How to File a Claim Guide

1-888-673-9940
Policy #: 914587
www.unum.com

Short-term disability information and checklist

Optional: You are not required to have state and federal taxes taken out of your disability payments. UNUM will send you an income tax form at the end of the year. 

If you choose to have taxes withheld, complete the tax forms below and fax to UNUM.

Fax: 800-447-2498

• MI-W4 Tax Form
• 2024 W-4S Tax Form

Optional: You are not required to supplement; however, it is recommended that you use your leave banks to supplement your disability payments while you are off to reduce your contributions that are unpaid during disability.

Any unpaid healthcare contributions from the time of your short-term disability will be taken out of your County paycheck(s) immediately upon your return to work (Merit Rule 22.2.3.8).

• Supplement Form

All Full-Time Employees in active employment in the United States with the Employer, excluding Elected Official and Plan B Employees.

Long Term Disability Fringe Benefits

As health care costs continue to rise, many people have trouble paying medical expenses that insurance doesn’t cover. Luckily, Unum's EAP — with the Medical Bill Saver feature — can help.

How does it work?

When a covered employee has a medical or dental bill totaling over $400 in out-of-pocket costs, Unum's skilled negotiating team works with the provider(s) to get a discount. Successful negotiations can save employees hundreds, and sometimes thousands, of dollars.

Unum's experts can also show employees how to keep bills lower in the future — for example, by using in-network providers.

By helping reduce employees’ out-of-pocket-costs, Medical Bill Saver can make consumer-driven health plans (CDHPs) more attractive — and more effective.

Medical Bill Saver Flyer

if you experienced a medical emergency while traveling, would you know whom to call?

Whenever you travel 100 miles or more from home — to another country or just another city — be sure to pack your worldwide emergency travel assistance phone number. Travel assistance speaks your language, helping you locate hospitals, embassies and other “unexpected” travel destinations. Add the number to your cell phone contacts, so it’s always close at hand. Just one phone call connects you and your family to medical and other important services 24 hours a day.

Use your travel assistance phone number to access the following:

• Hospital admission assistance
• Emergency medical evacuation
• Prescription replacement assistance
• Transportation for a friend or family member to join a hospitalized patient
• Care and transport of unattended minor children
• Assistance with the return of a vehicle
• Emergency message services
• Critical care monitoring
• Emergency trauma counseling
• Referrals to Western-trained, English-speaking medical providers
• Legal and interpreter referrals
• Passport replacement assistance

Travel Assistance Program