Employer Pd Health

CathyMac

If an ee is on FMLA, employers are still required to pay the employer's portion of the ee's health insurance right? What if the ee does not return after the 12 weeks and claims it's an ADA leave accommodation? Then, does the employer still have to pay the employer portion? Further, what if the employee is also out on Workers Comp; then do we still have to pay????

What about optional products the ee has chosen -- we don't have to pay those premiums for FMLA or ADA do we?

I know these are a lot of questions but I'm really confused at this point & have ALL of these situations pending...

Whirlwind

Yes, while the ee is on FMLA you have to pay the employer's portion of health insurance premiums. Unless you have a state law or company policy that requires it, you don't have to pay this once FMLA has been exhausted, even if continued absence is permitted as an ADA accommodation.

Workers' Comp varies from state to state, but in my state the ee's WC payment includes compensation for benefits including health insurance so we don't pay the employer portion of health insurance for someone on WC once FMLA has been exhausted.

And no, you don't have to pay for any coverage or product that you don't normally pay for when the employee is working.

Down_the_Middle

The employer's obligation is to continue the employee's health benefit for the durration of the FMLA period. If employee fails to RTW following the expiration of the leave, or voluntarily announces no intention to return, the employer may d/c health coverage. You have no FMLA obligation to continue paying for any other benefit programs and certainly none that are 100% employee paid. Whether you have a precedent to do this is another thing.
What is an "ADA leave accommodation"???? Continuing to offer the employee health coverage??? If that's what you mean, there is no ADA requirement to do this.

CathyMac

I mean when an employee requests leave as an accommodation for a serious health condition. I think I'll just COBRA them at that point..

irenesmsaclaims

Just do not offer COBRA for a FMLA leave. The taking of a FMLA leave is not a qualifying event under COBRA.

CathyMac

Right... but what if FMLA runs out and they still need to be off?

Down_the_Middle

Not knowing your policies, but many employers offer an addt'l leave of absence once FMLA expires. Something like a non-FMLA or personal illness LOA enables the employee to remain off work while continuing to recover. Normally employees pay 100% of the premium costs (not COBRA)while on this unpaid status; their position is not guaranteed and the employer decides when and if to return the employee. Frequently if an employee is absent for more than 6 months (FMLA and other LOA combined), the employer will terminate them in accordance with an established policy. Hope this helps you think thru the issues........