FAQs for Employers

Employers FAQs for Employers

Here you’ll find answers to frequently asked questions about our life and disability products.

Eligibility and Coverage
Dependent Coverage
Evidence of Insurability (EOI)
Beneficiary
Billing
Conversion
Claim Submission
Waiver of Premium
Short-Term Disability
Long-Term Disability
Participation-Free Voluntary Program
Miscellaneous

Eligibility and Coverage

Who is eligible for coverage under a group plan?
All employees who are in an eligible class and work the minimum number of hours (indicated on the application) are eligible. An employee must be actively at work for his or her insurance coverage to be effective.

Does Consumers Life offer coverage to retirees?
Consumers Life offers coverage to retirees on a case-by-case basis.

What is the effective date for non-contributory benefits?
The effective date for non-contributory benefits is the day after the employee completes the waiting period (if the employee is actively at work that day).

If an employee waives all or some of their non-contributory coverage and chooses to enroll at a later date, the employee is considered a late applicant and must provide evidence of insurability. Coverage is effective the day Consumers Life determines the evidence is satisfactory and provides written notice of approval.

What is the effective date for contributory benefits?
An employee can apply for contributory insurance coverage at any time. If he or she signs the enrollment form on or before the end of the waiting period (if there is one), coverage becomes effective the day after the employee completes the waiting period.

If an employee signs the enrollment form within the 31 days after the end of the waiting period (if there is one), coverage is effective the day the employee signs the enrollment form.

If the employee signs the enrollment form after the 31-day period, the employee is considered a late applicant and must provide evidence of insurability. Coverage is effective the day Consumers Life decides the evidence is satisfactory and provides written notice of approval.

What is the effective date when an employee has a change in salary, class or age?
Any change in an employee’s benefit amount because of one of the following is effective on the date of the change:

  • Employee class change
  • Salary change
  • Age reduction
  • Policy amendment

If I rehire an employee, does he or she need to meet the eligible waiting period?
If an employee’s coverage ends because of employment termination and he or she returns to active work within six months, Consumers Life doesn’t apply a new hire eligibility waiting period or require evidence of insurability (if the employee re-enrolls within 31 days of the rehire date).

How do I contact the Policy Administration department?
You can contact the Policy Administration department by:

Dependent Coverage

Does Consumers Life offer coverage to dependents?
Yes. Consumers Life offers dependent life coverage.

What is the coverage effective date for dependents?
The effective date for dependents is one of these:

  • The date the employee’s coverage becomes effective
  • The effective date of the dependent life benefit
  • The date that the employee enrolls his or her dependents

When is a dependent no longer eligible for coverage?
A dependent is no longer eligible for coverage when:

  • The employee is no longer insured
  • The policy is canceled
  • The dependent child reaches an age when coverage is not available

If a husband and wife are employees of the same company, can they both insure their dependent children?
Only one of the spouses can enroll dependent children in life insurance.

Can an individual be insured as both an employee and a dependent?
A person can’t be insured as both an employee and a dependent under a group’s policy. If both the husband and the wife are eligible employees, they must each enroll as an employee.

Evidence of Insurability (EOI)

What is evidence of insurability?
Evidence of insurability (EOI) is a statement of medical history and related information. Consumers Life uses it to determine if an applicant will be approved for coverage.

When is EOI needed for life insurance?
EOI is required for any of these reasons:

  • When an employee is a late applicant
  • For insurance amounts in excess of the group’s non-medical maximum limit
  • For any other reason part of standard Consumers Life underwriting procedures and guidelines

Beneficiary

Who are benefits paid to if I didn’t designate a beneficiary?
If an employee didn’t designate a beneficiary, benefits are paid in this order:

  • Spouse
  • Children
  • Parents
  • Estate

We recommend employees update the beneficiary designation form at least once a year. The beneficiary form is available online on our Forms page.

Does Consumers Life need copies of the beneficiary designation forms?
The employer should keep all beneficiary designation forms on file. We only request a copy when there’s a claim.

Who is the beneficiary when a claim is for a spouse and/or children?
The employee is the beneficiary for spouse and/or children.

Does Consumers Life accept a beneficiary form from a prior carrier?
Yes. We accept a beneficiary form from a prior carrier.

