Income Continuation Insurance (ICI)
This section provides a basic overview of Income Continuation Insurance
for State and Local employees. Detailed program information is available
in the State Employee ICI (ET-2106)
brochure or the Local Employee
ICI (ET-2129) brochure.
What is ICI?
The Income Continuation Insurance (ICI) program is an income replacement
plan that replaces up to 75 percent of your salary if you are unable
to work because of sickness or injury. The plan provides replacement
income for disabilities that are considered short term in nature,
as well as those that may last for extended periods.
Benefits under the program will not duplicate benefits available
from employee-sponsored programs such as WRS retirement (regular
or disability retirement and lump sum or separation payments), Long
Term Disability Insurance (LTDI), Social Security (retirement or
disability), Worker’s Compensation, Unemployment Compensation,
employer sponsored/sanctioned salary continuation plans, etc., but
rather will supplement these programs so as to provide a specified
level of disability income. The ICI program is funded by contributions
from the state or local government employers and participants. The
Department of Employee Trust Funds contracts with a private company
(currently Broadspire, inc.) to issue eligibility determinations
and process individual claims.
Who is eligible?
The State ICI plan is available to all eligible State employees.
The Local ICI plan is available to eligible local government employees
whose employers have elected to participate in the ICI program.
An eligible employee is any person receiving earnings as payment
for personal services rendered to or for the benefit of the State
or a participating local government employer and who is contributing
a portion of those earnings to the WRS. Most employees must have
six months of service under the WRS before becoming eligible for
coverage. Some elected officials are immediately eligible for participation.
You may not be on a leave of absence at the time of enrollment.
What is Supplemental coverage?
The supplemental ICI plan provides additional coverage for employees
with annual earnings of $64000 up to $120,000. Employees pay the
entire premium for coverage beyond the $64,000 threshold. Individuals
with annual earnings greater than $120,000 who enroll in supplemental
ICI coverage are limited to a benefit based on earnings of $120,000.
Enrollment in the supplemental coverage is voluntary.
Who is eligible for Supplemental ICI Coverage?
If you meet the eligibility requirements for ICI coverage per
the applicable plan (i.e. Local or State/Faculty plan) and your
annual earnings exceed $64,000, you may apply for supplemental
coverage. If you elect supplemental coverage, you must insure
your entire salary above $64,000 up to a maximum of $120,000.
There is no partial supplemental coverage.
When to apply:
Local Employees: Employees newly eligible for ICI coverage with
projected earnings exceeding $64,000 may apply for supplemental
ICI at the same time they apply for standard ICI coverage.
State Employees: Employees newly eligible for ICI coverage and
those employees applying for ICI coverage during annual deferred
enrollment with annual earnings exceeding $64,000 may apply for
supplemental ICI at the same time they apply for standard ICI
coverage.
Employees with standard ICI coverage and earnings exceeding $64,000
who fail to enroll during their initial open enrollment period
may enroll on an annual basis, concurrent with the annual deferred
enrollment period or annual adjustment period. Such employees
may not apply for supplemental ICI coverage through evidence of
insurability (EOI).
An employee does not have ICI coverage whose earnings exceed
$64,000 may apply for both standard ICI and supplemental ICI coverage
by furnishing medical evidence of insurability.
Who pays the premium?
You pay the entire premium for supplemental ICI coverage; there
is no employer share.
How much does it cost?
The monthly premium rates vary depending on your salary and employee
group. Select the premium rate table that applies to you:
Contact your payroll/benefit representative if you have question
about your premium rate.
When can I enroll?
You may obtain coverage by completing an application form and
returning it to your payroll/personnel office within 30 days after
serving six months under the WRS (unless you are eligible to enroll
at an earlier date). Previous employment with an employer covered
under the WRS may allow you to enroll earlier.
State employees also have additional opportunities to enter the
plan based on your accumulated sick leave balance. Your payroll
representative can tell you the exact periods during which you can
enroll.
If you do not enroll for ICI coverage when you are first eligible,
you can enroll only by completing an Evidence of Insurability application.
Approval or denial of your application will be based on information
provided by you and your physician.
For more information about your enrollment period, refer to the
State Employee ICI (ET-2106)
brochure or the Local Employee
ICI (ET-2129) brochure. You may also contact your payroll representative
for more information and an application to enroll.
How do I file a claim?
You can initiate a claim by calling the ICI administrator, Aetna,
at 1-800-960-0052. When your claim is initiated, the claims administrator
will send you an introductory packet including a medical release
and complete claims processing information.
A claim may be submitted to the ICI administrator up to thirty
(30) days prior to the last day worked; however, no benefits will
be payable until after the last day worked based on the first date
of disability determined by the administrator and subject to your
elimination period. In no event will a claim be approved if received
more than twelve (12) months from the claimed first date of disability.
