FMLA exhausted
kim1513
4 Posts
I have an employee I placed on FMLA on 7/18/14 his Dr's states he will be off 6-12 months - Can I put him on Cobra?
Also WC employees is it ever okay to put thim on Cobra?
Any insight on wither would help out - Thank you in advance
Also WC employees is it ever okay to put thim on Cobra?
Any insight on wither would help out - Thank you in advance
Comments
You may also ask your insurance broker. The broker should be able to respond to the WC question as well.
94-103, taking leave under the FMLA does not constitute a COBRA-qualifying event setting off COBRA’s notification requirements. A qualifying event does occur if the following conditions are met:
• The employee (or spouse or dependent) is covered by the employer’s group health plan on the day before the first day of FMLA leave.
• The employee does not return to work at the end of the FMLA leave.
• The employee would, in the absence of COBRA, lose coverage under the health plan before the end of the maximum coverage period provided by COBRA.
If these three conditions are met, a qualifying event occurs on the last day of FMLA leave. The maximum COBRA coverage period is generally measured from the date of this qualifying event. If coverage would be lost on a later date, the maximum COBRA coverage period would be measured from that date.
The IRS guidance also says that:
• State and local laws that may require group health plan coverage during a leave of absence for more time than required by FMLA do not affect the determination of when a COBRA-qualifying event has occurred.
• A qualifying event also occurs if an employee fails to pay his or her share of group health plan premiums during the FMLA leave or declines group health plan coverage during the leave.
• The right to take COBRA continuation may not be conditioned upon repayment by an ex-employee of any premiums paid by the employer for group health coverage during FMLA leave.
COBRA notices should therefore be distributed whenever an employee fails to return from leave or exhausts FMLA leave.
As far as disablility goes when can I put an employee on Cobra?
On this page, the DOL notes the following:
"Employers often provide some employee benefits relating to disability. In the employee benefits environment, disability can be defined in many ways. What is considered to be a disability for one disability benefit plan may not be considered a disability under a different plan. Keep in mind that disability benefits are different from group health plan benefits. Generally, whether or not a condition is considered to be a disability or whether or not an individual is eligible to receive benefits from a disability plan depends on the plan rules. Therefore, if you have questions regarding whether or not you are entitled to disability benefits, you should consult the SPD (summary plan description) for your plan and contact your plan administrator. Having a disability can also affect your employment status - such as a job loss or reduction in hours - in a way that could affect your group health benefits, depending on the plan rules. Under some circumstances describe below, you or your dependents also may be eligible for a longer period of COBRA continuation coverage because of a disability.If you or your family lose group health benefits due to a qualifying event that is either a termination of employment or reduction in hours, you and your family members may be eligible to obtain COBRA continuation coverage at group rates. Generally, the maximum period of COBRA continuation coverage for these qualifying events is 18 months...." The page might also have more helpful information than the information I have quoted.