July 6, 2020
UFLAC Active Member
1571 W Beverly Blvd
Los Angeles, CA 90026
RE: UFLAC Long Term Disability Plan Clarifications
Dear UFLAC Member,
We have become aware that there has been false information distributed to our membership regarding the UFLAC Long Term Disability (LTD) plans. Any information communicated regarding the UFLAC LTD plans by anyone other than the UFLAC Trust and specifically, by the California Association of Professional Firefighters (CAPF), is used to market their LTD plan and is not accurate. False statements are made and are intended to mislead membership into buying their product.
As your UFLAC Benefits Trustees, we want to make sure that you are well informed of the comprehensive and enhanced LTD options available to you as UFLAC members. As a reminder, the UFLAC LTD plans are the only long-term disability plans endorsed by your Union.
Why did UFLAC leave CAPF?
CAPF is a “pay-as-you-go” system, which means the plan does NOT reserve for active or future claim payouts. “Pay as you go”, is a system in which current collected premiums are used to pay for active benefits and little to no money is put aside for potential future benefits. This means that if too many members become disabled in a brief timeframe, the plan could collapse, and benefits would not be paid. Additionally, because the CAPF product is not insured, the benefits are not guaranteed and are only paid if enough money is collected. As of 2013, CAPF only had total assets of approximately $3.5M, although they insured around 16,000 participants.
For comparison, the current UFLAC LTD plans are fully-insured through Reliance Standard Life Insurance Company, a company with over $30B in assets and reserves that can be used to pay plan participants. As of July 1, 2019, Reliance Standard had set aside nearly $4.2M in reserve just to pay future UFLAC LTD benefits for those currently out on claim.
This reserving process is extremely important for member benefits and security; if our current fully-insured LTD plan does not adequately or appropriately reserve, Reliance Standard Life Insurance Company will be subject to legal action. And no matter what, the benefits owed to our members are GUARANTEED TO BE PAID.
Moreover, CAPF has been found by a federal court to have violated ERISA by engaging in self-dealing. In addition, firefighter Barboza and the Department of Labor raised concerns that CAPF failed to undertake annual actuarial reviews, monitor the fund’s solvency, or adopt an adequate funding policy. On the next page, please find a comparison between CAPF’s “pay-as-you-go” LTD plan vs. the reserved fully-insured UFLAC LTD plans.
|Current enrollment||16,000 members||1,854 members|
|Reserves for current claimants only||None reported||$4,200,000|
|Insured||No – Not guaranteed||Yes – Guaranteed|
*As of July 1, 2019
How do the UFLAC LTD plans work?
The UFLAC LTD plans provide you with a monthly benefit in the event that you are unable to work due to an injury or illness, so long as your physician deems you as disabled. UFLAC offers members two fully-insured LTD options through Reliance Standard Life Insurance, the Premium and Standard plans. Below, is a comparison of the two UFLAC LTD plans:
July 1, 2019
July 1, 2019
|Percentage of Covered Monthly Earnings||70%
|Maximum Monthly Benefit||$10,000||$10,000|
|Minimum Monthly Benefit||$100||$100|
|Elimination Period||90 days||180 days|
Please note, this is not a complete list of the UFLAC LTD benefits. Review your certificate of coverage for more details.
How long do the LTD benefits last?
During the first 24 months, (known as the Own Occupation period), the plans pay benefits if you are unable to perform the duties of your own occupation with the LAFD. After 24 months, the plan pays benefits if you are unable to perform the duties of any occupation based on your education, training, or experience, which is known as the Any Occupation period. If you continue to meet the requirements of being Totally Disabled, benefits are payable up to the Social Security Normal Retirement Age (SSNRA). If you are not approved for disability during the Any Occupation period, your benefits will end.
Why did I receive a benefit payment less than 60% or 70% of my covered monthly earnings?
While you are using your LTD benefits, any income you receive or are entitled to receive because of your disability may be used to offset your monthly LTD benefit. Your monthly LTD benefit may be reduced if you are eligible to receive one or more of the following sources of Other Income Benefits as a result of your disability:
- Other Group Disability Benefits including LAFRA
- 4850-time (IOD Pay)
- Workers’ Compensation (State-Rate)
- Retirement Benefits
Please be aware that your accrued sick time, prior to your date of disability, is not considered an eligible Other Income Benefit and will not offset your monthly LTD benefit.
Please note, this is not a complete list of Other Income Benefits. Review your certificate of coverage for more details.
If you are already receiving more than your calculated maximum monthly LTD benefit from another source of disability income, the UFLAC plans will still provide you with a minimum monthly benefit of $100. The following examples are provided to help explain how the LTD benefits coordinate with Other Income Benefits.
