Ins benefits during LoA, WC, and FMLA

denjen

We are looking at changing our policy for persons on Leave of Absence, Workman's Comp and FMLA. We currently continue to pay our share of their health, dental, STD premiums while out. Are we obligated to do this? If not, can we offer to pay for some ee and not others? Can we offer a reimbursement of the premiums as an insentive to return to work?

LindaS

In absence of state laws requiring the continuation of benefits during WC absences, the following is what you are required to do...

When EEs are off work on FMLA absences you are required to continue their group insurance while they are off work but you can require them to pay their portion (the portion they would pay if they are working). If they do not pay their portion you can terminate their coverage but there are notification requirements that need to be met. This would also apply if they are off work due to a WC injury that also qualifies under FMLA (if you run both together - recommended).

As for some other type of LOA, you are not required to maintain their benefits but they are then offered COBRA coverage.

As for doing for one group and not the other, no you do not have a choice as long as it is FMLA. Outside of that, it is your decision.

Does this answer your questions?

denjen

Yes it does. Thank you.
Just to be clear.
FMLA: everything continues as before, it at least has an ending date.
WC: A new ee (not qualifying for FMLA but is on the health plan) is on WC, we don't need to pay or continue their ins? Valuable ee can be offered continued health ins benefits for LoA or WC; and those not working up to the standards we want to see, we could offer COBRA or have them pay the er share as well as the ee share of the premium.
Right?
Does Exempt or non exempt play into this at all?
Thank you for sharing your knowledge.

NaeNae55

You have your facts straight, but I would not go that route. What if the valuable employee is a young white male and the one less valuable is an older black female? You are setting yourself up for trouble.

Be consistant with set rules. For instance, no one gets benefits if they do not qualify for FMLA. It doesn't matter who they are or what they do. When FMLA runs out, so do the benefits. Or, everyone gets benefits once they qualify for FMLA, even after it runs out. It is your choice to cover whatever you want (keeping in mind you are setting a precedent). As soon as you put subjectivity into the mix (valuable employee) you are bound to get sued sooner or later. I highly recommend that you leave it out.

Good luck!

Nae

LindaS

Have to agree with NaeNae. While you have the lega right to do as you have suggested, bringing that type of subjectivity into the mix will only create problems down the road. Not something I would ever suggest doing.