Disability CompensationVoluntary Plans
Section § 3251
This law allows either an employer, the majority of their employees, or both to submit a request to the Director of Employment Development for a special plan that voluntarily provides disability benefits to consenting employees. Any benefits given through this plan must be clearly marked as 'unemployment compensation disability benefits' and must be separate from any other benefits.
Section § 3252
This law explains the rules for employers and employees regarding contributions to the Disability Fund when an employee is under a voluntary disability plan. Normally, while under a voluntary plan, neither the employer nor the employee needs to contribute. However, the voluntary plan itself must pay 14% of the contributions based on the worker's taxable wages to the Disability Fund each year. Part of these payments will cover administrative costs and refunds related to the voluntary plans.
The law requires these payments to be submitted quarterly, and they become overdue if not paid by the end of that month. Moreover, standard rules for assessing and collecting contributions apply. If changes to the payment rates are necessary, the director must inform the Governor and Legislature.
Section § 3253
If an employee is covered by an approved voluntary plan when they start a period of disability, they can't get benefits from the state's Disability Fund. Instead, the benefits must be paid by the voluntary plan. This rule applies even if the employee develops new health issues during their disability period. The Director of Employment Development will make rules for people who are covered by both a voluntary plan and the Disability Fund at the same time.
Section § 3254
This law explains when a voluntary employee benefits plan can be approved by the Director of Employment Development. The plan must offer better employee rights than standard state benefits, be available to all of an employer's workers in California or at a specific site, and have consent from the majority of those workers. It should provide for future employees, have employer agreement on deductions, and be filed for at least a year. If it offers insurance, the policy must be approved by the Insurance Commissioner and offered by an authorized insurer. Changes to the plan or its withdrawal need proper notice, especially if related to changes in benefits or worker contributions. Additionally, wage deductions can't be increased more than once a year, unless legally allowed otherwise, and the plan can’t negatively affect the state Disability Fund.
Section § 3254.1
This section outlines the requirements for small-business-third-party administrators (SBTPAs) that want to manage voluntary disability plans for small businesses. To qualify, an SBTPA must have specific business setups and serve a minimum number of small clients, mostly with fewer than 20 employees, and also provide workers’ compensation insurance.
The law allows a single voluntary plan for all client employees, provided certain conditions are met, including setting up a master trust account and ensuring financial security. The plan must offer better employee rights than the current basic ones and be available to all employees. The section also details how these plans can be amended or terminated and emphasizes financial security, ensuring disability claims are settled from the SBTPA's resources rather than the state's Disability Fund.
Lastly, the department has the authority to develop necessary forms and procedures to ensure compliance, and in cases of insolvency, claims should first be satisfied from the SBTPA’s security.
Section § 3254.5
If a business with a voluntary plan is taken over by a new owner but continues to operate with largely the same staff, the plan remains in effect unless the new owner or insurer requests withdrawal within 30 days. If no action is taken, the plan stays unless changes in the law make withdrawal possible. Generally, the plan can be withdrawn on the plan's renewal date or if laws or worker contributions change, provided 30 days' notice is given. Insurers must update policies if ownership changes unless the plan is withdrawn. Plans can also be amended to match new legal requirements if they aren't withdrawn in time.
Section § 3255
This law allows workers who typically work for multiple employers in the same industry to set up a voluntary disability benefits plan. An appointed agent or most of the workers can apply for this plan if their wages are centrally managed. The Director of Employment Development will approve such a plan if it meets certain conditions.
The plan should give better rights than typical state-provided benefits and cover all employees paid through the central system. It requires the consent of 75% of regularly paid workers, agreement from all participating employers, and approval from the Insurance Commissioner if insurance is involved. The plan must include new employees and have a minimum duration of one year, continuing unless withdrawn with proper notice.
The plan must conform to any legal changes in benefits or contributions promptly, and workers' wage deductions cannot increase except on plan anniversaries unless legally permittable. The plan should not adversely affect the Disability Fund's risk profile.
Section § 3256
This section permits an employer, or their designated agent, to make payroll deductions according to an approved plan for all jobs that are part of that plan. This can only happen while the plan is active and approved under a specific earlier section.
Section § 3257
This law explains how an employer can make a benefits plan applicable to its employees. If 85% of employees eligible for a plan agree to it, the employer can choose to apply it to everyone except those who turn it down. Once consent is obtained, a notice must be filed with the Director of Employment Development specifying when the plan will begin. Employees have a chance to reject the plan by notifying their employer in writing within a certain timeframe. New hires are automatically assumed to agree to the plan unless they reject it upon hiring. Employees can also opt-out at the start of any calendar quarter if they inform their employer in writing. All necessary notices and forms must be approved by the Director of Employment Development.
