Frequently asked questions

Here is a list of answers to questions our customers have been asking during the COVID-19 emergency. Some of the answers confirm existing policies or procedures. Others indicate where we are temporarily making an exception to better support our customers during the pandemic.

Unless otherwise noted, the following information does not apply to Individual Disability Insurance (IDI).

Please note that any exception to a policy provision only applies if that provision is included in the policy. Unless otherwise noted, all other policy provisions continue to apply.

Exceptions may be reevaluated, corrected or limited at any time. We will communicate any revisions promptly.

Important note about premium payment

We can continue to cover employees under the circumstances described in the FAQs below as long as premiums continue to be paid. We understand that some employers are reducing hours or earnings for employees as the pandemic creates financial hardship. Please note that you must continue to pay premiums based on your employees’ earnings and benefit elections before the pandemic, so they can receive benefits based on those earnings, when applicable, if they file a claim.

Maintaining coverage for current policies and customers questions

Updated 9/10/20

Can employees maintain their in-force coverage during furloughs, temporary layoffs, leaves of absence or reductions in hours worked?

We understand that the COVID-19 pandemic may require customers to unexpectedly furlough, temporarily lay off or provide leave of absence for employees. We will continue to cover employees who are not currently working for their employers or who experience a reduction in hours or earnings due to the pandemic, under these conditions:

Group coverage:

• We will consider employees who are furloughed on or before September 30, 2020, to be on approved temporary layoff or leave of absence.
• Employees on a temporary layoff or leave of absence that began on or before May 31, 2020 will remain eligible for coverage for 90 days or the length of the temporary layoff/leave of absence provision in your policy, whichever is greater.
• Employees on a temporary layoff or leave of absence that begins after May 31, 2020, will remain eligible for coverage for the length of the temporary layoff/leave of absence provision in your policy.
• Unum is aware that our customers are facing extraordinary challenges at this time. If you have a unique situation that merits additional consideration, we encourage you to contact your Unum representative to discuss your specific needs.
• Premium payments should be based on the employee’s earnings, when applicable, prior to the change in hours or work status.
• During this furlough extension, we will not strictly apply minimum-hours-worked requirements for an employee to be considered actively employed.

Accident, Individual (including IDI) and Health benefits:

• Employees are eligible to keep their coverage as long as they pay their premiums.
• If premium payroll deductions are discontinued, we will send a conservation letter allowing the employee to be direct billed or the employee can port or convert their coverage, depending on the benefit.

Dental and Vision:

• Employees on temporary layoff or leave of absence may keep their coverage for up to a year, as long as the premiums are paid.

Statutory Plans Insured by Unum (NY DBL, NY PFL, NJ TDB, Hawaii TDI)

Unum’s interpretation of state law is that employees who have been furloughed are ineligible for benefits under New York’s Disability Benefits and Paid Family Leave laws, New Jersey’s Temporary Disability Benefits law, and Hawaii’s Temporary Disability Insurance law.

This is primarily because a furlough is akin to a temporary leave of absence — not a termination — and these state laws either stipulate or imply that employees on temporary leave of absence are not eligible for coverage. (New Jersey extends TDB coverage for two weeks after the temporary leave of absence or furlough begins.)

Given this, premiums are not required from employees while they are furloughed. After the employee returns to work and premiums restart, employees become eligible for benefits without having to satisfy a new waiting period.

It is important to note that furloughed employees might be eligible for unemployment benefits. The New York Attorney General’s Office indicates that employees may be entitled to unemployment insurance payments for 26 weeks if they are permanently or temporarily laid off through no fault of their own. Please check with your state’s unemployment office for benefits eligibility and requirements.

Can employees maintain their coverage while they are quarantined and unable to work?

If an employee is quarantined based on a government order, or if the quarantine is an approved leave as defined by your policy’s leave provisions, the individual will be considered “actively employed.” They would thus be eligible to maintain their coverage, provided premiums are paid. People who self-quarantine will be considered to be actively employed for the length of time recommended by the Centers for Disease Control and Prevention (currently two weeks).

Can employees maintain their coverage if our company falls below the participation requirements in our contract?

Our current process is flexible, allowing 90 days of continued coverage if your employment falls below the required number of insured people. To account for impacts to your business caused by COVID-19, we have temporarily paused policy terminations due solely to low participation until September 1, 2020.

How are you handling re-enrollments scheduled between April and July?

We will allow inforce re-enrollments with an anniversary date from April 1 to July 1, 2020 to be delayed for up to 90 days.

If an employee is on leave/furlough and has a qualifying life event, when would the employee be able to change their elections?

