Health insurance during FMLA leave: How to comply.


FMLA regulations say that if employees are provided group health insurance, they are entitled to the continuation of the group coverage during FMLA leave on the same terms as if they had continued to work. If family coverage is provided to an employee, family coverage must be maintained during the FMLA leave, as well.

Also, the same services your group plan provides to on-the-job employees must be available to those on FMLA leave. So if you change coverage while the employee is on leave, the new benefits must be available to FMLA leave-takers.

Employees can also choose to forgo health coverage during leave, perhaps to avoid paying their share of the premiums. But if they pause coverage, you must reinstate them on the same terms without any qualifying period or exam.

No free ride on premiums

Employees on FMLA leave do not get a free health insurance ride. If the employee paid part of the health insurance cost while working, he must continue to do so while on FMLA leave. If premiums are raised for all workers, on-leave employees are required to pay the new premium too. Payments by those on leave can be made directly to you or to the insurance carrier.

What happens if an employee on leave does not pay his premiums? If payments are 30 days late, you can terminate coverage. However, you still have to take him back on the plan at the end of his leave and restore coverage and benefits to their former status (without a waiting period or exam).

But you can't just cut...

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