Disability Insurance Is Mission
Company group benefit plans provide employees with short-term and long-term disability insurance coverage. As an illustration, if you become ill or injured and can’t work, you could replace a significant part of your income with disability insurance benefits. But what if you’re a small business owner or self-employed? If you’re the sole breadwinner in your family, how would you cope without disability insurance? Without a doubt, disability insurance coverage will protect your income. If you become disabled, you might have to use your savings just to maintain your lifestyle. And what if you’re single and have monthly mortgage, car and other loan payments? Disability insurance benefits could help you get the help you need if you became disabled.
Third Party Sick Pay Reporting Faqs
Category: Supplemental Benefits
Like many reporting requirements, Third Party Sick Pay Reporting can be confusing. As a specialist in benefits administration, we want to help you better understand the process.
Because we provide disability insurance and pay disability benefits directly to employees, American Fidelity is considered a third-party payer of sick pay. Below are some FAQs weve received:
Seriously Do You Really Need To Understand Your Short
Heres the short answer: yes. While its not exactly a fun topic to think about, its important that you familiarize yourself with the details of your planso you dont have to get up to speed when you actually need the benefit.
However, wading through our own plan documents is a step that most of us skip. That informational booklet is immediately relegated to our desk drawer or filing cabinet.
Do you remember the first day you started your job? Its kind of a firestormyou cant focus well or often, says McDonald. So we dont spend a lot of time achieving clarity about the benefit in the beginning. We only acquire an understanding of it when we are in deep need of the benefit.
But particularly if you have an existing problem or condition, youre going to want to know the ins and outs of the benefit thats available to you.
Anybody who goes into a new job and has any kind of serious medical condition that could at some point in time render them unable to work, I think its a good idea to be able to see the actual short-term and long-term disability plan documents to see how they define disability and how they handle pre-existing conditions, adds Bartolic.
Ideally, youll never have to take advantage of your short-term disability benefits. But in the event that the unexpected happens, youll be glad that you took the time to understand whats offered to you. This explainer is a good place to start, but you also need to read through the details of your specific plan.
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How Is A Recurring Disability Handled
If a claimant satisfies the qualifying period, returns to active work, becomes disabled again, and has remained insured under the policy, then the same period of disability may continue.
The return to active work must be for less than six months if the later disability results from the same or related cause, or less than one day if the later disability results from a different cause.
If the return to active work is more than those periods shown above, the claimant must satisfy the qualifying period again.
How Much Will You Get Paid When You Take Short
When you take advantage of your short-term disability benefit, your time off is paidbut that doesnt necessarily mean youll be getting your full paycheck.
The amount youll earn is dependent on your specific plan. Some plans offer full salary replacement, but most dont. Instead, they offer a percentage of compensation with a dollar amount cap.
There are also programs that award you different amounts based on your longevity with the company, says McDonald. If you are there for 10 years and have a 26-week disability period, you might get three months at 100% and then three months at 50%.
If you live in one of the five states where short-term disability benefits are mandated, then the amount youll be compensated will be regulated as well.
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Why Was No Fica Withheld Why Did Fica Withholding Stop
We are required to withhold FICA taxes for the first full six-month period following the last day the claimant worked for the policyholder. If Sun Life’s first payment is made after the conclusion of this six-month period, FICA taxes will not be withheld. Payments made within this six-month period will be subject to FICA. Any payments made after this six-month period will not be subject to FICA, unless the claimant returns to work for the policyholder in any capacity.
IRC regulations require FICA withholding from benefit payments issued within the first full six months following the last day worked for the policyholder. However, once this six-month period has ended, no FICA is withheld from benefits paid unless the claimant returns to work for the policyholder in any capacity.
Why Do I Need To Match The Fica Withheld From Benefits Paid To The Claimant
Internal Revenue Code regulations consider disability benefits as wages. Sun Life withholds, from the disability benefits paid, the employee portion of FICA taxes for the first full six month period following the claimant’s last day worked for the policyholder. The employer is required by law to match, as the employer portion of FICA, the amount of the employee portion of FICA withheld by Sun Life.