If otherwise allowed by the policy, and premiums are paid, election changes may be made for a qualifying life event / status change as follows:

• If furloughed on or before May 31, 2020, an employee can change their elections for 90 days or the length of the temporary layoff/leave of absence provision in your policy, whichever is greater.
• If furloughed after May 31, 2020, an employee can change their elections for the length of the temporary layoff/leave of absence provision in your policy.

All other plan requirements, such as Evidence of Insurability, will apply.

Can a late entrant enroll in coverage at an annual enrollment while on a covered furlough, temporary layoff or leave of absence?

Yes. Late entrants can apply for coverage while on a covered furlough, temporary layoff or leave of absence at an annual enrollment or at a time otherwise allowed by the policy. Coverage will take effect when Evidence of Insurability is received and approved by Unum, if required, and the employee returns to active employment. All policy provisions will apply.

Can an employee elect increases in coverage during an annual or open enrollment that occurs while they are on a covered furlough, temporary layoff or leave of absence?

Yes, provided they remain covered during the furlough, temporary layoff or leave of absence. The date the increased amount goes into effect depends on the specific policy language. All policy provisions will apply.

If the employee falls out of a covered furlough, temporary layoff or leave of absence status before the increased coverage goes into effect, they will need to reapply when they return to active employment, as defined by the policy.

What plan rules apply when an employee returns to active employment?

Different rules apply based on the type of benefit, when the furlough, temporary layoff or leave of absence began; how long the employee was away from work; and whether premiums continued to be paid during the time away from work.

Group benefits

Employees don’t need to re-enroll if premiums are paid during the furlough, temporary layoff or leave of absence AND:

If employees return to work outside of these time frames OR if premiums are not paid during the furlough, temporary layoff or leave of absence, they would need to re-enroll in coverage. They would be subject to any rehire provisions in the contract, which generally waive the employee waiting period if the employee is rehired within a specified period of time.

All provisions of the contract would apply, with the following administrative exceptions:

• Group Disability. If an employee was previously enrolled at the same coverage level and had already satisfied the pre-existing condition exclusion period, we won’t apply a new pre-existing period, as long as the employee is rehired within six months of their coverage end date, or within the rehire term in the policy, whichever is less. The coverage end date equals the date for which premium payments cease.
• Group Life. If an employee was previously enrolled at the same coverage level, we won’t require evidence of insurability for the re-enrolled coverage, as long as the employee is rehired within six months of their coverage end date or within the rehire term in the policy, whichever is less. The coverage end date equals the date for which premium payments cease.

Employees rehired at reduced hours can continue to be eligible for benefits subject to all provisions in the contract. Continued eligibility requires the employee to meet minimum hour requirements upon return and benefits would be based on current earnings as defined in the contract. Enrollment requirements are based on scenarios described in the two previous FAQs.

Voluntary benefits

Employees don’t need to re-enroll if premiums are paid during the furlough, temporary layoff or leave of absence and they return to work immediately after the furlough, temporary layoff or leave of absence, ends.

If premiums are not paid during the time away from work, coverage will lapse. For these benefits, however, they may not need to re-enroll. These conditions apply:

• For employees furloughed on or after March 1, 2020 due to COVID-19, and who had coverage before being furloughed, we will work with you to reinstate their coverage upon request once they return to active employment up through December 31, 2020.
  • Payment of past due premium is expected and required to keep coverage intact continuously.
  • We are willing to reinstate coverage with a new effective date and will not cover the gap period during which premiums weren’t paid. Please make sure your employees understand this.
  • If an employee reinstates with the same coverage level, we will not require Evidence of Insurability or apply a new pre-existing conditions exclusion period, provided the employee already satisfied the pre-ex period before their coverage lapsed.

  Employees rehired at reduced hours will be considered actively at work and eligible to reinstate their coverage, as long as they are expected to return to full active employment and will meet the minimum hours requirement under the policy by December 31, 2020.

  What options are available for employees whose group Life coverage contains portability or conversion provisions?

  If an employee is temporarily laid off, on leave of absence, or furloughed, but remains an active employee, and if the employer is no long remitting the premium, an employee can convert their coverage to an individual policy, with guaranteed coverage and no requirement for evidence of insurability. Once the employee returns to work and is re-enrolled under the group policy, they can choose to cancel or keep this converted coverage.

  If the employee does not return to active employment and is subsequently terminated, they can keep their converted individual policy. However, because premium was not remitted for the employee while they were on temporary leave or furloughed, they will not have the option to port their coverage. If premium is paid during the furloughed period, the employee is eligible to port or convert that coverage, effective on the date of termination.

  • is temporarily laid off, on leave of absence, or furloughed
  • remains an active employee
  • has premiums paid for coverage during the permitted 90-day furlough/layoff period
  • is then terminated from employment at the end of the furlough/layoff period

  they would be able to port their coverage at that time only, because premiums have been paid.