Injured on Duty (IOD) LTD Claim Example
IOD Claim Example Year 1: A member is enrolled in the UFLAC Premium LTD plan and is injured on duty. The member earns $120,000 per year (including overtime), which translates to a maximum monthly benefit of $7,000 (70% of $10,000/month). The member is also receiving $8,000 from 4850-time for their first year of injury. Under this IOD scenario, the UFLAC Premium LTD plan would provide the minimum monthly benefit of $100, because the member’s LTD benefit is fully offset by their earnings from 4850-time for the first year.
IOD Claim Example Year 2: The same member’s disability continues beyond the first year of 4850-time. Now the member is eligible to receive a lower dollar amount from State-Rate, $6,000 per month. Under this IOD scenario, the UFLAC Premium LTD plan would provide a $1,000 monthly benefit to cover the gap between the member’s calculated $7,000 benefit vs. what they are receiving from State-Rate.
IOD Claim Example Year 3: The same member’s disability continues beyond the second year of State-Rate, and the member is still considered disabled in accordance with the LTD policy. Assuming the member is not receiving any other income, the UFLAC Premium LTD plan would provide the member’s calculated maximum monthly benefit of $7,000. Please note, this scenario also assumes that the member has been approved for benefits during the Any Occupation period.
Please note, if you experience an off-duty injury and you are not eligible to receive any other source of Other Income Benefits, LTD benefits will be paid in accordance with the Year 3 example above. As long as you continue to be considered Totally Disabled, benefits are payable up to the Social Security Normal Retirement Age (SSNRA).
As evidenced by this communication, the UFLAC Trustees believe CAPF to be engaging in predatory and false marketing to our represented members. They have been aggressively targeting our members to enroll in an unendorsed, non-payroll deducted, and non-guaranteed product. We hope the information included in this communication will help provide our members with better transparency on the benefits available through the UFLAC LTD plans and empower them to make an informed decision for themselves and their families.
UFLAC is here to serve you – our Los Angeles City Firefighters. We want to make sure our members are well informed about ALL benefits available to you. For more information, please visit www.uflacbenefitenrollment.com or contact the UFLAC Benefits Staff at 213-977-9014, Ext. 2.
Very truly yours,
Westchester Medical – Center for Heart and Health Comprehensive Physicals
Westchester Medical has reopened their offices and are now scheduling LAFD comprehensive physicals after being closed due to COVID-19 restrictions. Westchester Medical has taken additional precautions to ensure the safety of the members and staff. Call (310) 670-1120 to make your appointment now.
Please note, that if you are not feeling well or show any signs of illness, please notify the facility and reschedule. You will be required to wear a mask during the physical and practice social distancing. Make sure that you fast 4 hours prior to the exam (water consumption is permitted), bring a copy of your insurance card, and bring your parking ticket for validation. Also, come dressed exercise clothing and a shower is available if desired.
UFLAC MOU Reminder-Wellness “Bonus”:
As a result of the UFLAC Negotiating Team’s commitment to promote health and wellness, the City agreed to a premium pay to encourage employees to complete an annual comprehensive physical. Each member completing will be eligible to earn up to 1.5% for a 12 month period following the exam beginning June 20, 2021. Please refer to Article 9.3 WELLNESS of MOU 7/1/2019 to 6/30/2022 for specific details, but plan ahead and have your physical scheduled near your date of birth. Also note that UFLAC has also negotiated to have the members be paid four hours of pay for completing the physical off-duty.
UFLAC Anthem HSA PPO Members:
If you are part of UFLAC’s Health Saving Account (HSA) benefit, you are eligible for receiving “up to” $300 per month for completing a yearly comprehensive physical. If you have previously completed a comprehensive physical, you will continue to receive the full benefit as the deadlines have been temporarily extended due to COVID-19 restrictions. However, the extensions will expire, so do not delay scheduling your physical to ensure that you continue to receive the full benefit.
If you are not yet taking advantage of the HSA PPO, please inquire during the Fall 2020 Open Enrollment so that you do not miss out on the cost saving PPO health plan.
As always, please sign up for email notifications and follow UFLAC social media platforms for up to date information.
