted duties. CORE will contact the employer to determine
if job modifications can be made. The employee will receive written
correspondence from CORE regarding any determinations made on
- CORE contacts the physician for an ongoing review of the employee's
disability claim to obtain updates on the diagnosis, symptoms,
treatment and return to work plan.
- Prior to the employee's return to work date, CORE may call
to confirm the employee's return to work plans if, at the
last medical update, the physician did not indicate the possibility
of an extension of the individual's claim.
For LTDI Claims:
- The physician is still required to complete the ETF medical
report form (ET-5303 or ET-5338) as required by Wisconsin Administrative
Code ETF 50.48 (2).
CORE will contact the employer for employee information using the
e-mail address provided or via telephone call or letter sent via
U.S. Postal Service. If you do not have an e-mail address, and you
would like the information faxed, provide CORE with a fax number.
E-mail address changes should be directed to the Employer Communication
Center at (608) 264-7900. Please note the information needed
from the employer has not changed -- only the manner in which the
information is requested has changed. Responses to CORE's requests
may be sent via e-mail (ICILTDI@COREINC.com) or faxed (1-310-348-7126).
ICI/LTDI Claim Approval or Denial Notice
CORE will notify the employer of the ICI or LTDI claim determination
using the e-mail address provided or by letter sent via U.S. Postal
Service if e-mail was not available. ICI approval and denial notices
will also indicate whether the ICI premium will be waived or the
individual will be required to pay the premium.
If you, as the employer, disagree with the LTDI determination,
you will need to request a departmental review from ETF. This request
must be in writing and received by the Department within 90 days
of the date of CORE's determination. Employees have the same
opportunity to request a departmental review if they disagree with
CORE's determination. This departmental review must be completed
prior to the employee's appeal to the Group Insurance Board.
For an ICI claim, the employee must go through a reconsideration
process with CORE prior to submitting a written request for a departmental
Income Continuation Insurance Transaction Report
CORE must be notified whenever an employee receiving ICI benefits
has one of the following events occur:
- The employee returns to full-time employment.
- The employee returns to part-time employment.
- The employee will not be returning to work.
- The employee dies.
- Local employers only - Any time vacation, sick leave, comp time,
etc., are paid after the employee's selected elimination period.
The ICI Transaction Report (ET-5901) for employees who
have returned to part-time employment must be faxed to CORE by 12:00
p.m., Central Standard Time, the Friday before the biweekly scheduled
payday. Timely submission of earnings information is required in
order for the claimant to receive their ICI benefit check on the
scheduled payday. If the employee is on a monthly pay schedule,
the ET-5901 should be sent to CORE as soon as possible after the
close of the month. Fax the ICI Transaction Report
(ET-5901) to CORE, INC. at 1-310-348-7126.
The ICI Transaction Report (ET-5901) can be found
on the Internet at http://badger.state.wi.us/agencies/etf under
Employers. For those who do not have access to the Internet, a supply
of forms may be ordered from CORE through the use of the Income
Continuation Insurance Forms/Booklets Order Form.
Income Continuation Insurance Application (ET-2307) and
Evidence of Insurability (ET-2308)
You should continue to send the Income Continuation Insurance enrollment
forms to ETF.
CORE is responsible for contacting you regarding any issues that
may occur while processing the Income Continuation Insurance
Application (ET-2307) form. CORE will send you a request for
a correction or notify you if the application is denied. In addition,
CORE will notify you of the Evidence of Insurability (ET-2308)
approval or denial.
When contacting CORE by telephone, you will be given the following
- If you know your party's extension, please press 1, the
extension number and the # sign.
- If you are calling to report a new claim, please press 2.
- To check your enrollment application status, please press 3.
- For payment inquiries, please press 4.
- For all other inquiries, please press 5 or remain on the line
for the next available representative.
CORE representatives are available from 7:45 a.m. to 4:30
p.m. CST, Monday through Friday, except State holidays. Callers
can also leave voice-mail messages 24 hours per day, 7 days per
Please contact the Employer Communication Center at (608) 264-7900