In a letter dated August 2, 2006, Carmen Division President Rich Johnson has an update re supplemental sickness benefit requirements described below, particularly regarding the 20 day filing limit (from the onset of disability). The issue has been added as an amendment to Section Six notices for negotiations. (Also see FAQ developed by Aetna to help answer Carmen members’ questions.) On another matter, the union won an important interpretation of terminated members’ rights from Aetna which Johnson describes in the last several paragraphs of his letter.
TCU has negotiated a valuable supplemental sickness benefit for Carmen members covered by national agreements with the freight railroads. This benefit provides payments to sick or injured members in addition to amounts they may receive through Railroad Retirement sickness benefits.
Too many of our members, however, lose out on this important benefit by failing to file a claim or failing to file in a timely manner. Remember, if you are going to miss work for five or more days due to sickness or injury, you should file a Notice of Claim for supplemental sickness benefits within 20 days of the onset of your disability. (Read the August 2, 2006 notice from Carmen Division President Rich Johnson stressing this point.)
On January 1, 2006, administration of the Supplemental Sickness Benefit Plan Covering Railroad Shop Craft Employees (the APlan) was changed from UnumProvident to Broadspire and is now Aetna. Aetna ( Broadspire) has been rigidly applying the 20-day time limit for employees to file a Notice of Disability.
As information, Section IV of the Plan booklet (page 13) reads as follows, in pertinent part:
Notice of Claim
Notice of any injury or sickness must be given within 20 days of the start of disability or as soon as reasonably possible.
In order to avoid a denial of benefits, please file your Notice of Disability within the 20 days time limit.
You can provide Notice of Disability by completing the Notice of Disability form found in your Plan booklet and mailing it to Broadspire at P. O. Box 189145, Plantation, FL 33318-9145, or by faxing it to 954-452-4124. You can also provide Notice of Disability by telephone (800-205-7651) or by going online to www.wkabsystem.com. For more information on filing a claim, refer to page iv in your Plan booklet.
In the event that the Notice of Disability is not filed timely due to circumstances beyond your control, you should advise Broadspire to this effect when filing your initial notice. In addition, you can also formally appeal any initial Broadspire denial (as described on pages 14-16 of the Plan booklet).§
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