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Is Sun Life Responsible For Futa And Suta Taxes
No. The policyholder is responsible for FUTA and SUTA taxes. Sun Life will not pay FUTA and/or SUTA on disability payments. The policyholder is responsible for determining the amount of FUTA and SUTA taxes that are due on benefits paid. FUTA taxes follow the same guidelines as FICA taxes, that is, if FICA taxes were withheld, FUTA taxes are payable if the claimant has not yet met the FUTA wage limit. The policyholder must determine the wage limits that apply for FUTA and SUTA.
The Variability Between These Factors Can Create A Number Of Situations
When disability benefits are awarded retroactively , the insurer and your employer will arrange to have an amended T4 prepared. In order to limit the tax burden, the arrears can be spread over the years when you were entitled to benefits by filing a T-1198 with CRA. Again, your insurer and employer handles this for you on any negotiated settlement.
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What Are Your Options If Your Short
The first thing to do is to carefully read the correspondence thats saying its not being approved, advises Bartolic. That will tell the person a lot, and will tell them what to do if they disagree with the decision.
Most disability plans in America are covered under the Employee Retirement Income Security Act , which means claims are reviewed through the lens of this federal law.
If your plan is covered by ERISA, the law requires that the denied individual be presented with a right to appeal that decision. Its a mandatory feature of it, explains McDonald. That period of appeal is 180 days. During that time, you have perhaps your single best opportunity to give evidence to the insurer or plan administrator about why theyre wrong and why youre entitled to those benefits.
If you go through the appeal process and still are unable to convince them of your disability, then unfortunately youll have to initiate a lawsuit.
What Qualifies For Short
To qualify for short-term disability benefits, an employee must be unable to do their job, as deemed by a medical professional. Medical conditions that prevent an employee from working for several weeks to months, such as pregnancy, surgery rehabilitation, or severe illness, can qualify to receive benefits. Since employers in most states must legally provide workers’ compensation insurance to all employees, any injuries incurred on the job are typically covered under a workers’ comp policy and are therefore not eligible for short-term disability.
While most non-work-related temporary medical conditions are covered by a short-term disability policy, there can be exclusions for preexisting conditions or intentional and foreseeable injuries . While employees can qualify for time off under the Family and Medical Leave Act to care for a sick relative, most short-term disability policies would not provide benefits if the covered employee is not the one with the illness.
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Is Social Security Disability Taxable
Income from social security disability isnt taxable if your provisional income isnt more than the base amount. Provisional income is your modified adjusted gross income plus half of the social security benefits you received. The base amount is:
- $25,000 if youre filing single, head of household, or
- $32,000 if youre
- $0 if youre married filing separately and lived together with your spouse at any point in the year
- Your modified AGI includes all other income without subtracting exclusions for:
- Interest from qualified U.S. Savings Bonds
- Employer-provided adoption benefits
- Foreign earned income or foreign housing
- Income earned by a bona fide resident of American Samoa or Puerto Rico
To figure your provisional income, use Publication 915, Worksheet A.
If your provisional income is more than the base amount, up to 50% of your social security disability benefits will usually be taxable. However up to 85% of benefits will be taxable if your provisional income is more than the adjusted base amount. The adjusted base amount is one of these:
- $34,000 if youre filing single, head of household, or married filing separately
- $44,000 if married filing jointly
- $0 if youre married filing separately and lived with your spouse at any time in the year
Disability Insurance Taxation On A Lump Sum Buyout
Your insurer may come to you with a lump-sum buyout offer. This is a one-time fixed payment where the insurance carriers want to pay you a percentage of the remaining value of your claim. The lump-sum payment puts an end to the continuing monthly payments.
Again, disability insurance taxation comes down to whether premiums were paid with pre-tax or after-tax dollars. If your lump-sum buyout is taxable, be aware that the one-time payment the insurer offers may be substantially reduced by taxes.
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Reporting Disability Insurance Benefits On Your Tax Return
You do not have to pay taxes on disability benefits you receive if you purchased your policy with after-tax dollars. But those who receive their policy through their employer may have to. Taxable disability insurance benefits are classified as âsick pay,â so if you anticipate receiving benefits, you have to submit IRS Form W-4S, titled âRequest for Federal Income Tax Withholding From Sick Payâ to the insurance company. You can also make estimated tax payments using Form 1040-ES, âEstimated Tax for Individuals,â which youâll file directly to the IRS.