Your UFLAC Board and Benefits Team
UFLAC E-Blast/Member Communication
Re: Important Benefit Contact Information for Coronavirus (COVID-19)
With growing concerns regarding the Coronavirus (COVID-19) we wanted to be sure our members and retirees have a peace of mind with access to available resources, just in case you or your loved ones start feeling sick. If you are enrolled in a UFLAC Anthem Blue Cross medical plan, you can always contact your Anthem Blue Cross provider, but please know that you and your enrolled dependents also have access to the following resources:
NEW! Sydney Care
Enrolled members/retirees and dependents now have access to Anthem’s Sydney Care mobile app at no cost. Sydney Care is available to help members assess their risk for COVID-19 and connect with a doctor if needed. Within minutes, you’ll be able to check your symptoms and connect to care. A Coronavirus Risk Assessment is embedded in Sydney Care. If you need medical care after you assess your symptoms, the app will connect you to a doctor through a LiveHealth Online video session or Virtual Care text session.
The doctor you see through your telehealth visit can evaluate your symptoms, help you understand whether you are at risk for COVID-19, and let you know whether you need to visit a local health care provider for COVID-19 testing.
The Sydney Care Coronavirus Assessment is always free. From now through June 14, 2020, members have access to one free virtual text session with a doctor through Sydney Care. Additional virtual text sessions with Sydney Care cost $19 each.
Members can download the Sydney Care app through the App Store and Google Play and get started in just minutes.
Enrolled members/retirees and dependents can sign up for LiveHealth Online which provides you access to a board-certified doctor from the comfort of home, minimizing the risk of exposure to yourself and others. Doctors are available 24/7 via smartphone, tablet, or computer webcam. The doctor you see via LiveHealth Online can evaluate your symptoms, determine whether you’re at risk for COVID-19, and let you know whether you need to visit a local health care provider in person for COVID-19 testing.
You also have access to virtual visits with licensed psychologists and therapists via LiveHealth Online Psychology and Psychiatry. Visits to LiveHealth Online psychologists and therapists are easy, confidential, and in most cases, you can see a provider within four days or less.
Effective immediately, visits to LiveHealth Online providers are available at no cost for enrolled Anthem members/retirees and dependents until June 14, 2020. Please note that you will be required to enter a credit card upon registration due to system requirements.
You can register for LiveHealth Online on your computer or mobile device via the LiveHealth Online app or on the web at www.livehealthonline.com. Alternatively, you can find LiveHealth Online through the UFLAC Mobile Health Consumer app; simply tap the tile on the home screen to launch LiveHealth Online from your mobile device. To make your first appointment with a LiveHealth Online psychologist or therapist you may also call LiveHealth Online at (844) 784-8409.
Registered nurses can answer your COVID-19 health-related questions wherever you are — any time, day or night. All you need to do is call the number included on the back of your Anthem Blue Cross ID card at (800) 977-0027.
IngenioRx Early Prescription Refill Limits
Anthem is relaxing early prescription refill limits, where permitted, for members/retirees and dependents who wish to refill a 30-day supply of most maintenance medications early. Additionally, please talk to your doctor about whether changing from a 30-day supply to a 90-day supply of their prescriptions is appropriate. Those filling 90-day prescriptions can get most of their medications through our home delivery pharmacy. Please call the Pharmacy Member Services number included on the back of your Anthem Blue Cross ID card at (833) 261-2466.
Attention UFLAC members and retirees. This message is to notify you that the UFLAC Open Enrollment Family Event on Saturday, October 12th has been cancelled due to the proximity of the fires in Santa Clarita.
The UFLAC Benefits Trustees are available to visit your stations and locations near your residence by appointment should you have any questions during Open Enrollment. You may also visit our online benefits enrollment website at www.uflacbenefitenrollment.com or call the Benefits Office at 213.977.9014, extension 2
IAFF Center of Excellence for Behavioral Health Treatment and Recovery
The IAFF Center of Excellence for Behavioral Health Treatment and Recovery is a one-of-a-kind addiction treatment facility specializing in PTSD for IAFF members – and IAFF members only – who are struggling with addiction, PTSD other related behavioral health challenges to receive the help they need in taking the first steps toward recovery. It is a safe haven for members to talk with other members who have faced or overcome similar challenges.
Care for your unique needs
If you’re struggling with post-traumatic stress along with co-occurring depression, anxiety or substance abuse disorders, you need treatment from professionals who understand the fire service culture and the unique pressures of your job. The IAFF Center of Excellence connects you to best-practice, evidence-based therapies delivered by clinicians who understand the types of trauma you experience on a day-to-day basis.
Completely confidential treatment
Center staff cannot discuss your treatment with anyone — your fire department, family or friends — unless given explicit permission by you. This applies before, during and after your stay at the IAFF Center of Excellence.
Our Partner: Advanced Recovery Systems
With seven treatment centers across the United States, the continuum of care provided by Advanced Recovery Systems is unsurpassed. The IAFF has partnered with Advanced Recovery Systems to provide members with specialized treatment for the everyday stressors that trigger PTSD, behavioral health disorders and substance abuse.