Connecticut Board of Paid Leave says backlog of claims cleared – Boston News, Weather, Sports

The Connecticut Paid Leave Authority and insurer Aflac announced Thursday that they have cleared a claims backlog caused in part by the COVID-19 Omicron variant and are taking steps to reduce future wait times.

The boy paid leave program, which began providing income replacement benefits to eligible workers in January, is administered by Aflac. The new employees were quickly inundated with claims for benefits when omicron arrived in Connecticut in January and February, with more than 10,000 claims filed in a month, officials said at a news conference.

Some applicants have had to wait up to six weeks or more for a decision on whether to receive the financial assistance, prompting Aflac to allocate more staff, technology and other investments.

“It took some time to work your way through this pool. But as of the 9th it has been fully resolved and now we are only dealing with pending applications that are 30 days before the holiday or less,” said Andrea Barton Reeves, the agency’s executive director, who apologized to families for the delays experienced.

Scott Beeman, Aflac’s senior vice president of Premier Life, Absence and Disability Solutions, acknowledged that there was a “learning curve” for everyone involved in the early months of the program that was exacerbated by the omicron variant.

“Our brand new Connecticut-based team struggled with the same pandemic as individuals and as heads of families while administering a new program,” Beeman said. “They were immediately challenged by their own learning curve and dealing with a high volume of recall request requests.”

While the system is expected to always have a backlog of applications as it goes through the review process, Beeman estimated the “extra” backlog was about 4,000 applications.

Ultimately, according to John Simonetti, a compliance specialist for the agency, about 85% of COVID-related applications were denied because they did not meet criteria for a serious medical condition. Just being exposed to COVID-19 or even being diagnosed with COVID-19 is not necessarily a serious health condition that would make someone eligible for financial assistance.

For COVID to be considered a serious medical condition, applicants must provide medical documentation showing their COVID diagnosis required, among other things, an overnight stay in a hospital or rendered them incapacitated for more than three consecutive days, according to the agency’s website.

The state paid leave program, funded entirely by employees through a 0.5% wage deduction, provides benefits for specific reasons, including caring for one’s own or a family member’s critical medical condition; connect with a new child; to address issues arising from domestic violence; and to care for a military family member injured while active federal service or to resolve issues arising from a parent, spouse, or child’s call to active federal military service.

The amount of income replacement is based on an employee’s earnings and is capped at $780 per week. The average claim amount so far has been about $560 a week, Barton Reeves said. To date, more than 44,000 claims have been submitted and over $86 million in benefits have been awarded.

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Nate Jones

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