Medical Premiums during Unpaid FMLA

Ms_Shepard · May 2003

Forgive me if this has been asked before, but I was just reading the FMLA page on the DOL web site, and it mentions that employees need only pay their share (meaning just the employee portion, not the entire premium) of health premiums during unpaid periods of FMLA. This conflicts with our employee manual, which states that employees must pay the ENTIRE health premium, as if they were on COBRA. We have never enforced this, as no one on our health plan has ever taken much time under FMLA. Am I interpreting the DOL web site correctly?

POPEYE · May 2003

You are correct. While on FMLA the EE is entitled to all benefits that any other employee would have including you paying the employer portion of premiums. There is even a 30 day grace period for them to keep their portion paid.

LindaS · May 2003

Agree with Popeye - I would suggest changing your handbook to ensure you are in compliance with FMLA.

David Nagle VA · May 2003

[font size="1" color="#FF0000"]LAST EDITED ON 05-02-03 AT 11:09AM (CST)[/font][p]The FMLA specifically provides that the employer shall maintain coverage under any group health plan for the duration of FMLA leave at the level and under the conditions coverage would have been provided if the employee had continued in employment continuously for the duration of such leave. So, yes, the employer has to keep paying the employer's share during the time an employee is on FMLA leave. No more, no less.

So, your policy is contrary to the FMLA and the handbook needs to be changed. Note, also, that the FMLA requires that you provide notice of FMLA rights in the handbook, so you need to be sure that an accurate description of FMLA is contained in it. I usually suggest use of the DOL description.

I note, however, my disagreement with one (or both) of the prior replies posted. The FMLA does NOT require that all benefits continue to accrue during FMLA leave. While the FMLA does specifically protect health insurance, as described above, and it says that benefits which accrued prior to FMLA leave cannot be lost by taking FMLA leave, it also specifically states: "Nothing in this section shall be construed to entitle any restored employee [one who returns from FMLA leave] to the accrual of any seniority or employment benefits during any period of leave." 29 USC 2614(a)(3)(a).

David Nagle
Editor, Virginia Employment Law Letter
LeClair Ryan
(804) 343-4077
[email]dnagle@leclairryan.com[/email]

System · May 2003

YOu might also want to look at taking ee premium liabilities out of his/her PTO/PDO wages to assist the ee with his/her coverage. Of course, all of this is addressed in the FMLA letter that is sent to the ee. Financial repayment arrangements are also worked out with ee in the event there is not sufficient PTO/PDO time. All of this is addressed in our FMLA policy which is sent along with the notification letter for clarification. Calling to check with ee while he/she is on FMLA is also a good idea. Maybe I have been extremely lucky with ee's, I have had no problems with reimbursement or getting proper documentation back in a timely manner. If you would like a copy of the FMLA policy and letter, I would be happy to share. Just email me at [email]cwinebarger@charter.net[/email]

Medical Premiums during Unpaid FMLA

Comments