Workers Compensation and Health Coverage Premiums

tfevergrn · January 2002

[font size="1" color="#FF0000"]LAST EDITED ON 01-31-02 AT 12:57PM (CST)[/font][p]Are the any restrictions in making an employee financially responsible for their health coverage premiums while on Worker's Compensation? We are an employer who pays 100% of the premium for employees.

At what point do you or can you, offer Cobra for continuation coverage? Of course this would be a situation where Workers Compensation leave is not run concurrently with FMLA.

Margaret Morford · January 2002

I think you may run the risk of penalizing someone for exercising their rights under WC. This may be seen as retailation. I'd suggest you get some legal advice on this.

Margaret Morford
theHRedge
615-371-8200
[email]mmorford@mleesmith.com[/email]
[url]http://www.thehredge.net[/url]

tfevergrn · January 2002

How do other companies handle their medical coverage while employees are on worker's compensation, especially when someone could be on workers comp leave for many months?

Theresa Gegen TX · January 2002

Workers' compensation law is extremely state specific (it is a state law program and the rules can be different in every state). Therefore, you may need to get legal advice from an attorney in your state. I would not rely on HR advice from employers who may not be in your state -- their state requirements may be different.

Good Luck!

peteing · March 2002

this is a timely question. We are located in CALIFORNIA and have a union and the union workers have a 'bank of hours' they can draw on while on WC to keep their 100% company paid health benefits. In the past we have sent COBRA letters when their 'bank of hours' ran out and they could not qualify 'hour wise' for company health benefits. Never a problem until today we send the cobra letter and get an attorney responding, citing CA labor code section 132 (a) and saying he would seek sanctions if we do not re-insure the employee...he had been off for months. and no FMLA notification was ever sent..

Any ideas???

thanks,

pete ingenhutt

Theresa Gegen TX · March 2002

Hire an attorney immediatly to help you deal with this issue. Since the employee has already gotten an attorney, you can bet that you will end up in litigation.

Good Luck!!

AnaFL · April 2002

tfevergrn

You've probably already dealt with this situation, but I was just reading it today....I have battled with this issue myself and I never did find a specific answer in my own State Law book (Florida). Our policy is almost the same as yours, in as far as we pay just about 100% for health coverage (employee only pays $10.75 per month for family coverage - ppo plan), so we have always continued to pay for all benefits for an employee out on wc no matter how long they were out, and some were out for over a year and a half! Our parent company in WI does things differently however. The policy states that if an employee is out for longer than six months on wc ,(and/or just not on active duty), then cobra would start after that. Every bit of research I did on this topic for Florida suggested that we keep the employee on our benefits due to the potential of a retaliation claim, so that's what we do. Additionally, since we are self-insured this is not a bad situation because the employee is covered for the medical under workers comp anyway, so it's not like we are technically actually paying out a whole lot for their health coverage, and if it keeps them from seeking out "legal help", all the better for us in the long run!

Workers Compensation and Health Coverage Premiums

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