Health Benifits while out on Workers Comp.
lfhill
8 Posts
Please Help
We have an employee that was out of work on a back injury from 9/01 through 4/02 during which time we paid not only the employees full health insurance benefits including employee portion but his voluntary insurance as well. The employee was released to come back to work on modified light duty in Mid April and we had this employee doing only the most sedentary work. When the EE returned to duty we were deducting a small amount each week for their pay to pay back the employee portion of health insurance and voluntary Insurance to the company.
The employee has again been taken out of work by his Doctor for what is described as a deteriorating back condition. And we have doubts as to wether the EE will ever be able to return to work. My question is because we do not want to fire or lay off an employee while on a questionable workers comp claim are we required continue to pay all or just the employer portion of health insurance benefits or can we send a COBRA notice to employee. I believe the employer is still responsible for their portion in the State of Tennessee while an EE is on Comp but not the employee’s portion, and if the employee fails to pay their portion does it fall under COBRA thereby terminating benifits.
We have an employee that was out of work on a back injury from 9/01 through 4/02 during which time we paid not only the employees full health insurance benefits including employee portion but his voluntary insurance as well. The employee was released to come back to work on modified light duty in Mid April and we had this employee doing only the most sedentary work. When the EE returned to duty we were deducting a small amount each week for their pay to pay back the employee portion of health insurance and voluntary Insurance to the company.
The employee has again been taken out of work by his Doctor for what is described as a deteriorating back condition. And we have doubts as to wether the EE will ever be able to return to work. My question is because we do not want to fire or lay off an employee while on a questionable workers comp claim are we required continue to pay all or just the employer portion of health insurance benefits or can we send a COBRA notice to employee. I believe the employer is still responsible for their portion in the State of Tennessee while an EE is on Comp but not the employee’s portion, and if the employee fails to pay their portion does it fall under COBRA thereby terminating benifits.
Comments
I can't speak for the rules in TN. I do know that in our company we simply requires all ees to pay their share of insurance premiums while on leave for any reason, including work comp. This requirement kicks in as soon as they hit a full pay period with no wages. If they are on leave for more than 12 weeks, we then force them into COBRA (again, regardless of the reason for leave). The 12 weeks conveniently ties to FMLA but it is also a requirement of our health insurance contracts. If you review your contract carefully, you will see that most carriers require the participants to be actively at work. If the ee is off work for more than 12 weeks, the carrier could claim fraud against you for continuing to carry them on your plan without notifying the carrier of the reduced hours. Good luck