California State Disability Insurance 2017 Information Technology Branch
California State Disability Insurance 2017
Information Technology Branch Administration Branch Public Affairs Branch Disability Insurance Branch EDD Policy Accountability & Compliance Branch Workforce Services Branch Unemployment Insurance Branch Tax Branch
State Disability Insurance Paid Family Leave
State Disability Insurance Vision The State Disability Insurance program is a model of excellence, innovation, and integrity.
State Disability Insurance Mission We provide California’s eligible workers with timely benefits and deliver quality service to all our customers.
What is SDI? State Disability Insurance (SDI) is a partial, short-term, wagereplacement insurance plan for California workers.
Workers Covered by Two Benefits Disability Insurance (DI) provides partial wage replacement benefits for up to 52 weeks per claim. Paid Family Leave (PFL) provides partial wage replacement benefits for up to six weeks within a 12 -month period.
Disability Insurance Which States Have It? California is one of six U. S. locations with State Disability Insurance. • • • Hawaii - DI New Jersey – DI, PFL New York - DI Rhode Island – DI, PFL The Commonwealth of Puerto Rico -DI
Key Points of SDI • Covers approximately 18. 1 million California workers. • Replacement of approximately 55% of an employee’s income. • Requires qualifying wages in the base period and attachment to the labor market when the DI or PFL claim begins.
More Key Points of SDI • Requires a seven day, non-payable waiting period. • Provides benefits starting on the 8 th day. • Must file a timely claim (no later than 49 days). • Can apply without regard to length of employment. • Does not provide entitlement to leave or job protection.
Can a Claimant work Part- Time? • Must be working less than their normal, regular and customary hours. • The reduction of work hours must be a direct result of the disability or family leave claim. • Must have a loss of wages.
How is SDI Funded? Employees pay into SDI through state -mandated payroll deductions. • 2017 withholding rate of 0. 9% • 2017 taxable wage limit = $110, 902 • 2017 maximum yearly employee contribution = $998. 12
Weekly Benefit Amounts (WBA) Minimum Weekly Benefit Amount Maximum Weekly Benefit Amount 1946 2017 $10 $50 $20 $1, 173 A base period of 12 months is used for calculating the maximum and weekly benefit amounts.
Base Period for WBA $15, 657 $11, 180 1/15 -3/15 (QTR 1) $12, 249 $11, 180 4/15 -6/15 (QTR 2) 7/15 -9/15 (QTR 3) 10/15 -12/15 (QTR 4) Base Period Quarters WBA = Weekly Benefit Amounts CED = Claim Effective Date $12, 249 1/16 -3/16 (QTR 5) CED 6/1/16 4/16 -6/16 (QTR 6)
State Disability Insurance Data State Fiscal Year 2015/16
SDI - Employer Responsibilities Post EDD Notice to Employees (DE 1857 A).
SDI - Employer Responsibilities Provide SDI brochures to new hires or employees who may need to file a claim: • DE 2515 for DI • DE 2511 for PFL
SDI - Employer Responsibilities Complete and return the Notice to Employer (DE 2503/2503 F) within two working days.
Key Points of Disability Insurance • Provides benefits for employees who cannot work due to a non-work-related illness or injury. • Includes: Elective surgery, alcoholism, drug addiction treatment and recovery, pregnancy, childbirth or other related conditions.
More Key Points of Disability Insurance • Employees must be unable to perform their regular or customary work. • Employees must be under the care of a physician/practitioner. • Certification must be from the treating physician/practitioner of the illness, injury, or disability.
Key Points Paid Family Leave • Paid Family Leave (PFL) is a component of State Disability Insurance (SDI) and applies to all employees covered by SDI. • PFL benefits are payable at the same rate as DI. • Payments are limited to six weeks over a consecutive 12 -month period for bonding or caregiving needs. • Mothers transitioning from DI maternity leave to PFL for bonding benefits do not serve a second seven day waiting period. • Employers may require employees to use up to two weeks of vacation before receiving PFL benefits.
Two Basic PFL Claim Types Bonding • Requires written proof of the new child such as birth certificate, adoption papers, or foster care placement document. • Must be claimed within 12 months of the child entering into family. • Child must be under 18 years of age.
