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What regulation requires the continuation of LTD benefits when out on FMLA?

JBestJBest 7 Posts
in FMLA/ADA/Workers’ Comp Vote Up0Vote Down
What regulation requires the continuation of LTD benefits when out on FMLA? Usually, LTD is suspended when called to active duty. I'm assuming LTD premiums should be continued if an ee is out on FMLA since they their status doesn't change unless possibly in the event they are out of FMLA and sick leave. Please provide insight to this issue.
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  • Don DDon D 9,834 Posts
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    The Act mandates that health care coverage for one taking leave be maintained on the same conditions that would have been provided had the ee not taken leave. Group policies must remain in force. I do not know that LTD falls within the definition of group health care coverage, although it may.

    Section 104(c)(1) states, "....during any period that an eligible ee takes leave under section 102, the employer shall maintain coverage under any "group health plan" (as defined in section 5000(b)(1) of the Internal Revenue Code of 1986) for the duration of such leave at the level and under the conditions coverage would have....." So there's the answer; whatever section 5000(b)(1) says about an LTD policy, if anything.

    An individual called into active military duty would not be utilizing your LTD policy anyway. If he had a need for that, his military policy would provide the coverage. That can be found within the USERRA regulations or you could also request a written opinion from the company administering your LTD policy. They are right on top of this, for sure, with so many people being called up in the past 2 years.
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  • valentinevalentine 116 Posts
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    Usually before LT kicks in, ST does. We have a policy. EE goes out on ST disability. Their 12 weeks of FMLA runs concurrent. EE is entitled to 26 weeks of ST disability. At the end of the 26 weeks, they FMLA has been exhausted and EE is told they either return to work on a full time basis or they're terminated. Usually if an ee cannot return to work at the end of 26 weeks they go on to LT disability and never end up going back to work anyway. We tell them if they are able to return to work at some time in the future, they may reapply for employment with the company.
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