SCOPE: RESPONSIBILITY & AUTHORITY:

Transcription

1 PURPOSE: To document the process for submitting life insurance claims to be sent to the life insurance carrier. SCOPE: Processing life insurance claims. RESPONSIBILITY & AUTHORITY: The Benefits Staff Member as designated by the Benefits Manager III. SAFETY: Follow all applicable City of Dallas safety guidelines associated with this work instruction/procedure. ENVIRONMENT: Follow all applicable City of Dallas Environmental procedures associated with this work instruction/procedure. DEFINITIONS: 1. Member Employees, Retirees and Dependents of the City of Dallas who participate in the City s Health Benefits Plan. 2. Third Party Administrator (TPA) - the City selected vendor who administers the City s life insurance plan. 3. LAWSON-HRIS the City s personnel and payroll management software/database for the COD. 4. Hartford Life former life insurance carrier for the COD, who still covers some retired members. 5. Fort Dearborn Life - former life insurance carrier for the COD who still covers some retired members. 6. Employee Retirement Fund (ERF) the pension system for members who are civilian employees. 7. Police and Fire Pension Fund (PFP) the pension system for members who are uniformed employees. 8. Under 65 Medical Plans - Consists of the following PPO medical plans: 75/25/HRA and the 70/30/$3000 medical plans 9. Over 65 Medical Plans Consists of the following: American Association for Retired Persons (AARP) Plans and the Medicare Part D Plan (MPD). 1 of 6

2 WORK INSTRUCTION 1. Notice of member s death received by Benefits Administration Benefits Staff Death Notice received from family member, city department, or their respective pension office; Employee Retirement Fund (ERF) office or Dallas Police and Fire Pension Fund (PFP) office. 2. Benefits Staff Member verifies coverage. 2.2 Benefits Staff Member logs into LAWSON-HRIS by typing the following URL in the address bar ( Once logged in, Benefits Staff Member types in search box BN32.2 located at the top right side of the screen Coordinator selects Inquire to locate deceased member. 2.3 If the deceased was an employee and a member of the City s health Benefits Plan, of the City s Health Benefits Plan, coverage must terminate If deceased was enrolled in medical, dental, vision, flexible spending account (FSA) and/or dependent care assistance program (DCAP), add a stop date to discontinue their benefits which will be effective through the last day of the month member passed away To do this: Benefits Staff Member must place an S in the FC Column and enter the stop date (last day of the month in which the member passes away) If deceased was enrolled in basic life, supplemental life, and/or accidental death & dismemberment (AD&D), enter members date of death in the stop date field. Benefits Staff Member places an S in the FC field, enter the stop date and click change If the deceased was a retired member of the City s Health Benefits Plan, coverage must terminate If deceased was enrolled in any medical (under 65 and over 65 plans), dental and vision, add a stop date to discontinue their benefits which will be effective the last day of the month member passed away. 2 of 6

3 To do this: Place an S in the FC Column, enter the stop date (last day of the month in which the member passes away) and click change If deceased was enrolled in Over 65 Plans (AARP plan or Part D Plan (PDP) plans), send notice to TPA: For AARP, Benefits Staff Member must include retiree s name, City Member ID number (in LAWSON), date of death and term date (last day of month in which retiree passes away). Please see Benefits External Contact List (PER-FRM-214) to obtain AARP address TPA Medicare Part D (MPD) Enrollment Eligibility Department. Please see PER-FRM-214 Benefits External Contact List. 3. Once the family of the deceased contacts the Benefits Staff Member, the Benefits Staff Member confirms pertinent information needed for the Life Insurance Claim Date of Death, Last Day Worked, current home address and phone numbers If deceased was a retiree, ask if the surviving dependents who are members of the COD Health Benefits Plan would like to continue their health plan coverage (see #4 below) If the deceased was an employee at the time of death, dependents will be offered COBRA. COBRA notice (external document) and election forms will be sent to the dependents address on file. 4. If surviving spouse would like to continue coverage, Benefits Staff Member confirms with the respective pension office that the dependent will continue to receive a monthly pension so that future deductions will be made for health benefits Benefits Staff Member completes the PER-FRM-209 Surviving Spouse Set-Up Form and submits it to the Payroll Division of the Human 3 of 6

4 Resources department so the deduction will continue to be made from their pension payment Once Payroll has added the surviving spouse in LAWSON-HRIS, enters the selected benefits Benefits Staff Member logs into LAWSON-HRIS 4.4. Once logged in, Benefits Staff Member enters BN31.2 into the search box at the top right of the screen and enters the new member ID of the surviving spouse Select Inquire to locate the surviving spouse Add an A in the FC column next to the benefit(s) the surviving spouse has elected to enroll in (on the 1 st of the following month in which the retiree passed away will be the dependents new effective coverage date) Enter BN32.2 in the search box to review entries made If the surviving spouse has dependent child (ren), go to LAWSON- HRIS enter HR13 and add dependent information Click on Main under the Related Pages link (name, status, SSN, relationship) Then click on Benefit Analysis and add spouse or dependent status, DOB, and gender) Click on Coverage and add a Y or N to medical, dental and/or vision benefits. 5. If the deceased was an active member at the time of death, Benefits Staff Member completes the current PER-FRM-204 TPA Report of Death Fax Form and faxes to the TPA. 6. If the deceased was a retired Member at the time of death, Benefits Staff Member logs into the retiree database, located in the Human Resources department shared drive. Update the deceased retiree s information that s housed in the retiree database. 4 of 6

5 6.1 If the Retiree is covered by the current TPA life insurance plan, Benefits Staff Member completes the PER-FRM-204 TPA Report of Death Fax Form to TPA. 6.2 Benefits Staff Member files the completed PER-FRM-204 TPA Report of Death Fax Form in the pending death claims file that is located in the Benefits Staff Member s cubicle. The file is located in the Benefits Administration Office at City Hall in room 1DS. 7. If the deceased was covered under Hartford Life, the Benefits Staff Member locates the deceased retiree s information in the Hartford Life Files, located in the Benefits Administration Office at City Hall in room 1DS Benefits Staff Member will collect a copy of the death certificate, because the COD must send documents to Hartford on behalf of the beneficiary of the deceased Benefits Staff Member will provide beneficiary with the Hartford Life Proof of Death Form (external document) for completion Benefits Staff Member must complete the Hartford Life Group Life Claim Form (external document) 7.4. Benefits Staff Member scans and s forms to Hartford Life. address can be obtained from the PER-FRM-214Benefits External Contact Lists Benefits Staff Member sends a copy of the claim form to the listed beneficiary via US Mail Once the claim has been processed and the beneficiary has been paid, Hartford will send a form letter acknowledging the actions taken. 8. If deceased was covered with Fort Dearborn Life, Benefits Staff Member completes the Fort Dearborn Life Claim Form (external document) and faxes to Dearborn Life. Please see the PER-FRM-214 Benefits External Contact List to obtain the fax number. 8.1 Once the claim has been processed and the beneficiary has been paid, Hartford will send a form letter acknowledging the actions taken. 5 of 6

6 REFERENCES: PER-FRM-214 Benefits External Contact List PER-FRM-217 Life Insurance Claims Process Log Employee Retirement Fund (ERF) Death Notice (external document) Dallas Police and Fire Pension Fund (DPFP) Death Notice (external document) COBRA Notice (external document) Retiree Database (system copy) Lawson/HRIS (system copy) RECORDS: PER-FRM-204 TPA Report of Death Fax Form PER-FRM-209 Surviving Spouse Set-up Form Hartford Life Proof of Death Form (external document) Fort Dearborn Life Claim Form (external document) 6 of 6