The 2020 General Assembly Session passed Senate Bill 567 resulting in maternity benefit changes for Short-Term Disability plans in Virginia
During the 2020 General Assembly Session, Senate Bill 567 – Disability Insurance: coverage for disability arising out of child-birth (SB567) was passed. The Commonwealth of Virginia established a new 12-week maximum benefit period for Short-Term Disability benefits for eligible insured women post childbirth.
- SB567 impacts all fully insured Short-Term Disability (STD & DisFlex) plans issued in Virginia with an effective date of July 1, 2021 or later.
- In-force customers will have the option to add the 12-week maximum benefit duration during their July 1, 2021 renewal or thereafter. (The 12-week change is not automatic; a request must be made by the employer to their Short-Term Disability plan provider)
- Rates will change when the new coverage is added.
- This change is for STD childbirth only, not Paid Family Medical Leave (PFML)
- The new 12-week maximum benefit duration is subject to a physician’s approval. (If a physician clears a claimant to return to work after 9 weeks, the benefit ends at 9 weeks. If a physician clears the claimant to return to work after 7 weeks, the benefit ends at the end of 7 weeks)
- A claimant must meet the definition of disability offered by their current Short-Term Disability contract. (Remaining on claim is determined by the claimant’s physician)
- The elimination period must be waived as of date of birth. (If birth is May 2 then the benefit begins May 2)
- Pre-existing condition limitations may apply. (If the employer short-term disability plan has a pre-existing condition limitation and the claimant is within the pre-existing period, no claim will be paid)
- To access the benefit, a claim form would need to be completed and sent to the carrier upon the birth of the child.
- Certain procedures will not qualify under the new maternity benefit. (If a short-term disability plan is in force, and a claimant is not in their pre-existing limitation period, a claim may be filed under the regular short-term disability benefit. If approved, the normal waiting period would apply).
As always, please contact your benefits team with any questions at (804) 285-5700 or email us at benefits@simafinancialgroup.com.
SIMA Benefits Consulting Group
This content is not intended to be exhaustive nor should it be viewed as legal or tax advice. Information presented is believed to be current. It is not intended as a thorough, in-depth analysis of specific issues nor a substitute for a formal opinion, nor is it sufficient to avoid any penalties. You should always consult an attorney or tax professional regarding your specific legal or tax situation.
