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PROUDLY SERVING UTAH
PUBLIC EMPLOYEES

Trust • Commitment • Value • Innovation • Excellence

Members

Utah depends on its public employees, and they depend on PEHP.

  • Using Your Benefits
    • Using Your Benefits
    • Preauthorization
    • Member ID Card
    • Appeals
    • FLEX$
    • COB
    • Save With an HSA
    • Long-Term Disability
    • PEHPplus
    • Health Insurance Basics
  • Your Network and Your Money
    • Your Network
    • In-Network Rate
    • Balance Billing
    • Out-of-Network Benefits
  • Prescription Drug Benefit
    • Prescription Drug Benefit
    • Express Scripts Home Delivery
    • Preauthorization
    • Specialty Medications
    • Covered Drug List
    • Common Pharmacy Questions
    • Locate a Pharmacy
    • Coordination of Benefits (COB)
    • Medicare Part D
    • Forms
    • Prescription Assistance Programs
    • Pharmacy Tourism Program
  • PEHP Value Providers
    • Overview
    • PEHP Value Clinics
    • Prescription Assistance Programs
    • Laboratory
    • Radiology
    • Ambulatory Surgical Center
    • Colonoscopy
    • Intermountain Connect Care
  • Preventive Services
    • Preventive Overview
    • Preventive: Why Am I Being Charged?
  • PEHP Wellness
    • PEHP Wellness
    • PEHP Healthy Utah
    • PEHP WeeCare
    • PEHP Health Coaching
    • PEHP Integrated Care
    • PEHP Quit Line
    • Resources for Diabetes
    • #LiveShareInspire Videos
    • myWellness Tracker
    • Wellness Resources
  • Publications
    • Publications
  • Appeals
    • Claims Appeal Process
    • Appeal Filing Form
    • Authorized Representative Form
    • External Review Request Form (Records Release Consent Form)

LTD Tier 2 Firefighter

LTD provides two-thirds of your regular monthly salary for accidental bodily injury, disease, or illness if you are unable to perform your regular firefighter job. If you are injured by external force or violence while performing your firefighter job, you may be eligible to receive 100% of your regular salary.

After two years on LTD you may be eligible to continue receiving LTD if you are unable to perform any gainful employment as defined by Title 49.

For disabilities caused by psychiatric illness, benefits are limited to the first initial 24 months unless institutionalized.

Volunteer Firefighters » Volunteer firefighters who began duty on or after July 1, 2011, may be eligible for PEHP Long-Term Disability benefits. The benefit is limited to line-of-duty injury and is 50% of the lowest monthly compensation of a firefighter of a city of the first class in Utah. You must meet specific criteria to be eligible. For more detailed information, contact PEHP Long-Term Disability at 801-366-7583 or 800-365-7347 or see Utah Code Title 49 at sections 16, 21 and 23.

» See Brochure

The LTD Program is established by Title 49 of Utah Code at 49-21-101. The information here provides a general description of benefits provided and is for informational purposes only. No error, misrepresentation or ambiguity in this information creates any rights or benefits not expressly granted by Utah Code Title 49.


Is there time limit for me to apply for LTD benefits?

You must apply for LTD benefits within six months from your last full-duty day worked in your firefighter job.


Do I accrue Utah Retirement Systems years of service toward retirement while on LTD?

You may accrue years of service while on LTD if your employer has signed a retirement “benefit protection contract” and pays the required retirement contributions while you are on LTD. Your employer or URS can tell you if you are eligible for this benefit.


What is “enough years of service to retire” above?

25 firefighter (public safety) years.


What happens to my PEHP health benefits (medical, dental and vision) while I am on LTD?

Your employer can tell you when your employer-sponsored health plans will end. PEHP will mail you a Notice of COBRA Rights and letters of creditable coverage when your employer-sponsored coverage ends.


What is the number I call if I have any questions or want to apply?

The phone numbers to call are: Local: 801- 366-7583 Toll Free: 1- 800-365-7347.


Where do I send my claim forms and other required information?

PEHP LTD
560 East 200 South
Salt Lake City, UT 84102-2004


How long can I receive LTD benefits?

As long as you remain disabled except as noted below, if you are unable to perform your full-duty firefighter job, you may remain on disability benefits up to 24 months. At that time, you can apply for ongoing benefits if you cannot perform any gainful employment based on objective medical disability and defined in Title 49. As long as you meet the disability requirements you can remain on LTD until you reach age 65 or have enough years of service toward retirement to retire (25 years), whichever occurs first.

If you become disabled at or after age 60, LTD is payable as follows (unless you accrue enough years of service toward retirement to retire first):

  • Age 60 or 61 > Five years
  • Age 62 or 63 > Four years
  • Age 64 or 65 > Three years
  • Age 66, 67 or 68 > Two years
  • Age 69 years or older > One year


How does other income affect my LTD benefits?

LTD benefits are reduced dollar for dollar by any amount received by or payable from sources such as Social Security, workers' compensation, unemployment compensation and third-party payments that you receive for your disability, such as legal settlements, etc. Other benefits such as employer sponsored retirement (non URS) and disability payments for the same disability may also reduce the LTD benefit.


If you receive sick/vacation, administrative, etc. pay from your employer after the LTD effective date your LTD benefit shall be reduced dollar for dollar by the amount received for the same period of time.

