How to file a claim

Claims should be filed with the claims administrator
control room

COVID-19 Extension for Filing Claims and Appeals

Due to the COVID-19 Pandemic and Declaration of National Emergency, the US Departments of Labor (DOL) and Treasury/IRS have provided revised guidance that extends deadlines related to filing claims and appeals under ERISA plans. The guidance states that every affected individual gets an extension to take actions based on when their claims event occurred. This extension applies to the following deadlines discussed in this claims section:
  • Filing a claim;
  • Appealing a claim denial;
  • Requesting an external review; and
  • Filing information needed to complete/perfect an external review request.
The extension pauses the deadline to take the above actions until the “Outbreak Period” for that individual is over. For each claims event, the Outbreak Period ends on the earlier of:
  • One year after the period starts for that event; or
  • 60 days after the Declaration of National Emergency ends. (The Declaration was recently extended and is still ongoing.)
Essentially, the claims and appeals deadlines for the actions listed above are extended (delayed) until the earlier of one year after the Outbreak Period starts for that event, or 60 days after the emergency declaration ends. The normal deadlines then apply. Here is an example:

Assume the National Emergency does not end until November 30, 2022. Kendrick submits a claim on August 1, 2021. The claim is denied on August 5, 2021. Under the plan, Kendrick would normally have 180 days to appeal the claim. However, Kendrick’s Outbreak Period for his appeal does not start until he receives his claims denial. Kendrick’s Outbreak Period will end on August 4, 2022. He will have 180 days after that to submit his appeal.

The rules for these extensions are complex and subject to change. Please contact the bp Benefits Center for assistance. However, since the end of the extension period is currently unknown, please do not delay submitting your claim or appeal in a timely manner.

When you suffer a disability that is expected to continue for more than six months, you must notify:

  • Your supervisor immediately.
  • New York Life during the fourth month of your disability by:
    • Calling 1-800-362-4462.
    • Submitting your claim online at https://mycigna.com. Register (or login if you already have an account), select Disability under "Coverage," and then submit your claim.

A New York Life representative will handle your claim for benefits over the phone. After you provide your basic medical and employment information to the New York Life representative, you will be assigned a case manager to help you through the LTD benefits claim-filing process.

You must provide New York Life with proof of disability within 180 days of the date your disability begins. If you miss this deadline, your claim for benefits may still be considered if it can be shown that proof of disability was provided as soon as reasonably possible. New York Life will not consider any proof of disability provided more than one year after the end of the 180-day period. These time limits do not apply if you lack the legal capacity to make the claim for benefits. 

New York Life will determine whether the proof of disability you have provided substantiates your inability to perform the duties of your job as performed at bp. Periodically, New York Life may ask you to provide additional proof that you are still disabled. New York Life may also ask you to be examined by a doctor who is designated by New York Life. 

As often as it may reasonably require, New York Life has the right to examine any person, at its own expense, for whom a claim for benefits is pending or approved.

Because bp pays the full cost of your basic LTD coverage, benefit payments are considered taxable income and are subject to federal and state income taxes. Withholding is not mandatory. To have these taxes withheld from your LTD payments, submit a W-4S form (federal) and a state income tax voluntary withholding request form to New York Life. Call the bp benefits center to request these forms and New York Life for instructions on submitting them.


Need help with claims issues?

The Advocacy Service is available to help you with issues regarding claims and appeals.

You must make at least one attempt to contact and resolve your issues directly with the appropriate claims administrator before contacting the Advocacy Service. To reach the Advocacy Service, call the bp benefits center.

Keep in mind that your issues may not necessarily be resolved in your favor, as the terms of the plan will apply in all situations.

 

Publication date: April 2021

 

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