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Disability > Group Disability Timeframes > Flashcards

Group Disability Timeframes Flashcards

1
Q

How long does it take for an Acknowledgement package to be mailed to the Claimant?

A

Mails out as shown for leaves below (additional details).

  • STD - Next business day after claim is filed.
  • LTD - Within 5 business days after initial receipt.
  • TAM / NY PFL - Within 2 business days after claim is filed.

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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2
Q

How long does it take for a Family Medical Leave (FMLA) Rights Package to be mailed to the claimant?

A

Mails out as shown below.
-Standalone FMLA - Within 2 business days after claim is filed.
-Includes claims opened via methods shown below, regardless of the date of disability or first date of absence.
-Telephonically
-Electronically (e.g. MetLink or MyBenefits)
-Paper
-LTD bridged from STD
Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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3
Q

How long does a Claimant have to appeal a decision on a claim?

A
  • ERISA plans allow EE’s 180 calendar days to submit an appeal request.
  • MetLife then has 45 calendar days to review the appeal request and any additional information submitted.
  • If additional time is needed, MetLife will notify the claimant of an additional 45 day period of time.

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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4
Q

How long does it take for a check to be issued once the claim has been approved?

A

The business day following claim approval.

Reference Knowledge Article: Group Disability Timeframes-Overview tab-Checks- Issued- Retroactive benefits for additional details.

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5
Q

When are checks issued for current/future benefits?

A

Issued according to the Next Repetitive (cycle) date during period of time claim is approved.

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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6
Q

What is the timeframe for the claimant to receive an issued check for their claim?

A
  • Up to 10 business days.
  • Allow up to 10 business days for EE to receive.

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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7
Q

What is the timeframe for a stop payment to process?

A

Processed same day

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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8
Q

How long does it take for a check to be reissued?

A

7-10 calendar days provided the original check was in open status.

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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9
Q

How long does it take for a caller to receive an email/fax from MetLife?

A

Received by end of the same business day

Reference Knowledge Article: “Group Disability Timeframes-Overview tab- for additional details.

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10
Q

What is the processing timeframe for correspondence to be mailed to a caller?

A

Processed within 24-48 hours

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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11
Q

What is the timeframe for an email to be posted to a claim?

A

Posted to the claim within 1 business day after the date of receipt (including photos).

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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12
Q

How long does it take MetLife to scan documents to a claim?

A

12 hours

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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13
Q

What is the timeframe for correspondence to be scanned to a claim if the appropriate identifiers are NOT included on the correspondence?

A

48 hours

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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14
Q

How many day(s) can a claim be in EA status before associate can follow the escalation process?

A

2 Business days.
-If a claim is in EA status more than 2 business days after being placed there, follow procedure to escalate the review.

EA Review section
Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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15
Q

How long does it take to setup EFT for STD Claim?

A

STD:

  • Up to 5 business days.
  • Do not count the date request is received.
  • Applies for all request methods, e.g., verbal, written, online.

EFT Review section
Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

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16
Q

How long does it take to setup EFT for All Coverages Besides STD?

A

No Timeframe can be provided.

  • Do not provide timeframe to initiate, change or stop EFT - CS will advise.
  • CS will update EFT as soon as possible and written confirmation of the initiation / change will mail out to EE.
  • CS will contact EE if any questions.
  • If callers press for status or question above timeframe further: Offer return call from CS.

EFT Review section
Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

17
Q

What is the timeframe for the Health Care Provider Certification Form (HCPC) to be returned to MetLife?

A

Should be completed and returned by the beginning of the absence or within 15 calendar days of the date of the letter (5 additional days provided for mailing) total of 20 days.

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

18
Q

What is the timeframe for an Info received task to be completed by the claims office?

A

-5 Business days following the date task was created.

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

19
Q

What is the timeframe for CS/UL Call Back Request?

A

Returned in 1 business day regardless of when the call is received (business day ends at 5pm EST)

Reference Knowledge Article: “Group Disability Timeframes-Overview tab” for additional details.

20
Q

What is the timeframe for an initial claim decision on a Short-Term Disability Claim?

A

Initial claim decision generally within 10 business days following claim receipt

Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

21
Q

What is the timeframe for an initial claim decision on a Standalone Family Medical Leave Act (SA FMLA)?

A

Initial claim decision generally within 5 business days following receipt of complete HCPC
Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

22
Q

What is the timeframe for an initial claim decision on a Long Term Disability (LTD)?

A

5 business days following receipt of:

  • Coverage verification
  • All required medical/vocational information

Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

23
Q

What is the timeframe for an initial claim decision on a CA PFL & CT / MA / WA PFML Claims?

A

14 calendar days
-Exception: CT PFML = 15 calendar days

Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

24
Q

What is the timeframe for an initial claim decision on a New York Paid Family Leave (NY PFL) Claims?

A

18 Calendar days

-Includes re-opening claims due to receiving documentation after the claim was closed for failure to submit required
information timely.
-Count does not begin until ALL required information and forms are received.
-Applies to standalone and concurrent claims.

Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

25
Q

What is the timeframe for an initial claim decision on a Total Absence Management (TAM)/Absence Management (AMS) Leaves?

A

5 business days following receipt of certification information (if applicable).

Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

26
Q

What is the standard timeframe for Medical to be reviewed?

A

The Goal is 5 Business Days

Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

27
Q

How long does it take for a Claim Specialist (CS) to be assigned to a Short Term Disability(STD) Claim?

A

CS assigned within 24-48 hours (1-2 business days).

  • For past DoD, contact is within 2 business days from claim filing
  • For future DoD, contact is within 2 business days from DoD

Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

28
Q

How long does it take for a Claim Specialist (CS) to be assigned to a Long Term Disability(LTD) Claim?

A

LTD
-EEs are contacted by CS within 3 business days.
Reference Knowledge Article: “Group Disability Timeframes-Details tab” for additional details.

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