Sick Employee out almost 2 months - How long does Company have to carry health insurance ? Forever

cebudragonlady

An employee in our factory, at first took 3 weeks unpaid vaction. Then
he called in sick, and said he had some form of Hepititis. I told him that he had to have a doctor clearance before returning to work. He calls and says he will be in on such and such a day...and never comes in, then he calls again and the says it again for another day for his return, and so forth. We haven't seen this employee for almost two months. In the meantime, we have continued his health insurance -for which he is supposed to pay 50% according to our policy. He has paid nothing during his absence.Obviously, this can't go on forever.What should we do ?

bsa

[font size="1" color="#FF0000"]LAST EDITED ON 05-15-02 AT 03:50PM (CST)[/font][p]QUESTIONS??
1. Do you have 50 employees, FMLA qualified?
2. Is the employee qualified for FMLA (1250 hours/1 year employment)?

If you answered "no" to either question -- send a letter of termination for failure to return to work as scheduled and COBRA notification.

If you answered "yes" to both questions -- mail him a "request for FML", already approved including insurance payment information, with a deadline to return the enclosed medical certification. You can access the DOL .pdf forms (WH-381 & WH-380) in the DOL website. If you don't get a response by your deadline, send a letter of termination for failure to return to work as scheduled and COBRA notification.

Carol CA

I agree that you need to take this in hand. Check on FMLA because you may need to provide the 12 weeks of leave. However, regardless as to whether or not he qualifies for FMLA, he still needs to pay his portion of the medical insurance. Failure to do so will result in termination of coverage.

cebudragonlady

Update: I told the General Manger we have to send a letter by Monday. This employee unexpectedly showed up for work yesterday with a doctor's clearance, agreed to pay the unpaid premiums, and did work. However, when other employees were also leaving at the end of the day, the other employees found this employee passed out in the parking lot in his car ! After reviving, this sick employee was driven home by another employee. Today is Friday, and the sick employee did not show up today. the General Manger, I am sure, wants to fire this sick employee, but agreed to talk it over with the Production Manager on Monday. We have less than 50 employees in our company, so FLMA does not apply.

So much for doctor clearances !!!! Wasn't worth the paper it was printed on. Do we have to ask for another one ?? What a mess.

Carol CA

I agree you have quite a mess on your hands. If you decide to keep this employee, I would definitely get another doctor's note. If he is passing out in his car in the parking lot, what would happen if he passed out while operating machinery at work? Then you have worker's comp issues. You need to have a serious talk with this employee - for his own good. What would have happened if he had passed out while driving home?

If you decide to let him go, you have to be sure that you are consistent in your treatment of him. Have you termed other employees who had a serious illness and were out for extended periods? If not, you probably can't term him. There are also ADA issues as to whether you can reasonably accommodate him.

Good luck and let us know what happens.

cebudragonlady

Update: I insisted on sending letter to employee on 05/22 , after Gen. Mgr. waffled back and forth - informing sick employee still out that without payment of at least $100 ,premiums coverage will terminate 05/31 at 4 pm sharp.Letter went out - still waiting for employee action.

cebudragonlady

Update & question: No word from sick employee.The owed premiums are more than the accrued vacation this employee has. Can we in California, take all of his accrued vacation pay toward part of the owed premiums ? He has NOT yet been fired. But I get the feeling that the General Manager wants the guy to just not come back and avoid formal termination. At any rate, the question I asked will
eventually come up.

Carol CA

I would say that yes you can take the owed premiums out of the vacation pay coming to him. When the employee signed up for the insurance it was understood that the premiums would be deducted from his paycheck. It doesn't matter if that paycheck consists of regular hours, vacation hours, sick hours, etc. He owes the premiums and you can do the payroll deduction.