Overview

At Citi, we offer insurance that protects your income in the event that you are unable to work, including:

Short-Term Disability (STD)

Eligibility

If you’re a regular full-time or part-time U.S. Citi employee scheduled to work 20 or more hours per week, you’re covered by Short-Term Disability (STD) at no cost to you.

STD pays 100% or 60% of base salary (not benefits eligible pay) during an approved disability of up to 13 weeks based on your years of service with Citi prior to the date of your disability. For purposes of the Plan, your years of service are based on your actual time providing services to Citi as an employee.

For newly hired and rehired employees (regardless of prior service), there is a 90-day waiting period before disability benefits are payable. For a schedule of benefits, refer to the Benefits Handbook.

Note: If you aren’t eligible for Citi STD benefits and you work in CA, HI, NJ, NY or RI*, you may be eligible for state benefits. MetLife will advise you of the applicable state benefits.

*If you work in RI, you must report your claim to the state by calling 1 (401) 462-8420 and to MetLife.

When and How to Report a Disability

If you become unable to work due to an injury, illness, pregnancy, you must report all absences to your manager/supervisor immediately. However, if you’ll be absent from work for more than seven consecutive calendar days, you also must follow the steps below:

When to Report it If you’ll be absent from work for more than seven consecutive calendar days due to a non-work-related injury or illness
Whom to Contact

MetLife by using one of the following methods:

 

Information You Must Provide

Provide the following information to MetLife:

  • Name, address, telephone number and Citi GEID
  • Manager’s/supervisor’s name, telephone number, email address and mailing address
  • Your health care provider’s name, address and telephone number
  • Information about your illness

 

Note: You should not give specifics, such as a medical diagnosis, for non-work-related injuries or illnesses to your manager/supervisor.

Additional Information

Notify your health care provider(s) that MetLife will handle your claim and a representative will contact his or her office. MetLife may request additional medical information so a claim decision can be made.

Form(s) You Must Complete

Complete the Health Care Provider Certification Form and Medical Authorization Form that will be mailed to you after your claim has been reported to MetLife.

These forms will authorize your health care provider to release your medical information to MetLife. These forms are very important and will help expedite the handling of your claim. You may also receive state or local benefit forms (where applicable).

When an STD Benefit Is Payable

An STD benefit is payable and begins when you’re medically certified as unable to work due to a total disability incurred while actively employed. To qualify for an STD benefit, you must be receiving appropriate care and treatment on a continuing basis from a licensed health care provider.

Your STD payments will be based on your eligibility as well as the “approved through” date designated by MetLife. Upon request, you must continue to provide documentation to MetLife throughout the claim period. If you fail to provide the appropriate documentation to MetLife within 10 business days of the request, your claim can’t be evaluated and will be closed. If your claim is closed and you don’t return to work, your STD benefit will stop. For more information on how your STD benefits are paid, refer to the Benefits Handbook.

iconRecurrent Disabilities

If you qualify for an STD benefit, return to work and within 30 days or less from your return-to-work date you’re unable to work due to the same or a related total disability, your absence will be processed as a recurrent claim. You’ll be eligible to receive an STD benefit for the balance of the STD period of up to 13 weeks and may qualify for LTD.

If either a recurrent disability or an unrelated disability occurs after you returned to work for more than 30 days following an initial disability, you may be eligible for an additional STD benefit, not to exceed 13 weeks, if approved.

Other Provisions

If you’re not eligible for disability benefits but may need a leave for your own serious health condition within your first 90 days of employment, you must submit a claim to MetLife. If it’s determined you’re disabled and unable to work, MetLife will medically manage the claim only, meaning that you will continue to receive medical coverage, paying the same rates that active employees pay for coverage.

What Happens Once You Report STD

iconInitial Review

After you submit a claim for disability benefits to MetLife, MetLife will review your claim and notify you of its decision to approve or deny your claim. MetLife will assign a case specialist to you and mail a Health Care Provider Certification Form, Medical Authorization Form, state or local forms (where applicable), and information on your rights and responsibilities under the Family Medical Leave. If you don’t return the forms on time, your claim may be denied.

