Overview

At Citi, we offer insurance that protects your income in the event that you are unable to work, including:

Short-Term Disability (STD)

Eligibility

If you’re a regular full-time or part-time U.S. Citi employee scheduled to work 20 or more hours per week, you’re covered by Short-Term Disability (STD) at no cost to you.

STD pays 100% or 60% of base salary (not benefits eligible pay) during an approved disability of up to 13 weeks based on your years of service with Citi prior to the date of your disability. For purposes of the Plan, your years of service are based on your actual time providing services to Citi as an employee.

For newly hired and rehired employees (regardless of prior service), there is a 90-day waiting period before disability benefits are payable. For a schedule of benefits, refer to the Benefits Handbook.

Note: If you aren’t eligible for Citi STD benefits and you work in CA, HI, NJ, NY or RI*, you may be eligible for state benefits. MetLife will advise you of the applicable state benefits.

*If you work in RI, you must report your claim to the state by calling 1 (401) 462-8420 and to MetLife.

When and How to Report a Disability

If you become unable to work due to an injury, illness, pregnancy, you must report all absences to your manager/supervisor immediately.

However, if you’ll be absent from work for more than seven consecutive calendar days, you also must report your absence to MetLife, as explained in the table below, to initiate the following benefits.

When to Report it If you’ll be absent from work for more than seven consecutive calendar days due to a non-work-related injury or illness
Whom to Contact

MetLife by using one of the following methods:

 

Information You Must Provide

Provide the following information to MetLife:

  • Name, address, telephone number and Citi GEID
  • Manager’s/supervisor’s name, telephone number, email address and mailing address
  • Your health care provider’s name, address and telephone number
  • Information about your illness

 

Note: You should not give specifics, such as a medical diagnosis, for non-work-related injuries or illnesses to your manager/supervisor.

Additional Information

Notify your health care provider(s) that MetLife will handle your claim and a representative will contact his or her office. MetLife may request additional medical information so a claim decision can be made.

Form(s) You Must Complete

Complete the Health Care Provider Certification Form and Medical Authorization Form that will be mailed to you after your claim has been reported to MetLife.

These forms will authorize your health care provider to release your medical information to MetLife. These forms are very important and will help expedite the handling of your claim. You may also receive state or local benefit forms (where applicable).

When an STD Benefit Is Payable

An STD benefit is payable and begins when you’re medically certified as unable to work due to a total disability incurred while actively employed. A “total disability” is defined as a serious health condition, pregnancy or injury that results in your inability to perform the essential duties of your regular occupation for more than seven consecutive calendar days. If you remain totally disabled and are unable to work on the eighth calendar day, an STD benefit — if approved — will begin on the eighth day of disability and will be paid retroactive to the first day of disability.

To qualify for an STD benefit, you must be receiving appropriate care and treatment on a continuing basis from a licensed health care provider.

You are not considered to have a total disability if you are able to perform the essential duties of your job at home or elsewhere, and your illness, injury or pregnancy only prevents you from commuting to and from work. You can’t qualify for an STD benefit if you return to work on a part-time basis (except for statutory benefits required under applicable state law).

Your STD payments will be based on your eligibility as well as the “approved through” date designated by MetLife. Upon request, you must continue to provide documentation to MetLife throughout the claim period. If you fail to provide the appropriate documentation to MetLife within 10 business days of the request, your claim can’t be evaluated and will be closed. If your claim is closed and you don’t return to work, your STD benefit will stop.

Recurrent Disabilities

If you qualify for an STD benefit, return to work and within 30 days or less from your return-to-work date you’re unable to work due to the same or a related total disability, your absence will be processed as a recurrent claim. You’ll be eligible to receive an STD benefit for the balance of the STD period of up to 13 weeks and may qualify for LTD.

If either a recurrent disability or an unrelated disability occurs after you returned to work for more than 30 days following an initial disability, you may be eligible for an additional STD benefit, not to exceed 13 weeks, if approved.

Other Provisions

As stated in our Plan document, notwithstanding any provision to the contrary, STD benefits may be offset by any money owed to Citi and/or by any state or local benefits, including Worker’s Compensation and Social Security disability benefits. However, the Plan does not subrogate STD payments.

If you’re not eligible for disability benefits but may need a leave for your own serious health condition within your first 90 days of employment, you must submit a claim to MetLife. If it’s determined you’re disabled and unable to work, MetLife will medically manage the claim only, meaning that you will continue to receive medical coverage, paying the same rates that active employees pay for coverage.

