Claims Disputes over LTD. The claims dispute process is described in the Summary Plan Description or Evidence of Coverage. Human Resources Risk Management Division will assist employees with claims dispute processing.
Claims Disputes over LTD. Employees shall utilize the appeal procedures in the PORAC plan for any dispute regarding claims under this plan.
Claims Disputes over LTD. The Provider (PORAC) claims dispute process is described in the Plan Document.
Claims Disputes over LTD. Full-Time Employees PORAC Plan: Employees shall utilize the appeal procedures in the PORAC plan for any dispute regarding claims under the plan described in Section 18.4.1.
Claims Disputes over LTD. Full-Time Employees
Claims Disputes over LTD a. County Self-Insured Plan: Any dispute by an employee over a claim processed under the County's Long Term Disability (LTD) plan shall be appealed to the Risk Management Division of the General Services Department for a final County decision. If the dispute remains unresolved to the satisfaction of the employee, the Association may file a grievance on behalf of the employee at the Arbitration Step of this Memorandum's Grievance Procedure for a final and binding decision.
b. Outside Provider Plan: Employees shall utilize the appeal procedures in the PORAC plan for any dispute regarding new claims under this plan.
Claims Disputes over LTD. County Self-Insured Plan: Any dispute by an employee over a claim processed under the County's Self-Insured Long-Term Disability (LTD) Plan shall be first appealed through the Risk Management Division of the Human Resources Department for a final County decision. If the dispute remains unresolved to the satisfaction of the employee, the Union may file a grievance on behalf of the employee at the Arbitration Step of this Memorandum's Grievance Procedure for a final and binding decision. The arbitration process will be expedited as much as reasonably possible in the interests of a timely resolution of the dispute. Outside Provider Plan: The Provider claims dispute process is described in the Plan Document. The County Risk Management Division will assist employees with claims dispute processing related to the County’s outside LTD provider.
Claims Disputes over LTD. Full-Time Employees 57 18.4.3 Part-Time Employee Coverage 57 18.4.4 Long-Term Disability Claims Dispute – Part-Time Employees 58 18.5 Workers’ Compensation Claims Disputes 58 18.5.1 Workers’ Compensation Temporary Disability – Supplementing With Paid Leave 58
Claims Disputes over LTD. Full-Time Employees 44 18.4.3 Part-Time Employee Coverage 44
Claims Disputes over LTD. County Self-Insured Plan: Any dispute by an employee over a claim processed under the County’s Long Term Disability (LTD) plan shall be appealed to the Risk Management Division of the Human Resources Department for a final County decision.
