twc leave and disability administration

TWC Leave and Disability Administration Employee ToolkitAn Employee Guide to Managing a Leave of Absence or Disability Claim through Sedgwick

TWC Leave and Disability Administration Employee Toolkit 2013 2

What’s in this guide?

This guide is designed to help you

understand our updated leave policies and

work with Sedgwick – our new Leave and

Disability Administrator. It includes important

details about:

• Wheretofindleavepolicyinformation

• Whichleavepolicieshavechanged,

andwhatthosechangesmeanforyou

• Howtoaccessandusethenewtool

to view a leave or disability claim

This change in leave administration will make

itsimpleandeasyforyoutomanageyour

leave and/or a short-term disability claim.

You will have leave and disability-related

informationinaconsolidatedresource,as

wellastheabilitytosearchforandupdatea

specificclaimorleavethroughSedgwick’s

onlinetool,viaOneExpress.

Sedgwick’sconsolidatedapproachprovides

areal-time,onlinesolutionforleaveand

disabilityinformation.

Thankyoufortakingthetimetolearnabout

this change. These policies and processes are

tohelpyoumanageyourbenefitsandleave,

whenorifyouneedthem.


Leave and Disability Administration updates – Questions and Answers

What’schanging?

Reporting a leave or disability claim

Access by Phone

Step-by-step guide:

Access Online — viaOne Express

Step-by-stepguidetoviewingandupdatinganexistingleaveand/ordisability

HowtoaccessviaOneExpress

Howtoviewyourleaveand/orclaim(s)

Howtosearchforaspecificleaveand/ordisabilityclaim

Howtoviewthedetailsofyourleaveand/ordisabilityclaim

HowtoconnectwithyourSedgwickresources

Table of contents

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TWCLeaveandDisabilityAdministrationEmployeeToolkit2013


Q. Why are we making this change?

A.Arecentevaluationofourleaveand

disability programs and processes

provided the opportunity to improve

andsimplifyhowweworkinthisspace.

Asaresult,wemadethedecisionto

moveouradministrationpartnershipfrom

UnumtoSedgwickandCigna.Aspartof

ourevaluation,ourleavepolicieshave

beenupdatedtoaccountforrecent

legislation and to align with best practices.

Q. When is this change effective?

A. BeginningonApril1,Sedgwickwill

administer our leave and disability

programs-FMLA,ancillaryleaves

(i.e.,military,personalleave,etc.)and

short-termdisability.Cignawilladminister

ourlong-termdisabilitybenefits.

Q. What does this change mean for you?

A. The Sedgwick solution makes it simple

andeasyforyoutoinitiate,updateand

manage your leave and/or disability claim.

In addition to calling and speaking with a

leaveordisabilityspecialist,youcan

accessandupdateyourinformationinasecure

onlineenvironmentthroughSedgwick’sviaOne

Expresssystem.

ThepolicyupdatesareeffectiveApril1,2013.

PolicieswillbepostedonChannelYouunder

EmployeeConnections>EmployeePolicy

Statements and Forms. You will also be able

to view the FMLA policy and the updated

DisabilitySummaryPlanDescription(SPD)

bygoingtotwcplusyou.com,clickingthe

gray“TWC+YouHealth&Welfare”button

andlinkingtoHealthandInsurance>Plan

Information.

Forthefullpolicydetails,gotoChannelYou

andselectEmployeeConnections>Employee

Policy Statements and Forms.

Q. What do I need to do?

A. No immediate action is required.

These policies and processes will

helpyoumanageyourbenefits

andleavewhen,orif,youneedthem.

Leave & Disability Administration Updates Questions and Answers for Employees


What’s changing?


TWC Leave and Disability Administration Employee Toolkit 2013

OurpartnershipwithSedgwickandCignaisonemorewaywecontinuetosimplifyourbenefitsservicedelivery

modelandprovideaccesstoinformationonline–whereverandwheneveryouneedit.Whetheryouareat

homeoratwork,youwillhaveaccesstobetterresourcesandservicesthroughSedgwickspecialistswho

areexpertsinleaveanddisabilityadministration.

What’s changing?

Here is a look at what this change means for you

Disability Sedgwick will manage short-term disability claims and coordinatethetransitiontolong-termdisability,managed byCigna,whenappropriate.

Military Leave RequestsformilitaryleavemustbeinitiatedthroughSedgwick.

Family Medical Leave (FML) • YoumustreportanewclaimtoSedgwickwithin two daysofyourfirstdayofabsence.

• YoumustreportintermittenthourstoSedgwickfor existingabsencesonthesame dayoftheabsence.

Personal Leave • Therequestforleaveisinitiatedwithyoursupervisor anduponapproval,managedbySedgwick.

• Youmustbeemployedingoodstandingforsixmonths at the time you request a personal leave.

• Themaximumdurationofapersonalleaveissixmonths.

• Acceptablereasonsforpersonalleaveare:

o Extendedbereavementandbonding

o Careforfamilymemberrelationshipsnot covered under FML

Topic Change Highlights

Forfulldetailsoneachspecificpolicy,goto Channel You > Employee Connections > Employee Policy

Statements and Forms.

TheupdatestoourleaveanddisabilityadministrationandpracticesareeffectiveApril1,2013.

Herearesomeofthehighlights:

6

Toinitiatearequestforleaveorreportadisabilityclaim,callSedgwickat 1-877-TWC-6707orcall1-877-TWC-BENSandsay“Life,DisabilityandLeaves.”Thisistheonlywaytoinitiatealeaveorfileadisabilityclaim.