Billing

What type of bill will I receive?
We offer two billing options:

  • List Bill – list bills are a good choice for employers who need monthly documentation of covered employees and premium totals
  • Self-administered Bill – self-administered bills are useful for employers with a Human Resources or Payroll system that maintains and reports employee benefit eligibility data such as salary, benefit elections, date of birth, etc. These employers don’t need monthly reconciliation and notify us of the number of lives, volume and premium due based on their own record.

When are premium payments due?
A group’s monthly payment must be submitted before the first day of the month that coverage applies.

Does the policy offer a grace period for premium payments?
After the first premium, we allow a 31-day grace period to pay any premiums due. We recommend you make payments on time because late payments can result in delayed claims payment, delayed services or policy cancellation.

When do I receive a rate renewal notification?
We provide your rate notification to your broker at least 30 days before your renewal date. If you do not have a broker, you will receive your renewal notification directly at your billing address via U.S. mail.

If an employee leaves employment or is no longer eligible, when does his or her coverage end?
Coverage ends the day the employee leaves employment or is no longer eligible.

Conversion

If an employee’s life insurance reduces because of age, can he or she convert the difference in coverage (as a result of the benefits reduction)?
No. Age reduction is not a conversion trigger for conversion.

Can an employee convert if his or her insurance ends because of retirement?
Yes, but only if her or she doesn’t remain in a class that’s eligible for life insurance.

Are conversion rights available for a spouse and/or children?
Yes. Dependents can convert to an individual life insurance policy because of eligibility or policy termination.

Claim Submission

Where can I get a death claim or disability form?
You can get these and other forms online or by calling 866.925.2542.

How do I file a life insurance claim?
The employer is responsible for completing a death claim form and submitting it to Consumers Life with:

  • A certified death certificate
  • A copy of the original enrollment form
  • The beneficiary designation forms (if applicable)

If accidental death benefits are being claimed, you should also include:

  • A copy of the police report
  • Newspaper clippings
  • Witness statement
  • OSHA accident report
  • Any other supporting documentation

Can I fax a life insurance claim to Consumers Life?
Yes. You can fax the claim form and related documents to 440.878.6916. However, you must mail the original certified death certificate.

What address should I mail a certified death certificate?
You should mail a certified death certificate to:

Consumers Life Insurance Company
Attn: Claims Department
15885 W. Sprague Road
Strongsville, Ohio 44136

How can I contact the Claims department?
You can contact the Claims department by:

When should I file a disability claim?
You should file a disability benefits claim when it’s evident the employee’s absence because of a disability will extend beyond the contractual elimination period.

How do I file a disability claim?
The claimant, the employer and the claimant’s doctor are each responsible for completing their respective portion of a disability claim form. After the form is complete, you should fax or mail it to Consumers Life for processing.

If I fax the disability claim form to Consumers Life, do I need to mail the original?
No.

Where should I send a disability claim?
You can fax the form to 440.878.6916 or mail it to:

Consumers Life Insurance Company
Attn: Claims Department
15885 W. Sprague Road
Strongsville, Ohio 44136

Waiver of Premium

What happens when a person is disabled (but not yet eligible for waiver of premium) and the group policy that he or she is insured under cancels?
We continue an employee’s life insurance benefit for a contractually specified period of time without additional life insurance premium payments if the employee becomes totally disabled (provided he or she is insured under the policy and is actively at work on or after the group policy’s effective date).

Please note: The employee is not automatically placed on waiver of premium. You must submit an application to Consumers Life for approval.

Short-Term Disability

Can the employer continue paying an employee while he or she is collecting short-term disability benefits?
If an employee is receiving any compensation from the employer, we will not pay short-term disability benefits until such compensation ends.

Does Consumers Life offer any special claim payment options?
Consumers Life gives claimants the option of receiving claim payments through direct deposit. This option lets a claimant request direct payment into a designated bank account.

How often will a claimant receive payments?
After the initial claim payment, we send bi-weekly claim payments.

Long-Term Disability

What is the definition of “long-term disability”?
We define long-term disability as an employee who can’t perform material and substantial duties of his or her regular occupation (or those of a reasonable employment option offered) during the elimination period and for the first 24 months of disability benefits. The elimination period is the period of time before your long-term disability benefits start. This is usually when your short-term disability benefits are paying.

During a long-term disability period, an employee is earning an income less than or equal to 80 percent of pre-disability earnings. After the first 24 months of disability benefits, an employee is still unable to perform the material and substantial duties of any gainful occupation. As a result, the employee is earning an income less than or equal to 60 percent of his or her pre-disability earnings. Different policy provisions can be quoted upon request.

