Short Term Disability
Short Term Disability (STD) replaces
lost income for up to 26 weeks if you are unable to perform all duties
of your occupation. You may select a benefit level based on your gross
annual salary. Benefits levels range from $360 to $3,000 per month.
The benefit pays the first day following a non work-related accident
and the eighth day following an illness (pregnancy/childbirth
is considered an illness). Acceptance
for STD coverage is guaranteed. You do not need to complete a health
questionnaire. However, there is a 12-month pre-existing condition
exclusion. You may only apply during the open enrollment period
or within 31 days of your hire date.
Enroll in Short Term Disability
To enroll in the short term disability benefit, click HERE.
Click HERE for
more information on short term disability benefits. To file a short
term disability claim, click HERE.
To File a Short Term Disability Claim
To file a short-term disability claim, complete and print
the two-page
claim form below. The employee is responsible for completing the
Claimant's Statement,
and the attending physician must complete the Physician's Statement.
The
Employer's Statement will be completed by the Employee Benefits
office once
the completed Claimant's and Physician's statement pages of the
form have been submitted by mail to 63 East Main Street, #101, Mesa
85201 or by fax (480) 472-0370. If you submit your form by fax,
you must also mail the original claim form to the Employee Benefits
office.
2008/2009 Short-term Disability Rates
| If Your Gross Annual
Salary Is At Least |
Monthly Benefit Level |
2008/2009 Monthly Premium |
Over 18 pay checks |
$6,480 |
$360 |
$5.44 |
$3.63 |
$9,180 |
$510 |
$7.70 |
$5.13 |
$13,500 |
$750 |
$11.33 |
$7.55 |
$18,000 |
$1,000 |
$15.10 |
$10.07 |
$21,600 |
$1,200 |
$18.12 |
$12.08 |
$27,000 |
$1,500 |
$22.65 |
$15.10 |
$30,600 |
$1,700 |
$25.67 |
$17.11 |
$36,000 |
$2,000 |
$30.20 |
$20.13 |
$40,500 |
$2,250 |
$33.98 |
$22.65 |
$45,000 |
$2,500 |
$37.75 |
$25.17 |
$49,600 |
$2,750 |
$41.53 |
$27.69 |
$54,000 |
$3,000 |
$45.30 |
$30.20 |
$72,000 |
$4,000 |
$60.40 |
$40.27 |
$90,000 |
$5,000 |
$75.50 |
$50.33 |
$108,000 |
$6,000 |
$90.60 |
$60.40 |
$126,000 |
$7,000 |
$105.70 |
$70.47 |
$144,000 |
$8,000 |
$120.80 |
$80.53 |
Questions?
Contact the Employee Benefits Department at (480) 472-7222
|
