2019 Short-Term Disability

Employees scheduled to work 30 hours or more are automatically provided Short-Term Disability coverage at no cost. This benefit provides income protection if you become unable to work due to non-work-related illness or injury, if your disability claim is approved.

  • You are eligible for Short-Term Disability the 1st of the month following 60 days of employment.
  • Disability benefits begin on the first day of an injury or the eighth day of the illness and last up to 90 days.
  • For accidents or injury, there is no waiting period before benefits are payable.
  Benefit Amount

Hourly

75% of base earnings*

Salaried - Non-Exempt       

80% of weekly earnings

Salaried - Exempt

100% of weekly earnings

State Disability

YOUR STATE’S MANDATORY DISABILITY BENEFITS STATUTE WILL APPLY TO YOU. MOHAWK WILL OFFSET THE DIFFERENCE TO MAKE YOU WHOLE BASED UPON THE COMPANY’S DISABILITY BENEFITS*. To figure the amount, if Mohawk provides you with a benefit of 75% of your base earnings, and the state provides you with 50% of your base earnings, you will receive the full state benefit and Mohawk will pay you the difference or 25% so you will receive the full 75% benefit between the two plans.  In some cases, Mohawk may not offset your state disability if your state disability benefit is equal to or greater than the company’s disability benefit. The benefit payable to you will never be less than the minimum benefit shown in the policy.

*For state plan information or to file a claim, please refer to the links provided below:

States of CA, NJ, RI, or PR Short-Term Disability

California:  www.edd.ca.gov 

  • Disability Insurance - 800-480-3287 (English) / 866-658-8846 (Spanish)
  • Paid FML - 877-238-4373 (English) / 877-379-3819 (Spanish)

New Jersey:  lwd.dol.state.nj.us

  • Customer Service Information Center - 609-292-7060 (English and Spanish) 
  • Toll Free number provided only for deaf, hard of hearing, or speech impaired individuals - 800-852-7899

Rhode Island:  www.dlt.ri.gov

  • Customer Service Unit - 401-462-8420

Puerto Rico:  www.trabajo.pr.gov

  • 787-754-5353 (Website and info in Spanish only)
State of New York Short-Term Disability

This information only applies to employees working in New York state.  The Hartford will now accept new Short-Term Disability claims for New York employees via telephonic submission.  Simply contact Hartford’s designated toll-free claim line at 866-945-4558 to initiate and expedite the process.  Paper claim forms are acceptable.

Changes in New York state law required all private-sector employers like Mohawk with employees working in the state of New York to provide Paid Family Leave (PFL). All employees working in the state of New York will automatically be covered on Jan. 1, 2018. As with all leaves, the employee should report their leave to the Benefits Service Center at 866-481-4922. Click here for more details about New York state Paid Family Leave.

pdf button State of New York Short-Term Disability Instructions

pdf button State of New York State Short-Term Disability Claim Form  


State of Hawaii Short-Term Disability

This information only applies to employees working in the state of Hawaii.  Please complete the paper application located below and refer to the attached instructions. For any questions, please contact The Hartford at (888) 236-4918 Tel / (855) 819-8915 Fax.

pdf button State of Hawaii Short-Term Disability Instructions

pdf button State of Hawaii Short-Term Disability Claim Form


In the Event of a Short-Term Disability Claim or Workers Compensation Claim:
  • Your pay type prior to your STD determines if deductions for medical, dental/vision, 401(k) contributions, critical illness and/or life insurance benefits are taken from your pay.

  • If you are an hourly or salaried non-exempt associate on an STD leave of absence, you will not have deductions taken from your pay for the benefits mentioned above.

  • For salaried exempt associates on an STD leave of absence, deductions will be taken from your pay for the benefits mentioned above.

  • For all pay types, deductions will continue to be taken for 401(k) loan payments, Health Savings Account and any Health Care or Dependent Care Flexible Spending Account contributions.

  • If at any time you anticipate that your disability may extend beyond 90 days, you should begin the process of filing a Long-Term Disability (LTD) claim close to your 45th day (approximately 6 weeks) of disability.

+ Note:

  • If you experience the same or similar disability within a rolling 12-month period, the combined maximum period for which the Short Term Disability benefit is payable is 90 days. This 12-month period begins when the first Short Term Disability period started.
  • If the combined Short-Term Disability and Long-Term Disability leaves of absence will extend beyond 12 months, your HR representative will contact you regarding your continued employment status. LTD benefits will not be adversely affected by termination of employment. 
  • For Workers Compensation leaves, all benefits are handled in the same manner.
To Request a Leave, Contact The Benefits Service Center at 1-866-481-4922

Representatives are available from 8:00 am - 6:00 pm EST, Monday - Thursday and 8:00 am - 5:00 pm Friday EST.  Please make your request 30 days prior to the start of your leave (or as soon as practical under your circumstances).  You will also need to advise your supervisor of any request being made for a leave. Leaves must be requested within 15 days of the initial date of absence, or the leave may be denied.

Continuation of Coverage through COBRA
  • Please note that on the 90th day of your Short-Term Disability personal medical leave of absence (including Short-Term Disability and Worker's Compensation), your Medical, Dental and Vision benefits will cancel, however you will be eligible to continue your benefits through COBRA.
  • Once you have been out of work for one year, if you wish to continue COBRA coverage, the standard COBRA rate of 102% of premium will apply.

pdf button Benefits Continuation Notification

Additional Information

pdf button Short-Term Disability Summary

pdf button Employee Statement

pdf button Employer's Statement

pdf button Attending Physician's Statement

pdf button Authorization to Obtain Information

Short-Term Disability Contacts

Benefits Service Center (BSC) | Phone: 866-481-4922 | Fax: 866-597-2187

New York State Only - The Hartford - 866-945-4558

Hawaii Only - The Hartford - 888-236-4918

 

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Cigna
1-855-566-4295
WebTPA
1-844-380-4564
Express Scripts
1-877-887-2879
Cigna MDlive
1-855-818-3627
Metlife
1-855-488-0520
Aflac
1-800-433-3036
TaxSaver Plan
1-888-602-6272
Fidelity
1-800-835-5087
One America
1-855-279-6375
HLC
1-877-365-0051