Does Consumers Life offer Social Security assistance?
If an employee receives payment from Consumers Life, we can offer advice about the disability claim and help with an application for Social Security disability benefits or appeals.

Do long-term disability insurance benefits reduce income from an individual disability income policy?
Consumers Life does not subtract any amounts received from an individual disability income policy.

Are long-term disability insurance benefits taxable?
Long-term disability benefits are taxable only if the premiums are paid by the employer.

How long are benefits paid for mental and/or nervous conditions?
We pay benefits for mental illness, substance abuse or special conditions for up to 24 months.

What if an employee returns to work on a part-time basis during the elimination period?
If an employee returns to work during the elimination period for less than 30 days, the same elimination period continues if the disability is due to the same sickness or injury.

What is a pre-existing condition?
A pre-existing condition is a sickness or injury that an employee received treatment for during a specific time period before the coverage effective date.

Do your long-term disability policies provide continuity of coverage?
Yes. We will cover an employee if he or she was insured by the prior plan and the coverage cost from the prior plan was paid.

Participation-Free Voluntary Program

What are the employer requirements when offering participation-free voluntary life insurance or accidental death and dismemberment insurance?
To offer participation-free voluntary life insurance or accidental death and dismemberment insurance, employers must offer Consumers Life basic life insurance coverage. Employers must also allow premium payments to be made via payroll deduction.

Is participation-free voluntary life coverage portable?
Yes. Participation-free voluntary life coverage is portable, meaning employees can continue coverage if they apply for portability within 31 days of their employment ending.

How is an employee eligible to enroll in participation-free voluntary life insurance or accidental death and dismemberment insurance?
An employee is eligible if he or she is an active at-work full- or part-time employee working 20 or more hours per week and enrolled in Consumers Life basic life insurance. Applicants must be able to answer “no” to five health-related eligibility questions. Late enrollees must provide evidence of insurability.

How much participation-free voluntary life insurance or accidental death and dismemberment insurance coverage can an employee buy?
Eligible employees can get participation-free voluntary life/accidental death and dismemberment benefits in increments of $10,000, up to $50,000.

What are the employer requirements when offering participation-free voluntary short-term disability insurance?
Employers must sponsor basic life insurance and participation-free voluntary life insurance and accidental death and dismemberment insurance coverage with Consumers Life. Employers must also allow premium payments to be made through payroll deduction.

How is an employee eligible to enroll in participation-free voluntary short-term disability insurance?
An employee is eligible if he or she is an active at-work full- or part-time employee and enrolled in the employer-sponsored basic life insurance and participation-free voluntary life insurance and accidental death and dismemberment insurance plan.

Does the participation-free voluntary short-term disability insurance policy have a pre-existing condition exclusion?
Yes. Disabilities that begin in the first 12 months after the employee’s effective date caused by, contributed to or resulting from a pre-existing condition are not covered.

How much participation-free voluntary short-term disability insurance can an employee purchase?
Eligible employees can get voluntary short-term disability insurance coverage in increments of $50. The minimum weekly benefit is $100 and the maximum is $750 (without exceeding 66 2/3 percent of the employee’s basic wages).

The employer can pick either a 1/8/13 plan or a 1/8/26 plan. For example, benefits are payable on the 1st day of absence because of an accident and on the 8th day of absence because of illness. The employer can pick either a 13-week or 26-week duration period.

Miscellaneous

Does your policy include a family status change?
If you offer an insurance program with group term life insurance for dependents and an employee wants to add dependent coverage, he or she must submit an application form requesting the change and list all eligible dependents.

Applications for dependent coverage should be made within 31 days after the employee acquires eligible dependents by marriage, a child’s birth or adoption. After 31 days, the coverage may be subject to evidence of insurability requirements.

When does an employee’s life insurance/accidental death and dismemberment insurance coverage reduce to age – birth date or effective date?

Any change in an employee’s benefit amount caused by any of the follow is effective on the change date:

  • Change in class
  • Change in salary
  • Age reduction
  • Policy amendment

Does an employee have to be actively at work when I increase benefits?
Yes. If a change results in increasing the insurance amount, the employee must be actively at work on that day. If the employee is not actively at work, the increase takes effect on the day that he or she is next actively at work.

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Consumers Life Insurance Company
15885 West Sprague Road
Strongsville, OH 44136-5197