All WRS Employers
Vol. 18, No. 14
August 24, 2001
Income Continuation Insurance (ICI) and Long Term Disability
Insurance (LTDI) Claim Process Filing Instructions
The Department of Employee Trust Funds (ETF) has developed an instruction
sheet for employers to distribute to employees considering filing
a claim for Income Continuation Insurance (ICI) or Long-Term Disability
Insurance (LTDI) benefits. The claim filing instruction sheet, Claim
Filing Instructions for the Income Continuation Insurance (ICI)
and Long-Term Disability Insurance (LTDI) Plans (ET-5106),
can be found on the ETF Internet site at badger.state.wi.us/agencies/etf
or it can be ordered through CORE, INC. via e-mail at ICILTDI@COREINC.com.
The instruction sheet provides the employee with the CORE, INC.
toll free number and explains what will happen when a claim is filed
over the telephone. If an employee plans to file a claim for ICI
benefits, please give the employee the most recent version of the
Income Continuation Insurance brochure (ET-2106) State
or (ET-2129) Local (revised 2/21/2000), along with the instruction
sheet. The brochures are available on the ETF Internet site or can
be ordered through CORE, INC. via e-mail.
E-mail Inquiries to CORE, INC.
There are several ways in which employers and employees may contact
CORE, Inc. These include submitting inquiries via e-mail to CORE,
INC. operations at ICILTDI@COREINC.com. To expedite the e-mail request,
please use the following subject lines:
ICI/LTDI – Customer Service Issue
ICI/LTDI – Payment Information
ICI/LTDI – Pending Claim
ICI/LTDI – Overpayment
ICI/LTDI – Rehabilitation
ICI/LTDI – Adverse Decisions
ICI/LTDI – Other
ICI/LTDI – Ombudsman Escalation
The correspondence unit at CORE forwards the e-mail internally
and simultaneously sends an e-mail message back to the sender, confirming
receipt. E-mails will be tracked for follow-up within 10 calendar
days from receipt as outlined in the contract with CORE.
Escalating Issues and Communication with CORE, INC.
ETF and CORE, INC. have developed and implemented an escalated
issue process (Ombudsman), for employers and employees to use for
focused research and resolution on issues or communications that
have not been satisfactorily addressed through the initial escalation
Employers and employees are asked to first request a Customer Service
Lead or Claims Supervisor to resolve the situation, prior to escalating
the issue or complaint to the Ombudsman.
Referrals to the Ombudsman function may be made by telephone (800-960-0052,
ext. 7149) or through the e-mail address with the subject header
ICI/LTDI – Ombudsman Escalation. The Ombudsman function hours
of operation are Monday through Friday, 10:00 a.m. to 3:00 p.m.
Central Standard Time. The Ombudsman will call back within 48 business
hours on all messages received.
ICI Transaction Report (ET-5901)
Employers use the ICI Transaction Report (ET-5901) to
report part-time earnings and return to work date(s) for employees
receiving ICI benefits. This form is now available on the Department's
Internet site to download, complete, and send to CORE, INC. as an
e-mail attachment. Adobe Acrobat software is required to download
and use the form, which is in PDF format.
Please note that an ICI Transaction Report (ET-5901) received
after the cutoff date for ICI pay-date cycles will be applied to
the next ICI pay-date cycle. Previously, the Department had indicated
that these reports needed to be at CORE no later than noon on the
Friday before the next pay date. The Department now requires employers
to have these reports to CORE by noon on the Wednesday before the
next pay date in order for the information to be entered into the
pay system. In the case of no further ICI benefits due, the employee
will have an overpayment that will need to be refunded to ETF (not
CORE). An employee receiving a check may question you about the
overpayment, expecting instead, that the earnings would be offset.
ICI Return to Work Process
Clinical management team members of CORE, INC. will contact employers
to discuss modified and restricted return to work duties for employees
receiving ICI benefits. The following steps are being used for this
CORE will contact the employee's designated employer ICI
CORE will inform the employer ICI contact person of the restrictions
under which the claimant's physician will release the employee
to return to work, including duration.
The employer will take one of the following actions immediately:
Inform CORE, INC. whether or not the employer will accommodate
Inform CORE, INC. that the employer representative will
get back to CORE within 24 business hours with an answer
on accommodating the restrictions, OR
Inform CORE if the 24-hour turnaround time cannot be met
and provide a reasonable expectation when CORE will receive
an answer on accommodating the restrictions.
CORE will continue to pay benefits if the restrictions cannot
CORE will clarify all uncertainties with the claimant's
physician(s) including duration, lifting restrictions, bending,
frequency of breaks, etc.
It remains the responsibility of the employer to monitor for ADA
compliance when discussing whether or not to accommodate the restrictions.
Long-Term Disability Insurance (LTDI) Employer Certification
Wisconsin Administrative Code §ETF 50.48 (3) requires that
the employer complete certification based on the medically determinable
impairment described on the claim. With the new telephonic claim
process, a copy of the claim form is no longer sent to the employer.
As a result, ETF has revised the LTDI Employer Certification
(ET-5315) to include the description of the disability as reported
by the employee in question #8 on the ET-5315. This will serve as
the notice of disability upon which the employer may make certification.
Questions about information indicated in question #8 and questions
about other areas of this Bulletin should be directed to
CORE, INC. Dial toll-free 1-800-960-0052.