The Differences Between Short- and Long-term Disability Insurance and COBRA

Jun 26

Voluntary benefits are becoming increasingly important to employees as they focus on their physical, mental, social andfinancial health. As a result, many employers have expanded their voluntary benefits offerings to address employees’ needsand improve their attraction and retention efforts.

Among these offerings are disability benefits, which can provide guaranteed income or job protection to employees who areunable to work due to serious illness or injury. The most common disability benefits are short-term disability (STD) and long-term disability (LTD) insurance. However, understanding the differences between STD and LTD benefits and other laws, such asthe Consolidated Omnibus Reconciliation Act (COBRA), can be complicated and difficult for employers to navigate.

This article provides a general overview of STD, LTD and COBRA and explores how both types of disability insurance differ fromCOBRA.

What Are STD and LTD?

STD and LTD insurance are the most common forms of disability benefits.

Short-term Disability Insurance

STD insurance replaces all or a portion of an employee’s income due to a temporary disability. Under STD plans, employeesreceive a percentage of their income, typically 40% to 70% of their base pay, but employers can allow employees tosupplement their STD benefits with paid sick leave or other benefits. An STD insurance policy is paid either fully or partially bythe employer, and the median length of STD insurance coverage is 26 weeks, according to the U.S. Bureau of Labor Statistics.

To qualify for STD insurance, an employee files a claim under their insurance policy. The employee must prove their illness orinjury qualifies as a disability under the plan’s terms. STD insurance generally requires employees to wait for a short period—on average, seven days—before they start receiving benefits to discourage abuse and because many employers’ paid-time-offbenefits cover shorter absences than those covered by STD insurance. While STD insurance plans do not guarantee jobprotection, employees may be entitled to it through their employers’ policies or under state and federal laws, such as theFamily and Medical Leave Act.

Employers offer STD insurance because it helps employees remain financially stable while recovering from an illness or injury,allowing them to stay productive and focused when they’re physically able to return to work. Since the income employeesreceive under STD insurance is paid by insurance companies, employers have the financial resources and flexibility to hiretemporary or contract workers to fill workforce gaps without experiencing high labor costs. In states that don’t requireemployers to participate in disability income plans, employers can offer full, partial or noncontributor STD insurance plans.

Long-term Disability Insurance

LTD insurance provides employees with income for long-term illnesses and injuries. Employees generally receive 60% to 80%of their base pay; however, some employers’ LTD plans offer more limited income replacement benefits. Similar to STD,employees receive income benefits until they are able to return to work or have exhausted policy limits. LTD benefitsrequirements tend to be more rigorous than STD because workers need to demonstrate they’re unable to perform any job, notjust the job they were working before the illness or injury.

These plans often work together with STD, so when an employee exhausts their STD benefits, LTD benefits continue to providethe employee with income. As with STD benefits, LTD does not provide workers with job protection. Employees who becomepermanently disabled may continue to receive LTD benefits through their retirement date or until they’re eligible for SocialSecurity disability benefits.

What Is COBRA?

COBRA allows individuals to continue their group health plan coverage in certain situations. This law requires group healthplans maintained by private-sector employers with at least 20 employees to offer continuation coverage to covered employeesand dependents when coverage would otherwise be lost due to certain specific events. These events include the following:

Death
Termination
Reduction in employment hours below the plan’s eligibility requirements
Divorce or legal separation
Medicare eligible
Child’s loss of dependent status under the plan’s rules

COBRA sets rules for how and when continuation coverage must be offered, how employees and their families may electcontinuation coverage, and when continuation coverage may be terminated. Employers may require individuals to pay forCOBRA coverage. Group health coverage for COBRA participants is usually more expensive than coverage for active employeesbecause many employers pay a portion of the premium for active employees.

COBRA continuation applies to plans that qualify as group health plans as defined by the Employee Retirement IncomeSecurity Act (ERISA). Under ERISA, a group health plan must be a plan, fund or program that is established or maintained by anemployer and has the purpose of providing medical care. Health insurance plans, self-funded health plans, health maintenanceorganizations and prescription drug plans generally meet ERISA’s criteria for a group health plan. Medical care is defined ascare for the diagnosis, cure, mitigation, treatment or prevention of disease and any other undertaking affecting any structureor function of the body.

The Differences Between STD and LTD and COBRA

An employer is not required to offer COBRA continuation on a voluntary benefits plan if the plan does not qualify as a grouphealth plan and the plan is considered completely voluntary. STD and LTD benefits generally provide income replacement forindividuals who must take a leave of absence from work due to a qualifying condition instead of medical care. Because STDand LTD typically do not provide medical care, they’re not subject to COBRA and would not be required to continue underCOBRA. However, although uncommon, if an STD or LTD insurance provided medical care, it may be considered a group healthplan under COBRA and subject to continuation coverage.

While STD and TLD benefits are generally not subject to continuation coverage under COBRA, an employee’s disability caninitiate COBRA requirements if it produces a qualifying event. For example, if an employee becomes disabled and doesn’treturn to work at the end of their disability leave or notifies their employer of their intent not to return, the employer’s plan willdetermine whether this is a qualifying event. If this is determined a qualifying event, COBRA requires the employer to notifythe employee of their COBRA rights and provide the employee with the option to continue group health insurance coverage.

Summary

STD and LTD benefits can provide sick and injured employees with financial stability and peace of mind when they’re unable towork. Understanding how these types of disability insurance differ from COBRA can help employers stay compliant and ensureemployees have the benefits they need and desire.

Reach out to The Hilb Group for more information on voluntary benefits.

Tony Scida