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Calculating Partial Benefits

Calculating Partial Benefits. Problems and Solutions. Problem 1:. Alice was injured 5/3/10. Her AWW is $693 and her filing status is “married/joint” with two dependents. Her employer’s payroll week runs from Sunday through Saturday.

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Calculating Partial Benefits

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  1. Calculating Partial Benefits Problems and Solutions

  2. Problem 1: Alice was injured 5/3/10. Her AWW is $693 and her filing status is “married/joint” with two dependents. Her employer’s payroll week runs from Sunday through Saturday. She was unable to work as of 5/4/10 and you paid her TTD until you learned that she returned to light-duty work on 5/26/10 (Wednesday). • She earned $500 for the week ending 5/29/10. How much will you pay her for that week?

  3. Problem 1 (Alice)AWW $693/Comp Rate $482.39 A. TTD 5/23 through 5/25 = 3 days @ $482.39 = $206.74 TPD W/E 5/29: $500 (Earnings)/$361.34 (Comp Rate) Compare Comp Rates to determine “TPD due”: $482.39 - $361.34 = $121.05 Calculate offset for TTD benefits already paid (for 5/23/09 – 5/25/10): 3 days @ $482.39 = $206.74 Apply offset to “TPD due”: $121.05 - $206.74 = $000.00 ________ Benefits Due W/E 5/29/10: $206.74

  4. Problem 2: Carol was injured 3/09/10. Her AWW is $1230 and her filing status is “single” with no dependents. Her employer’s payroll week runs from Monday to Sunday. She was unable to work as of 3/10/10 and you paid her the maximum rate ($616.74) until she returned to light-duty work on 4/19/10. • She earned $100 for the week ending 4/25/10. How much will you pay her for that week? • She earned $1000 for the week ending 5/2/10. How much will you pay her for that week?

  5. Problem 2 (Carol)AWW $1200/Comp Rate $695.34Max effective 7/1/09 = $616.74 • TPD W/E 4/25: $100 (Earnings)/$73.88 (Comp Rate) Compare Comp Rates to determine “TPD due”: $695.34 - $73.88 = $621.46 (cap @ $616.74) = $616.74 • TPD W/E 5/2: $1000 (Earnings)/$587.05 (Comp Rate) Compare Comp Rates to determine “TPD due”: $695.34 - $587.05 = $108.29

  6. Problem 3 Bill was injured 1/12/10. His AWW is $775 and his filing status is “married/joint” with four dependents. The weekly value of his fringe benefits, as of 1/12/10, was $250. His employer stopped paying his fringe benefits, effective 3/13/10. (The SAWW effective 7/1/09 is $685.27.) His employer’s payroll week runs from Saturday through Friday. He was unable to work as of 1/13/10 and you paid him TTD until he returned to light-duty work on 4/5/10 (Monday). • What is the 80% net rate (from the Weekly Benefit Table) for his AWW without fringe benefits? • AWW $775/Comp Rate $548.63 • What is the 80% net rate (from the Weekly Benefit Table) for his AWW with fringe benefits? • AWW w/fringes $1025/Comp Rate $695.37 • If fringe benefits are included in Bill’s AWW, his weekly benefit cannot exceed what amount? • SAWW effective 7/1/09 = $685.27 (2/3 = $456.85) • What was his TTD rate as of 3/13/10? • TTD rate as of 3/13/10: $548.63

  7. Problem 3 (Bill)E. He earned $100 for the week ending 4/09/10. How much will you pay him for that week? TTD 4/3/10 through 4/4/10 = 2 days @ $548.63 = $156.75 TPD W/E 4/9/10: $100 (Earnings)/$73.88 (Comp Rate) Compare Comp Rates to determine “TPD due” (choose greater product): $548.63 - $73.88 = $474.75 $695.37 - $73.88 = $621.49 (cap @ $456.85) Calculate offset for TTD benefits already paid (for 4/3-4/4/10): 2 days @ $548.63 = $156.75 Apply offset to “TPD due”: $474.75 - $156.75 = $318.00 __________ Benefits Due W/E 4/9/10 $474.75

  8. Problem 3 (Bill)F. He earned $200 for the week ending 4/16/10. How much will you pay him for that week? TPD W/E 4/16/10: $200 (Earnings)/$147.76 (Comp Rate) Compare Comp Rates to determine “TPD due” (choose greater product): $548.63 - $147.76 = $400.87 $695.37 - $147.76 = $547.61 (cap @ $456.85) __________ Benefits Due W/E 4/17/10 $456.85

  9. Problem 4 Don was injured 4/7/10. His AWW is $1500 and his filing status is “single” with no dependents. His employer’s payroll week runs from Monday to Sunday. He was unable to work as of 4/8/10 and you paid him the maximum rate ($616.74) until you learned that he began receiving weekly Unemployment benefits in the amount of $150 on 5/21/10. • How much will you pay him for the week ending 5/23/10? • $616.74 (“TTD due”) - $150.00 (Unemployment benefit) = $466.74 (weekly benefit after Unemployment offset)

  10. Problem 5 Ellen was injured 2/10/10. Her AWW is $780 and her filing status is “head of household” with two dependents. Her employer’s payroll week runs from Sunday to Saturday. She has been unable to work since 2/11/10 and you have been paying her benefits weekly on Wednesdays. (Each payment covered the most recent Thursday through Wednesday period.) Today is Friday, and you just learned that Ellen returned to light-duty work on Monday (four days ago). • How will you transition your payments from “total” to “partial”?

  11. Problem 5 (Ellen) Your next Wednesday payment should cover partial benefits for the week ending tomorrow (Saturday), and your calculations for that payment should be based on her earnings for the payroll week that ends tomorrow (Saturday). Don’t forget to take an offset for the “total” benefits that you already paid (for Sunday through Wednesday).

  12. Problem 5 (Ellen) (example) AWW $780/Comp Rate $519.64 TPD W/E Saturday (tomorrow): $200 (Earnings)/$147.76 (Comp Rate) Compare Comp Rates to determine “TPD due”: $519.64 - $147.76 = $371.88 Calculate offset for TTD benefits already paid (for Sunday through Wednesday): 4 days @ $519.64 = $296.94 Apply offset to “TPD due”: $371.88 - $296.94 = $74.94 Pay $74.94 next Wednesday. All future Wednesday payments will now be in synch with the employer’s payroll (Sunday to Saturday).

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