Section § 3258
This section explains that if a business has a voluntary disability benefits plan not covered by an insurance company, the state must ensure the employer can afford to pay its obligations. To approve the plan, the employer has to either: provide a bond from a surety company, deposit approved securities, or give an irrevocable letter of credit. The amount needed is calculated based on a specific formula involving worker contributions and taxable wages. Once approved, any financial guarantees (bonds, money, or securities) are kept safe by the state Treasurer.
Section § 3259
If an employer's voluntary plan is covered by a licensed disability insurance company, that insurer takes the employer's place for any financial assessments related to the insured part of the plan.
Section § 3260
This law section allows an employer to choose whether to cover the full or part of the cost of a disability benefits plan for employees. If the employer decides not to cover the full cost, they can deduct a certain amount from the employee's wages. However, this deduction cannot be more than what would be required by specific sections of the law if the employee wasn't covered by the plan.
Section § 3260.5
This law outlines what happens to extra wages deducted from employees when a company withdraws its voluntary disability plan due to excess contributions. These extra funds must go to the state's Disability Fund. If the employer doesn't send the money to the fund, they will be charged.
It uses existing rules for assessing and collecting contributions but gives employers 30 days after receiving the notice of assessment before interest starts to accrue.
If there's a change in wage limits or tax rates at the start of a new year, deductions can increase without needing further approval, as long as the change is effective from January 1. This allows coverage to adapt to tax changes seamlessly.
Section § 3261
This law specifies that any employee contributions or income from a voluntary plan that an employer manages are considered trust funds, not part of the employer’s assets. Employers must keep these funds in a separate account or send them directly to a disability insurer. If funds are invested in securities, they must be in a distinct account. If these trust funds are mixed with other funds, or if the employer goes bankrupt or insolvent, or a receiver is appointed, those trust funds get the same priority as certain state claims.
Section § 3262
This law allows the Director of Employment Development to end a voluntary unemployment insurance plan if there is a risk that benefits won't be paid, the security is insufficient, or other issues arise. The director must notify relevant parties and can adjust the termination date. Once a plan is terminated, all funds associated with it—paid by employers or employees and any accrued interest—are transferred to the Disability Fund. If an employer fails to send owed funds, the director can charge them an amount equal to what they owe. Rules concerning these assessments are specified, with interest starting 30 days after assessment notice. Parties involved have 10 days to appeal the decision, which can be extended for valid reasons. Benefits from the fund must continue during an appeal about plan termination.
Section § 3263
If an employee's disability occurs after they've left a job with a voluntary disability plan, or if the plan is terminated by authorities, they are no longer covered by that plan.
In such cases, the employee, if eligible, can switch to receiving benefits from the general Disability Fund immediately, just as if they had been contributing to it all along.
Section § 3264
If an employee's claim for disability benefits is denied by their employer or insurer, the employee can appeal, following specific legal procedures. Any decision denying benefits can be challenged in court, but only after all administrative options are used. Before going to court, the employee must follow all the steps provided by the law and regulations.
Section § 3265
If an employee wins an appeal for disability benefits under a voluntary plan, and the employer or insurer doesn't pay within 15 days of the decision, the director will step in to pay and then charge the employer or insurer for the amount paid. These amounts are collected and put into the Disability Fund.
If a law increases benefit amounts and the employer or insurer does not pay the difference under an ongoing voluntary plan, the director will pay the employee the increase, charge the employer or insurer, and deposit the collected amounts into the Disability Fund.
Section § 3266
This section explains that a government official is responsible for figuring out how much money from refunds and credits can be attributed to voluntary plans tied with wage deductions. This calculation is based on comparing wages that were subject to contributions to the Disability Fund with wages that were not, during the previous year.
Section § 3267
Section § 3268
The Director of Employment Development must quickly provide employers, employees, or insurers with the necessary information to manage an approved voluntary plan, following the official regulations.
Section § 3269
The director is responsible for calculating the total costs each year for the additional administrative tasks that come from voluntary plans, following the rules they have been authorized to set.
Section § 3270
This law states that certain provisions concerning how risks that negatively affect the Disability Fund are selected became effective on January 1, 1962. These provisions are found in specific subdivisions of Sections 3254 and 3255.
Section § 3271
This section explains how amendments to a voluntary plan can be approved. The director must ensure the amended plan meets specific standards and one of three conditions must be met: (1) a majority of employees consent in writing, (2) all adversely affected employees consent in writing, or (3) the plan's insurer confirms that proper notice was given to the employees about their rights to withdraw. Additionally, the director can create supplementary regulations regarding these requirements.
Section § 3272
This law states that specific rules from another article apply to money collected under certain sections, money given to the Disability Fund, and payments made to employees after a final appeal decision that confirms they are entitled to disability benefits.