7TWC Leave and Disability Administration Employee Toolkit 2013 7

Reporting a Leave or Disability Claim



Initiate a leave or report a disability claim

Youshouldinitiatearequestforleaveor

report a disability claim by calling Sedgwick

directlyat1-877-TWC-6707orbycalling

1-877-TWC-BENSandsaying“Life,Disability

andLeaves.”This is the only way to initiate a

leave or file a disability claim.Whencalling,

pleasehavethelastfourdigitsofyourSocial

Securitynumber,EmployeeID(EID)andyour

dateofbirthavailabletoverifyyouridentity.

Report a New Leave or Disability Claim

3 Whenprompted,state“reportanew

leave”orpress1.Aspecialistwillhelp

you initiate the leave or claim request.

3 Bepreparedtoanswerspecific

questions related to your leave

or disability claim.

3 Your specialist will also be able to

answer any questions that you

may have regarding your leave

ordisabilityclaim,includinghow

to complete and where to submit

the appropriate paperwork.

Updating Status of an Existing Leave or

Disability or Reporting Intermittent Family

and Medical Leave (FML) Time

3 ToupdateyourFMLinformationwith

intermittenttime,youwillneedyour

leaveconfirmationnumberyou

received when you initiated the leave.

3 Toreportanintermittentabsencesay,

“Absence”orpress2andcontinueto

answer the questions.

3 Foranexistingdisability,accessviaOne

Voice to report a return-to-work date or

toreceivedetailedinformationonan

existingclaim.

Calling 1-877-TWC-6707 and viaOne Voice, the Interactive Voice system (IVR)

In addition to reporting an intermittent absenceforanexistingleave,accessthe IVR system to:

•Verifythestatusofareportedleaveorclaim–confirmthedetailsoftheleave,includingdate,time,reasonforleave and current status

• Askaquestionaboutforms-speakwitha specialist who can answer questions aboutyourapplicationsforaleaveand/ormedicalcertificationforms

• Findinformationonwheretomail orfaxyourcompletedinformation

RememberyoucanusetheIVRfeature24hoursperday,sevendaysaweek,onceyouhaveappliedforaleaveorfiledaclaim.

Access by phone

9TWC Leave and Disability Administration Employee Toolkit 2013 9

Step-by-step guide for viaOne ExpressTools to Manage Your Leave and Disability Claims



Sedgwick’sviaOneExpresssystemprovidestheabilitytoviewreal-timeleaveorshort-termdisability

claims through a secure online environment. This new claim management system is designed to provide

immediateaccesstovieweligibility,claimandcasestatus,andbalancesbyleave-type.ThroughviaOne

Express,youwillbeabletoconnectwithleaveanddisabilityspecialiststoopencase/claimnotesandlinkto

externalresourcesforadditionalinformationonleavesand/ordisability.

FromChannelYou,gototheQuickLinksdrop

downmenu,select“LeaveAdministration”

andenteryourEIDandWindowspassword.

ToaccessfromtheInternet,type

viaoneexpress.sedgwickcms.net/twc

How to access viaOne Express

From Channel You From the Internet

First-timeuserswillneedtofollowthe

registration steps.

• SSOlinksareavailableonthe

“DiscountsandOtherRewards”

andthe“ContactUs”pages.

• LinksarealsoavailableonTWC+You

Health&Welfare.TheSSOlinkislocated

ontheHealthandInsurance>Insurance

andOtherOptionspage.

From TWC + You


How to view your leave and/or claim(s)

Onceyouenterthesystem,select“Continue

toViewClaims”toseeaspecificclaimor

leave you have reported.

How to search for a specific leave and/or disability claim

The“ClaimSearch”featureallowsyoutoview

informationwithinthepast24months.Search

foranopenorclosedclaim.

Youhavetheabilitytoviewdetailsofaclaimor

leaveatanytime,byselectingthespecificclaim/

case number hyperlink.


How to viewthe details of your leave and/or disability claim

TheClaimInformation(ClaimInfo)Screen

navigation menu provides you with access

toviewdetailsforaspecificclaim.Fromthe

claiminformationscreen,youcanlinktoother

important details about your claim or leave.

Clickheretoviewyoureligibilityforleave

and disability.

Ifyouareonaleave,youcanviewyour

remainingentitlementforallapplicable

absenceplans,undertheUnused/Pending/

Available section.

Ifyouhaveadisabilityclaim,youcan

viewyourbenefitstatus.


FromtheClaimSummary(fordisability)screen,

viewthedetailsofaspecificclaim,absence

history(fordisability),status,restrictionsand

benefitinformation.

Youcanupdateyourinformationwithyour

anticipated return-to-work date.

FromtheCaseSummary(forFMLA/Leave)

screen,youcanviewyourleavestatus,absence

statusandcertificationinformation.

You can also view your work schedule and a

calendarofapproved,deniedandpending

absence periods.


How to connect with your Sedgwick resources

Forspecificquestionsaboutaleaveorclaim,

contact your Disability or Leave Specialist by

clickingthe“LeaveSpecialistorExaminer”

linkatthetopoftheCaseorClaimsSummary

screen.

Youcanalsocallaspecialistat1-877-TWC-6707.

Forquestionsaboutloginissuesorsiteaccess,

contactSedgwick’sTechSupportteamby

clickingthe“ContactSystemSupport”link.

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