DOL and Unum reach group life eligibility settlement
The deal, which is similar to those with three other insurers, limits use of retroactive insurability checks to 90 days.
A new deal between the U.S. Department of Labor and a Unum subsidiary could reduce workers’ confusion over whether they really have group life insurance.
The department negotiated a settlement with the subsidiary, Unum Life Insurance Company of America, over how Unum Life handles verification of whether group life insureds are eligible for coverage.
Unum Life has been collecting premiums on behalf of workers starting from the time when the workers sign up for coverage.
In some cases, if a worker died, Unum Life could review the records for evidence that the worker was eligible for coverage, then determine that the worker who died had no coverage because of the lack of evidence of insurability.
In other cases, Labor Department officials said, Unum Life would provide life insurance for dependents without evidence of insurability. If the dependent died within two years after enrollment, and Unum Life investigated and found the dependent was disabled at the time of enrolment, Unum Life would deny coverage, saying the effective data of coverage was delayed.
The new DOL agreement applies to workers in group life plans covered by the Employee Retirement Income Security Act.
The agreement limits the period when Unum Life can deny claims related to the deaths of ERISA plan insureds solely due to lack of evidence of insurability to 90 days.
Unum Life has also agreed to do more to make workers aware of the possibility that insurability verification rules for dependents could lead to delays in when the coverage for the dependents really starts.
Unum Life told the Labor Department it will voluntarily re-process claim denials based on lack of evidence of insurability from Jan. 1, 2018, to the present and denials based on the delayed effective date provision from July 1, 2016, to the present, officials said.
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The Labor Department has reached similar agreements in the past two years with life insurance subsidiaries of Prudential Financial, Mutual of Omaha and Lincoln Financial,
The department is hoping the new settlement will have an influence on other group life issuers.
“While Unum is changing its practices, we urge all insurers to examine their practices to ensure that they aren’t engaged in similar conduct,” ” said Carol Hamilton, a regional director with the Labor Department’s Employee Benefits Security Administration.