In addition, no benefits will be payable for the period which is
more than ninety (90) days prior to the date ETF receives the paper
claim form or the administrator receives the telephone claim.
How much will my benefit pay?
For most State employees, the amount of ICI benefit
payable is based upon your basic salary for your position during
the last complete payroll period prior to the first date of disability.
Benefits will be paid at 75% of gross basic salary, excluding overtime
or hours worked in excess of your position appointment.
For most local government employees, the amount
of ICI benefits payable is based upon WRS reported earnings in the
calendar year prior to the first date disability, rounded to the
next higher thousand. The rounded-up annual salary is divided by
12 to obtain the monthly salary and then multiplied by 75% to obtain
the monthly benefit amount.
For both State and local government employees, the maximum benefit
payable is $4,000.00 per month. However, for disabilities lasting
longer than 12 months, an additional $75 per month is added to the
normal benefit amount. If you enrolled in supplemental ICI coverage,
your maximum benefit is $7,500 per month (75% of maximum monthly
earnings of $10,000). The gross ICI benefit is reduced by other
income sources you receive or are eligible to receive.
When will my payments begin?
State employees--Disability benefits begin the
day after your elimination period has lapsed and you have not worked
due to a continuous and totally disabling condition during that
time. The elimination period begins on the first full day that you
are continuously and completely absent from work due to disability.
The elimination period for State employees is 30
calendar days or the date that your accumulated sick leave balance
is exhausted, whichever is later. The elimination period for employees
in the UW Faculty plan is your selected elimination
period (30 days, 90 days, 125 days, or 180 days) or the date that
your accumulated sick leave balance is exhausted, whichever is later.
If you still have sick leave hours remaining after using 130 days,
you may choose between continuing sick leave until part or all of
the remaining hours are used or beginning ICI benefits effective
the day after the last day of sick pay.
Vacation, personal holidays and compensatory time are not considered
in determining when benefits begin. Subject to personnel policies
and rules, you may use such time at your discretion. However, if
you receive earnings for vacation, personal holidays, or comp time
after the elimination period, ICI benefits will not be paid for
that period. When you have served your elimination period and your
sick leave credits are exhausted, ICI benefits are paid for every
calendar day of continuing disability. Benefit payments are made
monthly at the beginning of the month for the previous benefit month
(i.e. January benefits are paid February 1).
Local Government Employees-- At the time of your
enrollment, you chose an elimination period of 30 days, 60 days,
90 days, 120 days or 180 calendar days. Disability benefits begin
the day after your elimination period has lapsed and you have not
worked due to a continuous and totally disabling condition during
that time.
Vacation, sick leave, holiday time, and compensatory time are not
considered in determining when benefits begin. Subject to personnel
policies and rules, this time may be used at your discretion. However,
if you receive earnings for vacation, sick leave, holiday time,
and compensatory time, after the selected elimination period, ICI
benefits will not be paid for that period. You and your employer
are required to notify the claims administrator of all earnings
and benefits received after ICI benefits begin. When you have served
your elimination period, ICI benefits are paid for every day of
continuing disability, including weekends. Benefit payments are
made monthly at the beginning of the month for the previous benefit
month (i.e. January benefits are paid February 1).
Refer to the State Employee
ICI (ET-2106) brochure or the Local
Employee ICI (ET-2129) brochure for complete information about
your elimination period and benefit payment.
When are ICI premiums waived?
ICI premiums are waived as of the first of the month after the
date your benefits begin. However, if your benefits begin on the
first day of a month, the premium waiver begins on the same day.
The premium waiver remains in effect through the end of the month
in which you continue to receive benefits.
If benefits are terminated because your claim is closed, premium
payments for ICI coverage will resume. If you choose to remain on
a leave of absence after your disability ends, you must immediately
make arrangements for payment of premium. Otherwise, your ICI coverage
will terminate and can be reinstated only after you return to work
and reapply for coverage.
Are my benefits taxable?
If you receive benefits under the ICI program, you may be required
to report some or all of these benefits as taxable income. Generally,
the average percentage of the premium paid by your employer for
the three years prior to your initial disability payment is the
percentage of the benefit considered taxable. For example, if your
employer paid 75% of the premiums for each of the three years prior
to your initial disability payment, then 75% of the benefit payment
would be taxable for both state and federal taxes.
If you are receiving benefits based on the supplemental coverage,
that portion of the benefit is not taxable because you paid the
entire premium for the supplemental coverage.
If you have any questions about the taxability of insurance benefits,
you should consult the state and federal tax authorities or your
tax consultant.
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