If you start receiving taxable benefits, you need to include the amount of benefits you receive on your tax return as part of your salary or wages when you file. As with reporting traditional wages and salaries, if the amount you paid in estimated tax or via income tax withholding is higher than what you actually owe, youâll receive a refund. If you paid too little tax, youâll have to pay more to make up the difference on Tax Day.
The IRS will let you deduct qualified out-of-pocket medical expenses if youâre eligible to itemize your deductions, so if your disability benefits cover medical care and you owe taxes on them, those medical expenses may negate the tax.
Disability Income Splitting And Tax Reduction
By Jason Heath on January 15, 2019
Robs wife is unable to work due to a chronic illness. Hes trying to plan for tax reduction in retirement on their registered accounts.
Q: My wife has been diagnosed with a chronic condition known as Fibromyalgia, so she cant work anymore . My plan is to retire at 65 and we plan to have about $1 million saved in registered accounts . Can you recommend a tax efficient approach to drawing down the registered funds so that it reduces the impact on other benefits like OAS?
Rob
A: There are a bunch of different considerations here, Rob, so bear with me, as this will be one of my longer Ask a Planner answers. Before I jump right to income splitting in retirement, I think there are a few other pertinent points.
I assume if your wife was entitled to any short-term or long-term disability benefits through a workplace or private disability insurance policy, you have already pursued those. But I want to make sure you have also considered other government and income tax benefits that are available now, long before retirement.
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Sole Proprietorship Benefits Are Non
Many of our clients are business and medical professionals working as sole proprietorships, where the owner and business are the same. Disability insurance benefits would be purchased by the sole proprietor as an individual disability policy using post-tax dollars. These benefits, when paid to the sole proprietor, would not have any taxes due.
Requiring Use Of Pto With Fmla Leave
*Question:We are currently reviewing our Family Medical Leave Act policy and are considering requiring employees to use some portion of their accrued Paid Time Off in conjunction with FMLA. Our employees currently have the choice of taking unpaid FMLA leave or applying PTO time . I am curious whether other employers currently require use of some PTO in conjunction with FMLA.1. Does your FMLA/medical leave policy require employees to use PTO/vacation days?If yes,2. Is PTO/vacation mandated for both continuous and intermittent leaves?3. How much PTO/vacation must employees use?Wisdom of the Crowd:
Response # 1: We require our employees to use any accrued PTO concurrently with FMLA leave.
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Insufficient Objective Evidence Of Disability
Although insurers often cite insufficient objective evidence of disability to deny claims, this reason doesnt work with depression. Modern medicine has yet to find objective evidence for depression.
If you receive this as a reason, you should address it in your appeal letter. Fortunately, objective evidence is not a requirement under plans and programs.
Your letter should then focus on how your doctor followed best practices for diagnosis and treatment. Mention how you adhered to the recommended treatment faithfully. You should also emphasize all the things youve done to keep working. These aspects can make up for a lack of objective evidence.
How An Independent Insurance Agent Can Help
An independent insurance agent can be your knight in shining armor when it comes to figuring out your disability insurance. When you feel like it’s hopeless to find the right kind of coverage at the right price, they gallop in with coverage options that all fit right inside your budget.
And when it comes to getting answers on questions like tax deductions and so on, they’ve got your back. Go on, give your local independent insurance agent a call and get going on your short-term disability insurance before its too late.
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The above article is intended to provide generalized financial information designed to educate a broad segment of the public it does not give personalized tax, investment, legal, or other business and professional advice. Before taking any action, you should always seek the assistance of a professional who knows your particular situation for advice on taxes, your investments, the law, or any other business and professional matters that affect you and/or your business.
How Do I Fill Out A Form 941 To Send With Payment Of The Employer’s Portion Of Fica Taxes
Sun Life will send you periodic reports reflecting the taxable benefits paid and the applicable taxes withheld.
To prepare your Form 941, include the applicable wages and taxes on lines 2, 5a, and 5c of Form 941 and after completing line 6, subtract on line 7b the employee Social Security and Medicare taxes withheld and deposited by Sun Life. Enter that amount in the ÂSick Pay space provided. By making the adjustment on line 7b, you will only pay the employer’s portion of Social Security and Medicare taxes. You should not include any Federal income taxes withheld from third party sick pay on your Form 941 because any Federal income taxes withheld have been reported by Sun Life.
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