Health Insurance Continuation on WC EE?

I have an employee who was injured about two weeks ago, and will not be back to work for some time. We have no policy on WC injured ee's, regarding continutation of benefts.

This employee has his spouse on his insurance, which he pays for weekly.

If I continue his insurance, can I request that he pay the weekly amount for his spouse's coverage?

Thanks for any ideas.



  • 2 Comments sorted by Votes Date Added
  • If the employee is eligible for FMLA, you should probably assign the leave as such and follow FMLA procedures with the Benefits.

    If the employee or your company isn't covered under FMLA, what do you do with employees who request a personal leave of absence?  You should do the same.

    My company is covered under FMLA but if an employee is not eligible for leave under FMLA, we provide the employee an "FMLA like 6 week leave"  we keep their benefits but they are responsible for the deductions that would have come out of their normal pay.  They have the option of paying by check or being deducted the amount upon their return to work.  If they fail to return to work and do not pay their portion of the cost, the policy is then terminated retroactively.

  • First, see what your state law and associated regulations say on the subject.

    Second, find out if FMLA applies to your Company and, if so, if this person is eligible and, if so, if their injury meets the standard of a serious health condition.  If FMLA applies to this situation, follow your FMLA policy, which should stipulate if WC will run concurrently with FMLA leave.

    Assuming FMLA does not apply, do something reasonable with an eye toward favoring the employee's situation and then get a policy written for the next time.  There are a few things you can draw from to determine what is "reasonable".  Do you have STD or LTD coverage that applies?  How do you handle people out on those types of leaves?  What is the time frame of the absence?  Will it be 2 weeks, 2 months, or 2 years?

    If you are in Texas, considering going the non-subscriber route on WC.

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