Fringe Benefits while on WC

YCCACHR · October 2005

We have a policy that ee's who are on FMLA must pay their portion of fringe benefits while they are out. Are there special rules for those on WC leave? In the past, ee's on WC have NOT had to pay their fringe benefit (dental, medical, life or income protection insurances) back when returning from leave. Can anyone help?

deniseE · October 2005

I thought, and if wrong, I KNOW I'll be corrected---but I thought that the company was required to keep benefits intact (i.e. equal to active ee's) during the 12 week FMLA.

mushroomHR · October 2005

During FMLA the employer must keep the benefits for the employee however, the employee is still responsible for paying their portion of the premium. If you run FMLA concurrent with WC then you must maintain the benefits. If you do a search of this site there have been other discussions about this topic.

YCCACHR · October 2005

I fully understand that benefits must be kept in tact while on FMLA - I'm wondering if the rules are different for those on Worker's Comp - since some of our cases have run a whole lot longer than 12 weeks. As I said - the HR person before me gave those on WC "special treatment" - they were not required to pay back their portion of their benefits - however, those who were out on FMLA WERE required to pay.

deniseE · October 2005

I guess to unravel this we need to know what your ACTIVE employees are required to do. Does each ee contribute to his/her benefit package?

If the answer is NO, and you are requiring ee's on FMLA to make these payments, it is a problem.

The only reason I can think the WC would be different is that the employer would pay for any expense related to the work injury. But the basic policy regarding fringe benefits would remain.

crawfod · October 2005

The main FMLA requirement is to continue to provide fringe benefits, but it is the employer's choice as to collecting the employee's premium share. Treating all employees the same makes the most sense, but since each State has their own WC rules, you may want to check with your state to see if, by some unusual chance, they have some special provisions.

marc · October 2005

We have not had an EE out for any extended time due to a WC injury. The way we handle it, is that as long as the EE is receiving a company paycheck, their benefits continue as is. If they are out on FML leave, they must pay their portion of any benefits they selected. If they fail to pay, their benefits are subject to cancellation pursuant to the FML regulations.

IF they are on any leave that is not paid by the company, such as STD or WC, they are again responsbile for paying premiums. If they miss them, the related policies are cancelled.

njjel · October 2005

If an ee is out on w.c. and you run that concurrent with FMLA you are required to pay YOUR share of the benefits for the 12 weeks. After the 12 weeks of FMLA (assuming ee is qualified for that leave) you would follow your company policy on whether or not you pay the ee's portion of the benefits. Here we DO pay our share of the benefits the full time and the ee pays their share. If unable to pay during the time out we have a policy that it can be deducted upon their return to work.

YCCACHR · October 2005

We certainly would pay our share of the benefits while any ee was out for ANY type of leave - my question pertains to THEIR portion of the benefit. If their portion is left unpaid - whether out on FMLA or WC - after 30 days - are we allowed to terminate the insurance? There is never any guarantee that an ee will return from a leave.

Thanks for all the great input! I appreciate all the help!

njjel · October 2005

Yes, you may terminate their coverage if they do NOT pay their portion of the insurance IF you have notified them of that in the FMLA paperwork. Even so I certainly would not do so without providing them a notice of cancellation of insurance if not paid by such and such a date. We typically give them 30 days grace. With w.c. after the 12 weeks ends you may offer the ee COBRA if they are unable to return to work. But again it depends on what your company policy is for leaves.

Balloonman1 · October 2005

I have run into this in the past. WHat I do, and have found it works best is before the employee goes out, sit down with them to discuss the issue of paying for their portion of the health insurance benefits.

I have already drafted a form for them to choose payment options, pay each week or every other week. The form also clearly states that failure to pay their portion of the premium can and will result in the termination of their insurance benefits. If you do this all up front, employees are usually okay with it as there are no surprises regarding having to pay back some huge bill.

I started doing this after getting burned by people quiting after being out.

My $0.02 worth.
The Balloonman

Kennedy · October 2005

Balloonman,
I was wonder if you would be willing to share the form you've drafted regarding insurance payment options. We're recently had an employee on FMLA that has decided not to return to work. She did agree to pay her back premiums upon returning but since she is not, I'm afraid that we've been burned. I don't want this to happen again.

If you don't want to share, I totally understand.

Thanks,

Kennedy-Tx

Fringe Benefits while on WC

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