Be sure that your health care provider promptly completes the Health Care Provider Certification Form and returns all forms to MetLife so that MetLife can obtain additional information about your medical condition as needed pertaining to your claim so a benefits determination can be made. The address and fax number are on each form. Keep your manager/supervisor informed of your claim and/or leave status throughout the process.

iconIf Your STD Claim is Approved

If your MetLife case specialist approves your claim for an STD benefit, you’ll:

  • Receive a letter confirming the length of your approved disability.
  • Receive a separate letter from MetLife regarding your family and medical leave of absence, and state or local leave, if eligible.*
  • Receive an STD benefit through payroll based on your eligibility.
  • Continue to pay for health and insurance benefits (and Group Universal Life as well as Long-Term Care coverage, if enrolled) at the active employee rate. Contributions will be taken from your STD payments.**

Your MetLife case specialist will assist you, coordinate your claim and additional information with your health care provider, coordinate with your manager on your leave and return to work, and evaluate your eligibility for LTD after 13 weeks.

*You’ll receive separate communications from MetLife regarding your Family Medical Leave, STD and state or local leave, where applicable as these are treated as separate leave requests.
**In New Jersey, the state benefit will be paid directly to the employee and, as a result, benefits contributions may be handled differently.
iconIf Your STD Claim is Denied or Benefits Are Terminated

If your claim for a disability benefit is denied or benefits are terminated before the maximum benefit is provided, your MetLife case specialist will:

  • Contact you to explain the reason for denial or benefits termination.
  • Notify your manager/supervisor.
  • Notify HR Shared Services to stop your disability benefits, if applicable.
  • Document, via letter, the reason for the denial/termination of disability benefits and explain the appeal process and procedures.
iconBenefits Coverage If You Become Disabled

You and your eligible dependents may continue medical, dental and vision coverage for up to 13 weeks as long as you make the active employee contributions. For more information on coverage if you become disabled, refer to the Benefits Handbook.

If you have any questions about your benefits coverage while on a leave, call ConnectOne at 1 (800) 881-3938. From the “benefits” menu, choose the “health and insurance benefits as well as TRIP and spending accounts” option.

iconDo You Work in New York or California?

New York
If you’re approved for a state disability benefit from New York, the payment will be included in your STD benefit from Citi. If you’re denied an STD benefit from Citi, your New York state benefit will be paid by MetLife. If you’re later approved under Citi’s STD plan, you’ll be required to reimburse MetLife for the New York state benefit which you received. For more information about New York Paid Family Leave, review the Family and Medical Leave Act (FMLA) section.

California: 
If you’re eligible for a disability benefit and work in California, you’re covered by the Citi California Voluntary Disability (VDI) Plan, unless you reject the plan. You have the right to reject the Citi VDI plan by completing a Rejection Notice, which is available from HR Shared Services. If you reject the Citi VDI plan, your election will become effective the first day of the calendar quarter following the one in which you give the Rejection Notice to HR Shared Services who will notify MetLife.

At that time, you’ll:

  • No longer be eligible for an STD benefit from the Citi VDI plan.
  • Be subject to the California State Disability Insurance (SDI) tax, which will be deducted from your pay, in order for you to receive benefits under the California state program.

If you become disabled and aren’t enrolled in the Citi VDI plan, you must:

  • File a claim directly with the state of California for California SDI benefits.
  • Call MetLife to report your Family Medical Leave.

Long-Term Disability (LTD)

Long-Term Disability is provided through MetLife in the event you suffer a covered disability. You may be eligible to receive an LTD benefit if your approved STD claim was paid for 13 weeks.

LTD coverage is offered to replace 60% of your benefits eligible pay (pre-disability earnings) determined on the day before your approved STD. Your “pre-disability earnings” under the MetLife group disability policy constitutes your benefits eligible pay (as defined by the plan) for purposes of the LTD benefit.

Citi provides Company-paid LTD coverage to employees whose benefits eligible pay is less than or equal to $50,000.99:

  • If your benefits eligible pay is less than or equal to $50,000.99, you do not need to enroll for coverage and there is no cost to you.
  • If as a new hire, your benefits eligible pay exceeds $50,000.99, you will be automatically enrolled in LTD coverage with an option to decline coverage. You must pay for this coverage.
  • If your benefits eligible pay increases to $50,001 or above for benefits purposes for Annual Enrollment in the next plan year, you will be automatically enrolled in LTD coverage so your coverage continues uninterrupted.

The cost of LTD coverage will be deducted from your pay beginning January 1 of the next plan year (following Annual Enrollment) unless you decline coverage. When you’re billed directly for your benefits, you’re responsible for paying the employee share. Failure to pay your employee contributions will result in the termination of your coverage.