No STD benefit is payable for claims submitted more than six months after the date of disability. However, you can request that benefits be paid for late claims if you can show that:

  • It was not reasonably possible to give written proof of disability during the six-month period.
  • Proof of disability satisfactory to the claims administrator was given as soon as was reasonably possible.

 

icon 
Do You Work in New York?

If you’re approved for a state disability benefit from New York, the payment will be included in your STD benefit from Citi. If you’re denied an STD benefit from Citi, your New York state benefit will be paid by MetLife. If you’re later approved under Citi’s STD plan, you’ll be required to reimburse MetLife for the New York state benefit which you received.

For more information about the New York Paid Family Leave, review the Family and Medical Leave Act (FMLA) and Citi Family and Medical Leave (FML) Policy.

iconWhat Happens Once You Report STD
  1. MetLife will assign a case specialist to you and mail a Health Care Provider Certification Form, Medical Authorization Form, state or local forms (where applicable), and information on your rights and responsibilities under the Family Medical Leave. If you don’t return the forms on time, your claim may be denied.
  2. Your MetLife case specialist will review the information you reported and make an initial determination with respect to your claim and notify you and your manager/supervisor of the claim decision.
  3. You will need to assist your MetLife case specialist by providing the appropriate documentation — including your manager’s/supervisor’s name, work address and telephone number — to ensure adequate communications regarding your claim.
  4. You will need to sign the Medical Authorization Form and give it to your health care provider along with the Health Care Provider Certification Form and state or local forms (where applicable).
  5. Be sure that your health care provider promptly completes the Health Care Provider Certification Form and returns all forms to MetLife so that MetLife can obtain additional information about your medical condition as needed pertaining to your claim so a benefits determination can be made. The address and fax number are on each form.
  6. Keep your manager/supervisor informed of your claim and/or leave status throughout the process.
iconIf Your STD Claim is Approved

If your MetLife case specialist approves your claim for an STD benefit, you’ll:

  • Receive a letter confirming the length of your approved disability.
  • Receive a separate letter from MetLife regarding your family and medical leave of absence, and state or local leave, if eligible.*
  • Receive an STD benefit through payroll based on your eligibility.
  • Continue to pay for health and insurance benefits (and Group Universal Life as well as Long-Term Care coverage, if enrolled) at the active employee rate. Contributions will be taken from your STD payments.**

 

Your MetLife case specialist will:

  • Assist and guide you through the duration of your claim.
  • Call your health care provider periodically to ask about your current medical condition, treatment plan, prognosis and functional abilities.
  • MetLife may require additional medical information or an independent medical examination to re-evaluate your claim and continue disability benefits.
  • Call your manager/supervisor to discuss specific job duties in detail as well as explore potential return-to-work and job accommodation opportunities. Your case specialist won’t discuss confidential information with your manager/supervisor.
  • Re-evaluate your claim based on your individual circumstances and the expected duration of your absence.
  • Evaluate your eligibility for an LTD benefit once your STD benefit is nearing the maximum duration of 13 weeks. You may be required to furnish additional medical information to substantiate your continuing inability to perform your job.

 

*You’ll receive separate communications from MetLife regarding your Family Medical Leave, STD and state or local leave, where applicable as these are treated as separate leave requests.
**In New Jersey, the state benefit will be paid directly to the employee and, as a result, benefits contributions may be handled differently.
iconIf Your STD Claim is Denied or Benefits Are Terminated

If your claim for a disability benefit is denied or benefits are terminated before the maximum benefit is provided, your MetLife case specialist will:

  • Contact you to explain the reason for denial or benefits termination.
  • Notify your manager/supervisor.
  • Notify HR Shared Services to stop your disability benefits, if applicable.
  • Document, via letter, the reason for the denial/termination of disability benefits and explain the appeal process and procedures.

 

If You Work in California

If you’re eligible for a disability benefit and work in California, you’re covered by the Citi California Voluntary Disability (VDI) Plan, unless you reject the plan.

Benefits will be paid for the first 13 weeks of disability (work-related or non-work-related) according to the applicable schedule of benefits. You must report your disability claim to MetLife, not to the state of California.

The California Paid Family Leave (PFL) program enables an employee to care for a seriously ill family member (child, spouse, partner, parent) or to bond with a newborn, adopted or foster child. If you’re approved for a PFL benefit, you’ll receive payments directly from MetLife (not through Citi payroll).

iconRejecting the Citi VDI Plan

You have the right to reject the Citi VDI plan by completing a Rejection Notice, which is available from HR Shared Services. If you reject the Citi VDI plan, your election will become effective the first day of the calendar quarter following the one in which you give the Rejection Notice to HR Shared Services who will notify MetLife.

