CAN ANYONE HELP TO EXPLAIN THE PROCESS FOR HOW STD CLAIMS ARE TO BE HANDLED IN NY AND CA? ARE CLAIMS SUPPOSED TO BE FILED TO THE STATE FIRST OR TO THE EMPLOYER'S CARRIER? IN OTHER WORDS, WHO IS PRIMARY?

IS IT POSSIBLE FOR AN EMPLOYEE TO "DOUBLE DIP" AND COLLECT STD BENEFITS FROM THE STATE AND THE EMPLOYER? HOW CAN THIS BE PREVENTED?

ANY HELP WOULD BE GREATLY APPRECIATED. WE NEED TO PUT A PROCESS IN PLACE AND I AM NEW TO THE PROCESS. THANK YOU

Both the state and private STD insurance will pay but not more than 80% of wages prior to disability. The state is considered primary but the private carrier will deduct the states payment amount from what they pay, so their payment would be less but the employee will still recieve the maximum benefit under the STD plan. Both NY and CA state plans are paid for by the employer that is why they are considered primary.

I don't know about NY, but I'm pretty sure that CA requires employee contributions to the State SDI plan, although the contributions are nominal.

[This message has been edited by Kirk Maldonado (edited 05-25-2000).]

Kirk:
You are absolutly correct. Cal. requires employee contributions. NY allows employee contributions up to a maximum amount, but it is not mandatory. The employer can pay the full cost.
In addition, in order to avoid any confussion in NY, if an employer is going to provide enhanced benefits for STD (called DBL in NY)the employer would be wise to have one carrier and not two, or to self-insure the benfits for both.

In Cal. an employer is required to use the state fund unless it can get the employees to agree to a commercial insurer plan.

Both NY and Cal. disability plans are mandatory under the Workers' Comp. laws in each state.
Coordinating benfits between NY DBL and another STD plan is relatively easy because the maximum weekly benefit under NY is 50% of last eight weeks average earnings up to $170 and most full-time employees will qualify for the maxumum. Cal. on the other hand is a little diferent. Employees could get varying weekly benfit maximums depending on their earnings and where they fall in the Cal. schedule. We always had to contact Cal. to find out what an employee was entitled to before we could off set their enhanced benefits.