“Caveat Emptor” or in English, Buyer Beware
While a short-term disability (STD) policy may offer a 12-week maternity benefit, not all carriers “automatically” pay 12 weeks. Please make sure you understand how the carrier’s contract is written.
On July 1st, 2021, Senate Bill 567 was enacted in Virginia, requiring insurance carriers to offer STD plans that provide 12 weeks of coverage following childbirth. However, not all STD plans are required to include the maternity benefit, meaning that clients may still purchase STD coverage that does not include the maternity benefits.
After a deeper look from our TFA Compliance and HR Specialists, the law states that disability benefits are permitted for a disability if the insured qualifies, which may include any objective medical evidence and documentation required by the policy. This means that the carrier can require medical evidence of continuing disability for the insured to qualify for the entire 12-week benefit.
It is our understanding that many carriers are waiving the medical necessity requirement and automatically providing the entire 12 weeks. However, some may require proof of medical necessity and only allow 6 or 8 weeks, depending on the childbirth circumstances.
Don't hesitate to contact our Brokerage team for additional information regarding how carriers are adjudicating coverage.
If you're interested in learning more, MetLife's February 22nd CE regarding Paid Family and Medical Leave is a perfect adjunct to understanding the subject matter and helping your clients. Please see the attached to register.