At that time, you’ll:

  • No longer be eligible for an STD benefit from the Citi VDI plan.
  • Be subject to the California State Disability Insurance (SDI) tax, which will be deducted from your pay, in order for you to receive benefits under the California state program.

 

If you become disabled and aren’t enrolled in the Citi VDI plan, you must:

  • File a claim directly with the state of California for California SDI benefits.
  • Call MetLife to report your Family Medical Leave.

 

iconBenefits Coverage If You Become Disabled

During the 13 weeks of STD, contributions for your benefit coverage will be deducted from the STD benefit you receive from Citi for the following benefits:

  • Medical (at the active employee rate)
  • Dental (at the active employee rate)
  • Vision (at the active employee rate)
  • Group Universal Life (GUL) (at the active employee rate)
  • Supplemental AD&D Insurance (at the active employee rate)
  • Health Savings Account (HSA)
  • Health Care Spending Account (HCSA)
  • Limited Purpose Spending Account (LPSA)

 

For the Dependent Care Spending Account (DCSA) and Transportation Reimbursement Incentive Program (TRIP), coverage ends on your first day of STD. You’ll have until June 30 of the following year to submit claims incurred prior to the first day of STD.

If your disability continues and you subsequently are approved for LTD benefits, you will be direct billed your benefits coverage. When you’re billed directly for your benefits, you’re responsible for paying the employee share. Failure to pay your employee contributions will result in the termination of your coverage.

If you have any questions about your benefits coverage while on a leave, call ConnectOne at 1 (800) 881-3938. From the “benefits” menu, choose the “health and insurance benefits as well as TRIP and spending accounts” option.

Long-Term Disability (LTD)

Long-Term Disability is provided through MetLife in the event you suffer a covered disability. You may be eligible to receive an LTD benefit if your approved STD claim was paid for 13 weeks.

LTD coverage is offered to replace 60% of your benefits eligible pay (pre-disability earnings) determined on the day before your approved STD. Your “pre-disability earnings” under the MetLife group disability policy constitutes your benefits eligible pay (as defined by the plan) for purposes of the LTD benefit.

Citi provides Company-paid LTD coverage to employees whose benefits eligible pay is less than or equal to $50,000.99:

  • If your benefits eligible pay is less than or equal to $50,000.99, you do not need to enroll for coverage and there is no cost to you.
  • If as a new hire, your benefits eligible pay exceeds $50,000.99, you will be automatically enrolled in LTD coverage with an option to decline coverage. You must pay for this coverage.
  • If your benefits eligible pay increases to $50,001 or above for benefits purposes for Annual Enrollment in the next plan year, you will be automatically enrolled in LTD coverage so your coverage continues uninterrupted.

 

The cost of LTD coverage will be deducted from your pay beginning January 1 of the next plan year (following Annual Enrollment) unless you decline coverage.

For purposes of calculating your LTD benefit, benefits eligible pay is limited to a maximum of $500,000. Disability benefits received from any state disability plan, Social Security and the LTD portion of the Plan, combined, won’t exceed 60% of your benefits eligible pay.

iconImportant Items to Note

If you decline automatic enrollment in the LTD coverage and decide to enroll in LTD coverage at a later time, other than as the result of a qualified change in status, you must take a physical exam and/or provide evidence of good health before coverage will be approved. The Plan will not cover any disability caused by, contributed to, or resulting from a pre-existing condition until you have been enrolled in the Plan for 12 consecutive months.

iconPre-Existing Conditions

A pre-existing condition is an injury, sickness or pregnancy for which — in the three months prior to the effective date of coverage — you received medical treatment, consultation, care or services; took prescription medications or had medications prescribed; or had symptoms that would cause a reasonably prudent person to seek diagnosis, care or treatment.

iconOption to Decline LTD Coverage

If you do not elect “no coverage” during Annual Enrollment when your benefits eligible pay exceeds $50,000.99 for the next plan year (or as a new hire with the requisite benefits eligible pay), you will be automatically enrolled in LTD coverage. If you elect to decline LTD coverage within the first 90 days following your enrollment, you will receive a refund of your paid premiums. You can also decline LTD coverage after the initial 90‑day period; however, premiums will not be refunded to you.