For purposes of calculating your LTD benefit, benefits eligible pay is limited to a maximum of $500,000. Disability benefits received from any state disability plan, Social Security and the LTD portion of the Plan, combined, won’t exceed 60% of your benefits eligible pay.

iconImportant Items to Note

If you decline automatic enrollment in the LTD coverage and decide to enroll in LTD coverage at a later time, other than as the result of a qualified change in status, you must take a physical exam and/or provide evidence of good health before coverage will be approved. The Plan will not cover any disability caused by, contributed to, or resulting from a pre-existing condition until you have been enrolled in the Plan for 12 consecutive months.

If you elect to decline LTD coverage within the first 90 days following your enrollment, you will receive a refund of your paid premiums. You can also decline LTD coverage after the initial 90‑day period; however, premiums will not be refunded to you. For more information, refer to Benefits Handbook.

iconPre-Existing Conditions

A pre-existing condition is an injury, sickness or pregnancy for which — in the three months prior to the effective date of coverage — you received medical treatment, consultation, care or services; took prescription medications or had medications prescribed; or had symptoms that would cause a reasonably prudent person to seek diagnosis, care or treatment.

iconIf You’re Approved for an LTD Benefit

MetLife will continue to manage your claim and pay your monthly LTD benefit. If you have consecutive, concurrent or continuous disabilities, related or unrelated, which continue for a period of more than 13 weeks and if eligible and approved, you will receive an LTD benefit from MetLife.

For more information on how your LTD benefits are paid, refer to the Benefits Handbook.

iconWhat Happens After 52 Weeks of Disability

After receiving a total of 52 weeks of disability benefits, which includes both STD and LTD, and you’re unable to return to work and remain on an approved disability leave for more than 52 weeks, your employment may be terminated (unless an accommodation under the ADA or applicable state or local law has previously been approved).

MetLife will medically manage your claim to determine your eligibility to continue in applicable health and insurance benefits at the active employee rate as long as you’re disabled. If you’re a totally disabled employee who has been denied LTD benefit due to a pre-existing condition, did not enroll in LTD coverage, or who has reached the maximum benefit under the two-year limitation rule, the disability administrator will medically manage your claim, as well.

If you have any questions about your benefits coverage while on a leave, call ConnectOne at 1 (800) 881-3938. From the “benefits” menu, choose the “health and insurance benefits as well as TRIP and spending accounts” option. For more information on coverage if you become disabled, refer to the Benefits Handbook.

COBRA Coverage While on Disability

Due to your disability and termination of employment, you’re eligible to elect to continue your medical coverage under COBRA. COBRA allows you and your covered dependents to continue health care coverage at your expense under certain circumstances when coverage would otherwise end.

COBRA requires that you be given the opportunity to elect to continue your medical coverage for a minimum of 29 months (generally, 18 months; 11-month extension available for disabilities). At the end of the medical continuation period, you may continue coverage through COBRA for up to 29 months, if applicable.

If your medical coverage provided at active employee rates ends before 29 months after your employment terminates, and you continue to be disabled, you will have the opportunity to elect medical coverage for the remainder of the 29-month period available under COBRA. If you’re no longer deemed disabled before 18 months after your employment terminates and your medical coverage at active employee rate ends, the maximum COBRA coverage you can elect is 18 months. However, your cost will be the regular COBRA premium rates, which are higher than the group rates active employees pay. If you continue any coverage through COBRA, you must pay the entire contribution (employee plus employer contributions) plus a 2% administrative fee for the remainder of the initial 18-month period.

For COBRA coverage related to the disability extension, you’re required to pay a 50% administrative fee, in addition to the entire contribution for the 11-month period (months 19-29). Please note, you’re only eligible for the disability extension of COBRA as long as you are deemed disabled during the 11-month period by the Social Security Administration (“SSA”). If the SSA determines that you’re no longer disabled during the extension period, your eligibility for COBRA coverage ends as well. To elect COBRA under these circumstances, please call ConnectOne at 1 (800) 881-3938. From the “benefits” menu, choose the “health and insurance benefits as well as TRIP and spending accounts” option.

Note: Generally, if the medical continuation period after your employment terminates exceeds the 29-month period required under COBRA related to your disability, Citi is considered to have fulfilled its obligation to provide COBRA continuation coverage and is not required to provide additional medical benefits.

For more information on COBRA coverage, refer to the Benefits Handbook.