Two Basic PFL Claim Types Care • To care for seriously ill child, parent-in-law, grandparent, grandchild, sibling, spouse, or registered domestic partner. • Requires physician/practitioner certification of a serious illness and a need for care. • Requires the signature of the person receiving care or their authorized representative.
Differences Between DI and PFL Disability Insurance Paid Family Leave Up to 52 weeks per claim Up to six weeks per 12 -months Employee’s personal illness, injury, or disability Caring for a seriously ill family member or to bond with a new child Not required to use vacation benefits Employers may require employees to use up to two weeks of vacation Vacation pay is not in conflict with DI Vacation pay conflicts with PFL when employer requires employee to use Benefits are not reportable to IRS (unless in lieu of UI) Benefits are reportable to IRS
SDI – Fraud Prevention To deter fraud, please respond immediately to the Notice to Employer if you are not the employer shown or if the claimant: • • • Is not your employee. Has quit their job. Is receiving wages. Has not stopped or has started back to work. Is known to be working for another employer. Has filed for workers’ compensation or is believed to be planning to do so. • Is using a Social Security number incorrectly. • Is working under another name.
To Report Fraud To report Disability Insurance, Paid Family Leave or Unemployment Insurance fraud: • Call the EDD Fraud Tip Hotline at 1 -800 -229 -6297 To report Payroll fraud: • Submit an online Fraud Reporting Form at www. edd. ca. gov • Call 1 -800 -528 -1783 • Email ueo@edd. ca. gov • Fax 1 -916 -227 -2772
What is SDI Online? SDI Online: • Is an online claim filing system. • Allows online submission of SDI claims and other claim documents by claimants, physicians/practitioners, employers, and voluntary plan administrators. • Provides the best method to file a DI or PFL claim and for employers and physician/practitioners to submit their paperwork. • Is the faster and easier alternative to filing by mail.
SDI Online - Security Claimants can securely submit: • Disability Insurance (DI) claims. • Paid Family Leave (PFL) claims. • Required documentation related to their claim. Physicians/Practitioners and physician/practitioner representatives can: • View a patient’s initial claim for benefits • Submit DI and PFL claim certifications. • View claim certification history.
SDI Online - Convenience Employers, designated representatives, and Voluntary Plan Administrators can use an SDI Online account to: • • File the Notice to Employer of Disability Insurance Claim Filed (DE 2503) File the Disability Insurance Eligibility – Workers’ Compensation (DE 2578 A) File the Employer’s Statement of Job Duties (DE 2546 PE) Update contact information.
SDI Online - Benefits of SDI Online: • Improved access to services, claim status, and payment history. • Reduced claim processing time. • Improved detection and management of fraud and abuse. • Reduced paperwork and postage costs. • Health Insurance Portability and Accountability Act compliant.
SDI Online Access Visit www. edd. ca. gov/disability to register or login.
SDI Online Access Select Register for SDI Online to register for an SDI Online account. Existing users may go directly to the Log in to SDI Online.
SDI Online Access Select Employers to view tips, FAQs, videos, and tutorials.
SDI Online Access SDI Online page showing available Employer tips, FAQs and tutorials.
Paper Claim Form - DI DE 2501, Optical Character Recognition (OCR) form for Disability Insurance which can be scanned and interfaces with the SDI Online system. Part A (pages 1 -4): Claimant’s Statement Part B (pages 5 -7): Physician/Practitioner’s Certification
Paper Claim Form - PFL DE 2501 F, Optical Character Recognition (OCR) form for Paid Family Leave Part A (page 1): Claimant’s Statement
Paper Claim Form - PFL Page 2: Care Recipient’s Authorization
Paper Claim Form - PFL Parts B and C (page 3): Bonding Certification (B) and Statement of Care Recipient (C)
Paper Claim Form - PFL Part D (page 4): Doctor’s Certification
SDI Contact Information State Employee Disability Insurance 866 -352 -7675 Paid Family Leave 877 -945 -4747 Non-Industrial Disability Insurance 866 -758 -9768 Disability Insurance English 800 -480 -3287 Español 866 -658 -8846 Paid Family Leave English 877 -238 -4373
SDI Contact Information For Employers Only: SDI Online Services Help Desk 855 -342 -3645
Visit www. edd. ca. gov/disability for more information about State Disability Insurance and SDI Online. DIBOutreach@edd. ca. gov
Questions?
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