Note: If you decline automatic enrollment in the LTD coverage and decide to enroll in LTD coverage at a later time, other than as the result of a qualified change in status, you must take a physical exam and/or provide evidence of good health before coverage will be approved.

iconIf You’re Approved for an LTD Benefit

MetLife will continue to manage your claim and pay your monthly LTD benefit.

  • If you have consecutive, concurrent or continuous disabilities, related or unrelated, which continue for a period of more than 13 weeks and if eligible and approved, you will receive an LTD benefit from MetLife. See the chart in the Benefits Handbook for the maximum LTD Benefit.
  • If you’re approved for Social Security Disability Insurance (SSDI) for yourself and/or your dependents, your monthly LTD benefit will be offset by SSDI, dependent SSDI and any state disability benefits you may receive.*
  • Your LTD benefit won’t be offset for any SSDI cost-of-living adjustments. If you’re approved for SSDI retroactively and receive a lump-sum SSDI award, you’re required to submit any overpayment of benefits to MetLife. Any other income you receive while you’re receiving an LTD benefit may be used to offset your LTD benefit as described in the LTD policy between MetLife and Citi. This is not applicable to Individual Disability Insurance Plans (IDIs).
  • While on an LTD leave, MetLife will send you instructions on how to apply for SSDI benefits, tax information and relevant forms, and may request ongoing medical and financial information be provided to certify your continued disability under the plan.

 

*If you reside in a state that provides state disability benefits (CA, HI, NJ, NY or RI) or if you’re eligible for Social Security benefits related to your disability, these amounts will be used to offset your LTD benefit. The state and Social Security benefits may be subject to tax.

iconBenefits Coverage If You Become Disabled
  • During your first 39 weeks of LTD, you’ll be billed directly for your medical, dental and vision coverage by the Citi Benefits Center.
  • Group Universal Life and Supplemental AD&D coverage, if applicable, will be billed by MetLife.
  • For Long-Term Care Insurance you’ll be billed directly by John Hancock, if you were enrolled prior to January 1, 2012.
  • For the Health Savings Account, you may continue contributions on an after-tax basis by contacting ConnectYourCare.
  • You may continue contributing to your Health Care Spending Account through COBRA on an after-tax basis. If you don’t elect COBRA coverage, you can file claims for expenses incurred prior to your first day of LTD. You’ll have until June 30 of the following year to submit your claims.
  • You may continue contributing to your Limited Purpose Health Care Spending Account through COBRA on an after-tax basis. If you don’t elect COBRA coverage, you can file claims for expenses incurred prior to your first day of LTD. You’ll have until June 30 of the following year to submit your claims.

If your disability benefit continues beyond 52 weeks, unless an accommodation can be made, your employment may be terminated. Once your employment is terminated, your benefit coverage will be as follows:

  • Medical: Coverage continues at the same rate that active employees pay for up to 36 months. At the end of the medical continuation period, you may continue coverage through COBRA for up to 29 months, if applicable.
  • Dental and Vision: You may continue coverage through COBRA after 52 weeks.
  • Basic Life/Accidental Death and Dismemberment (AD&D) Insurance (if eligible*): Coverage stops after 52 weeks, but you can convert coverage to an individual policy. You’ll receive a Health and Welfare Benefits Conversion/Portability Notice from the Citi Benefits Center once you lose eligibility. The conversion for Basic Life insurance is administered by Massachusetts Mutual Life Insurance Company (MassMutual) and is time-sensitive. If you’re interested in converting your group coverage, call 1 (877) 275-6387 within 31 days.
  • Group Universal Life (GUL): GUL coverage can be continued through MetLife. You’ll be billed directly. Coverage continues at the active employee rate for as long as you are deemed disabled and are eligible for disability benefits under the Citigroup Disability Plan.
  • Long-Term Care Insurance (if enrolled prior to 1/1/12): You can continue coverage through John Hancock, which will bill you directly.
  • Health Savings Account: As long as you’re enrolled in a High Deductible Health Plan, you may continue contributions on an after-tax basis by contacting ConnectYourCare. Note: You’re no longer eligible to make contributions to an HSA once you enroll in Medicare.
  • Health Care and Limited Purpose Health Care Spending Accounts: You may continue coverage through COBRA on an after-tax basis until the end of the calendar year in which your employment terminates. If you don’t elect COBRA coverage, you can file claims for expenses incurred prior to your first day of LTD. You’ll have until June 30 of the following year to submit your claims.

 

*You’re eligible for employer-paid Basic Life and AD&D coverage if your benefits eligible pay is less than $200,000.