Health Benifits while out on Workers Comp.

Please Help

We have an employee that was out of work on a back injury from 9/01 through 4/02 during which time we paid not only the employees full health insurance benefits including employee portion but his voluntary insurance as well. The employee was released to come back to work on modified light duty in Mid April and we had this employee doing only the most sedentary work. When the EE returned to duty we were deducting a small amount each week for their pay to pay back the employee portion of health insurance and voluntary Insurance to the company.

The employee has again been taken out of work by his Doctor for what is described as a deteriorating back condition. And we have doubts as to wether the EE will ever be able to return to work. My question is because we do not want to fire or lay off an employee while on a questionable workers comp claim are we required continue to pay all or just the employer portion of health insurance benefits or can we send a COBRA notice to employee. I believe the employer is still responsible for their portion in the State of Tennessee while an EE is on Comp but not the employee’s portion, and if the employee fails to pay their portion does it fall under COBRA thereby terminating benifits.

Comments

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  • This issue has come up in other posts. You may want to do a search.

    COBRA can be used (and should be used) for reduced hours. It isn't just for termination. My concern is how you have treated other folks in the past. This is one area that cries out for a consistent policy.

    In our state, we make ees pay for their share of all health premiums while they are off work for any reason, including work comp. If they are out more than 12 weeks, we shift them to COBRA. Our health insurance contract won't allow us to carry someone more than 12 weeks on the policy if they are not "actively at work." Many employers forget to read that fine print in their insurance contracts...Insurance carrier could perceive fraud when you fail to notify them that an ee has reduced hours after that 12 week threshhold. Be sure to check your contracts as you draft your policy accordingly.


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