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Aetna - National Plan SSB Benefits FAQ and Furlough benefit information

Apr 17, 2020
Aetna - National Plan SSB Benefits FAQ and Furlough benefit information image

Below is an FAQ created by Aetna for National Plan SSB benefits.  

Question: I have had some questions around benefits during COVID-19.  So far, I have advised employee to not contact Aetna until they are deemed sick and can have SSB paperwork filled out by treating physician.  I have been told the RRB has been referring quarantined employees to your group and I have asked them not to as you do not pay sickness benefits unless a member is sick. 

Answer: The RRB has updated their policy to include coverage for the following scenarios:

1.    Employee tests positive for COVID-10, for the period that the employees is unable to work due to virus;

2.    Employee has symptoms for COVID-19, and subject to quarantine instructions or medical advice from a medical provider or public health official, for the period the employee is subject the quarantine instructions;

EE   Employee is directed by railroad management to self-isolate and refrain from reporting for duty due to COVID-19 exposure or potential COVID-19 exposure and the worksite remains open for the period the employer’s restriction applies.  

Question: Since the passing of the $2.2 Trillion Stimulus Package on Friday, Can you tell me if The Hartford are waiving the Four (4) day waiting period for the supplemental sickness benefit. The information would be helpful to our members since the Railroad Retirement Board’s seven (7) day waiting period was waived.

Answer: The 4 day waiting period under the Hartford Supplemental Sickness plan will not be waived. It will still apply. 

Question: Is the 4 day waiting period waived as a result of the state of emergency concerning the coronavirus?

Answer: No, the 4 day waiting period under the Hartford Supplemental Sickness Plan will not be waived. 

Question: If a person is sent home to be quarantined – are they eligible for supplemental sickness benefits?

Answer: If the employee is directed by railroad management to self-isolate and refrain from reporting for duty due to COVID-19 exposure or potential COVID-19 exposure and the worksite remains open for the period the employer’s restriction applies. A copy of the instruction from the employer will serve as proof of the medical restriction. Eligibility for SSB is still contingent on confirmation of RRB RUIA sickness benefits. 

Question: What happens if they are sent home due to a possible exposure but not verified positive for COVID-19?  Are the entitled to benefits?

Answer: If the employee is directed by railroad management to self-isolate and refrain from reporting for duty due to COVID-19 exposure or potential COVID-19 exposure and the worksite remains open for the period the employer’s restriction applies. A copy of the instruction from the employer will serve as proof of the medical restriction. Eligibility for SSB is still contingent on confirmation of RRB RUIA sickness benefits. 

Question: Can you provide the benefit rate sheets?

Answer: The new benefit rate sheets will be posted to the website (yourtracktohealth.com) on or before Friday, April 24. In addition, I am sharing a copy of the FAQ document released by the RRB.  Note: This is not a guarantee of benefits. Final Benefit Determination and Claim Determination will be made upon receipt and review of the actual claim and the governing plan documents.

Furlough Health & Welfare - Why are members paying for coverage when they are furloughed? (this has been a common question from LC's the last couple weeks)

In general, an employee's qualification for insurance is based on the work history in the prior month. For example, days worked in August would determine eligibility for September coverage. The deduction would be deducted on the 9/25 check for September's coverage. Furlough example: John works 7 days in August and is furloughed on August 10. Since John worked RACS in August for September coverage, a deduction is due in September and will be deducted whenever John receives pay again of any type. If employee is eligible for continuation of benefits (usually 4 months), it ends the 4th month following the month last worked. Insurance provider can provide specific dates.

Please let me know if you have any other questions.  If you click the blue Furlough Health & Welfare it will take to the information on the employee website.