Short Term Disability (STD) - Income replacement for people who are unable to work due to a disability, Attending Physician’s Statement - Statement of disability from the physician; doctor's write up; one of 3 proofs of claim, Basic Compensation (BWE)  - EE (employee's) basic weekly earnings (salary) that's used to determine the benefit amount, Benefit Amount - Typically a percentage of their BWE (basic weekly earnings) that we will pay during disability (60%, 70%) but can also be tiered, flat or incremental; can vary by group, not one set number, Eligibility - Process of confirming an employee has coverage, List Billed - A group where Lincoln is keeping eligibility records, Self-Billed - The ER keeps a record of all STD-eligible employees; we will need a census (sent from the ER) to confirm coverage, Census - List of employees who have elected coverage sent by self-billed groups to Lincoln, Premium - Cost of STD coverage paid for either by the EE or the ER (contributory or non-contributory), Contributory - A plan where an employee contributes to their std premium, Non-Contributory - Plan where the ER pays 100% of the premium (EE pays nothing to have the coverage), Policy - The contract decided upon between the ER and Lincoln that decides how a particular's group claim is managed and paid, Class - A breakdown of employees that determines the type of coverage for a claimant, Waiting Period - How long an employee has to wait after they're hired before they're eligible to sign up, Effective Date - The date an EE STD coverage starts, Elimination Period - How long EE has to wait before std benefit payment starts (0 days, 7 days, 14 days up to 30 days), Enrollment Form - Confirmation of coverage sent from ER, Exclusion - Any condition or situation where Lincoln will not pay a benefit (e.g., workers comp, suicide attempts, results of war), Evidence of Insurability - Proof of good health if EE adds coverage or is a late applicant, Date of Disability - The date an Employee is deemed disabled by their Attending Physician, Offset - Any other income that should be deducted from the std benefit (e.g. - sick pay, vacation pay, social security, no fault auto payments); policy specific, Partial Disability - When an EE is able to perform some of the duties of their occupation or able to work in a part time capacity; receive reduced benefit, Pending Claim - A claim where an interim decision is made, either due to eligibility issues or medical determination issues, Pre-Existing Condition - A condition that a claimant had prior to becoming effective that prevents them from receiving an STD benefit for their current disability, Prior Plan - Confirmation of coverage using a previous carrier, Total Disability - When an EE is unable to perform the main duties of their occupation and unable to work in any capacity, Minimum Benefit - Minimum amount we can pay on a weekly basis; per policy basis, Maximum Benefit - Maximum amount we can pay on a weekly basis for an std claim, Eligibility Date - Date after the waiting period is completed and an EE can sign up for coverage, Proof of Loss - Aka 3 proofs of claim (EE, ER and APS); must receive all 3 to be considered a complete claim,

Claim Terminology

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