You may participate in rehabilitative employment while on LTD. The monthly LTD benefit shall be reduced by 50% of the income you earn during the month from working. This part of your LTD benefit has specific requirements such as pre-approval, time limits and a review of the job duties.


Do I have to apply for Social Security Disability Insurance (SSDI)?

The LTD department will determine if you should apply for Social Security Disability Insurance depending on your disabling condition. You will be informed of any requirement and the process to apply.


Are the benefits I receive from LTD taxable?

Yes. LTD benefits are subject to state and federal income taxes.


If I am approved for LTD, when will I start receiving a monthly income?

There is a three month elimination period for which NO LTD WAGE BENEFITS WILL BE PAID. The elimination period begins the day after your last day of full-duty work in your firefighter job and for LTD payment purposes begins on the nearest first day of the month. Sometimes this period is called a waiting period.


If you are approved for LTD, your monthly LTD check will be paid to you once per month on the last working day of each month.


If I am approved for LTD, how much is my LTD benefit?

LTD provides two-thirds of your regular monthly salary.

If you are injured by external force or violence while performing your job, you may be eligible to receive 100% of your regular salary. This line-of-duty benefit requires disability, as a result of outside force or violence and is subject to applicable board resolutions and Title 49.


How does PEHP LTD confirm I am disabled?

We must be able to confirm your disability and impairment with objective medical documentation. This means you have an injury or illness which is diagnosed by a doctor and which is based on objective medical tests or findings rather than subjective complaints. We obtain this information by reviewing medical records from your healthcare providers.  Sometimes we pay for examinations by a doctor for our analysis.

While on LTD, you must be under the care and treatment of a doctor or your benefits may end.

If you recover from your illness or injury and become ineligible for the benefit, your LTD benefits will be terminated.


Is there a pre-existing condition limitation?

Yes. Medical or psychiatric conditions which existed prior to eligibility may not be a basis for LTD benefits until you have had one year of continuous eligibility in an LTD Program.


How do I apply for LTD benefits?

To apply please call PEHP LTD at 801-366-7583 or toll free 1-800-365-7347. A phone interview will occur and then you will be mailed an application and other forms that require your signature.


When should I apply for LTD benefits?

You can only apply for LTD benefits if you are unable to perform your full-duty firefighter job and have a last full-duty day of work in your firefighter job. In some cases you may be performing a temporary transitional assignment or a job with restrictions. In these cases you should immediately contact LTD to discuss your claim and your eligibility to apply.


We encourage you to apply as soon as you stop working full-duty as a firefighter and before six months elapses from your last full-duty day working in your full-duty firefighter job.


Who pays for my LTD benefit?

This benefit is provided and paid for by your employer.


Do I need to enroll in LTD?

If you are eligible, your enrollment is automatic and you do not need to complete an enrollment form.


How do I know if I am eligible for LTD?

Contact our office to confirm your eligibility. Generally PEHP LTD eligible firefighters were hired on or after July 1, 2011, work at least 2080 hours per year, are trained in firefighter techniques and employed by a participating employer under Utah Code Title 49.  The PEHP LTD Department can help determine your eligibility or you may refer to Title 49 at §49-21-102 and §49-23-102.

Volunteer firefighters who began volunteering on or after 7-1-11 may be eligible for PEHP Long term disability benefits.   The benefit is limited to line-of-duty injury and is 50% of the lowest monthly compensation of a firefighter of a city of the first class in Utah.  Specific criteria must be met to be eligible for the benefit.  For more detailed information about this benefit contact PEHP Long Term Disability at 801-366-7583 or 800-365-7347 or refer to Utah Code Title 49 at sections 16, 21 and 23.

PEHP Lighten Up

Join our FREE online weight management class developed by PEHP Registered Dietitians. PEHP Lighten Up is an eight-week, web-based course that is held multiple times throughout the year. Learn more about the class and reserve your spot here.

On-Demand Doctors

Intermountain Connect Care offers convenience and savings to all PEHP members with live, on-demand doctor visits online or by phone.

PEHPplus

PEHPplus provides savings of up to 60% on a wide assortment of healthy lifestyle products and services.

PEHP Healthy Utah

Access PEHP Healthy Utah. Make sure you and your spouse create your individual PEHP for Members accounts at www.pehp.org to schedule your testing session, see results, and to apply for rebates. Learn more

 

PEHP Healthy Utah

Access PEHP Healthy Utah. Make sure you and your spouse create your individual PEHP for Members accounts at www.pehp.org to schedule your testing session, see results, and to apply for rebates. Learn more

Find a Provider

Search for doctors, clinics, and hospitals in your network at the PEHP Provider Search. Find a Provider

On-Demand Doctors

Intermountain Connect Care offers convenience and savings to all PEHP members with live, on-demand doctor visits online or by phone.

PEHP Healthy Utah

Access PEHP Healthy Utah. Make sure you and your spouse create your individual PEHP for Members accounts at www.pehp.org to schedule your testing session, see results, and to apply for rebates. Learn more

Find a Provider

Search for doctors, clinics, and hospitals in your network at the PEHP Provider Search. Find a Provider

On-Demand Doctors

Intermountain Connect Care offers convenience and savings to all PEHP members with live, on-demand doctor visits online or by phone.


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