Questions about Short Term Disability

DB Hous

New Member
1
My wife and I are having a baby via surrogacy in another country. She would like to take FMLA (Family Medical Leave Act) time off if this is something that becomes a reality. She did not sign up for short-term when she started, so we are waiting to hear back from HR to see if she can receive it during open enrollment. HR has not been clear if surrogacy is covered. If these benefits do not include what we need is there a product out there that will help us?

We would probably have the baby in February of 2024 and do not mind paying for external insurance if needed. How can we benefit from insurance in Tennessee? How would all this work as I am confused by insurance having rarely used it. Your thoughts are appreciated and a possible sale, as long as that product can cover my wife being absent via FMLA and having a baby bonding time.

Text from HR Form:

Plan Effective Date: 01/01/2023

Short Term Disability Insurance

MetLife has developed this document to provide you with information about the optional insurance coverage you may select through the Shelby County Board of Education. Written in non-technical language, this is not intended as a complete description of the coverage, please reference a copy of the certificate for detailed plan descriptions.

Employer Plan Effective Date

The group policy effective date is January 1, 2023.
Eligibility

To become insured, you must be:

• A regular employee of the Shelby County Board of Education, excluding temporary or seasonal employees, full-time members of the armed forces, leased employees or independent contractors
• Actively at work at least 30 hours each week
• Approved by Medical Underwriting if you are considered a Late Enrollee.
Employee Coverage Effective Date
Please contact your human resources representative for more information regarding the following requirements that
must be satisfied for your insurance to become effective. You must satisfy:

• Eligibility requirements
• An eligibility waiting period of the first day of the month coinciding with or next following your date of hire
• An evidence of insurability requirement if you are a Late Enrollee
• An active work requirement. This means that if you are not actively at work on the day before the scheduled effective date of insurance, your insurance will not become effective until the day after you complete one full day of active work as an eligible employee.

Benefit Amount

Your weekly benefit will be 60% of the first $2,500 of your insured predisability earnings, subject to income which will reduce your disability benefit section.
Plan Maximum Weekly Benefit: $1,500
Plan Minimum Weekly Benefit: $100 or 10 percent of the STD benefit before reduction by deductible income, whichever is greater
Note: Late application is defined as applications received after 31 days of becoming eligible after the annual enrollment period as defined by Shelby County Board of Education.
Benefit Waiting Period
If your claim for STD benefits is approved by MetLife, benefits become payable after your benefit waiting period (7 days or 30 days, depending on the plan you enrolled in), remain continuously disabled.
 
If these benefits do not include what we need is there a product out there that will help us?
No. There are no products on the open market that will let you cover something likely to happen in the near future that you can buy today. Even if there was, you would have needed to own it before you went down this path.

Hopefully HR will tell you it's covered (group plans can have some options unavailable to stand-alone plans).
 
FMLA is unpaid leave but I cannot fathom a disability claim for a surrogate newborn. Ig YOUR employer is ni e, you should also be able to get FMLA for the newborn which gives your new family 12 weeks of unpaid leave. Getting any type of insurance for a deed already done or in the works is not how a carrier makes money
 
You need the explanation of benefits, along with the policy contract. No way to know if its covered based on the info you have given so far.

Group often does cover situations individual policies do not.

And the fact that you can choose to enroll each year via open enrollment makes it so they sometimes might take on a "pre-existing condition" in some circumstances.

But I highly doubt it will cover surrogacy. Your wife is not the one who is disabled.
 
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