Jane Dotson
The Family and Medical Leave Act (FMLA) provides job-protected leave from work for family and medical reasons, allowing eligible employees to take up to 12 weeks of unpaid leave per year. Employees are entitled to maintain their health insurance coverage during FMLA leave, although they may be required to continue contributing to the cost of health insurance premiums. This means that if an employee has health insurance through their employer's group health plan, they can continue their coverage on the same terms as if they were working. Additionally, other benefits, such as life insurance, disability insurance, sick leave, and vacation days, must also be available when the employee returns from FMLA leave, resuming at the same level as before the leave began.
| Characteristics | Values |
|---|---|
| Loss of insurance on FMLA | Employees on FMLA leave are entitled to maintain their health benefits coverage, including life insurance, health insurance, disability insurance, etc. |
| Payment for insurance | Employees on FMLA leave must continue to make normal contributions to the cost of health insurance premiums. |
| Payment methods | Employees can pay their share of health insurance premiums through payroll deduction or another agreed-upon method. |
| Employer contribution | Employers are not required to pay the entire cost of health insurance premiums unless that is their regular practice. |
| Reinstatement of insurance | Upon returning to work, employees have the right to be reinstated to the same coverage levels as before the FMLA leave. |
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What You'll Learn
- You are entitled to keep your insurance during FMLA leave
- You may need to pay your share of insurance premiums while on leave
- Your employer cannot require you to waive your insurance during FMLA
- Your employer must notify you of your FMLA eligibility and rights
- You must still accrue paid leave while on FMLA
You are entitled to keep your insurance during FMLA leave
The Family and Medical Leave Act (FMLA) provides job-protected leave from work for family and medical reasons. It is important to note that FMLA leave may be unpaid or used concurrently with employer-provided paid leave. An employee who takes FMLA leave is entitled to maintain their health benefits coverage. This means that employees must continue to receive benefit coverage for medical care, surgical care, hospital care, dental care, eye care, mental health counselling, substance abuse treatment, etc., on the same terms as before their leave began.
If an employee has health insurance through an employer's group health plan, they can continue their group health insurance coverage during FMLA leave. This means that if employees have family member coverage, they must continue to receive family member coverage during their FMLA leave. Employees must be given notice and the opportunity to change plans or benefits if plans or benefits change while they are on FMLA leave.
To maintain insurance coverage while on FMLA leave, an employee will need to continue to make any normal contributions to the cost of health insurance premiums. For example, if an employee uses paid leave at the same time as FMLA leave, the employee's share of group health plan premiums must be paid by payroll deduction or another such method normally used during paid leave. In some instances, an employer may pay the employee's portion of the premium, which the employee will need to repay, usually upon their return to work.
Additionally, if an employee chooses not to keep group health plan coverage during FMLA leave, they have the right to be reinstated to the same coverage levels, including family or dependent coverages, as before the FMLA leave began. For example, no qualifying periods or physical examinations may be required, and no exclusions based on pre-existing conditions may be applied.
Other benefits, such as life insurance, disability insurance, sick leave, vacation, educational benefits, pensions, retirement, or 401(k) benefits, must also be available when the employee returns from FMLA leave. These benefits must be resumed in the same manner and at the same level as when the leave began, unless changes affected the entire workforce.
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You may need to pay your share of insurance premiums while on leave
The Family and Medical Leave Act (FMLA) provides job-protected leave for qualifying family and medical reasons. Employees on FMLA leave are entitled to maintain their health benefits coverage. However, this does not mean that employers are required to cover the entire cost of the employee's health insurance. Unless an employer normally covers the entire cost of an employee's health insurance, they are generally only required to maintain group health benefits for employees on FMLA leave and ensure that the employee can continue to make their normal contributions to the cost of health insurance premiums.
If an employee is on unpaid FMLA leave, they may be required to pay their share of the insurance premiums while on leave or upon returning to work. During any period of paid leave, an employee's share of group health plan premiums must be paid by payroll deduction or another method normally used during paid leave. If an employee chooses to discontinue their group health plan coverage during FMLA leave, they have the right to be reinstated to the same coverage levels, including family or dependent coverages, upon returning to work.
The FMLA gives employers several options for collecting premium payments from employees on FMLA leave. One option is to require employees to pay their share of the premium at the same time it would ordinarily be due through payroll deductions. This means that employees may be required to pay the premium every payday, even while on unpaid leave. Alternatively, employees and employers can negotiate a different arrangement for paying premiums. For example, instead of writing a check every payday, an employee might prefer to make one large payment.
It is important to note that FMLA leave may impact other employee entitlements, such as the accrual of annual and sick leave. Additionally, other benefits, such as life insurance, disability insurance, vacation, educational benefits, pensions, retirement, or 401(k) benefits, must also be available upon an employee's return from FMLA leave. These benefits must be resumed at the same level as when the leave began, unless changes affected the entire workforce.
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Your employer cannot require you to waive your insurance during FMLA
The Family and Medical Leave Act (FMLA) provides job-protected leave for eligible employees of covered employers for qualifying family and medical reasons. FMLA leave is unpaid, but employees may use paid leave at the same time. The FMLA requires that employers continue group health insurance coverage for employees on FMLA leave under the same terms and conditions as if the employee had not taken leave.
If an employee has health insurance through an employer's group health plan, they can continue their group health insurance coverage during FMLA leave. To maintain insurance coverage while on FMLA leave, an employee must continue to make any normal contributions to the cost of health insurance premiums. For example, if an employee uses paid leave at the same time as FMLA leave, the employee's share of group health plan premiums must be paid by payroll deduction or another such method normally used during paid leave. In some instances, an employer may pay the employee's portion of the premium, which the employee will need to repay, usually upon their return to work.
An employer may not require an employee to sign a release or waiver as part of the medical certification process. This means that an employee cannot be forced to waive their insurance during FMLA leave. If an employee chooses not to keep group health plan coverage during FMLA leave, when they return to work, they have the right to be reinstated to the same coverage levels, including family or dependent coverages, as before the FMLA leave began.
Other benefits, such as life insurance, disability insurance, sick leave, vacation, educational benefits, pensions, retirement or 401(k) benefits, must also be available when the employee returns from FMLA leave. These benefits must be resumed in the same manner and at the same level as when the leave began, unless changes affected the entire workforce. An employee returning from FMLA leave does not have to re-qualify for any benefits they had before the leave began.
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Your employer must notify you of your FMLA eligibility and rights
The Family and Medical Leave Act (FMLA) provides job-protected leave for qualifying family and medical reasons. Employees are eligible for FMLA if they have worked for their employer for at least 12 months and have completed at least 1,250 hours of service in the 12 months before their leave starts.
When an employee first takes time off for a reason that may qualify for FMLA leave, the employer must notify them of their eligibility. If the employee is eligible, the employer must then inform them of their rights and responsibilities under the FMLA in writing. This includes notifying the employee of their entitlement to maintain health benefits coverage during their FMLA leave. This applies to group health insurance coverage, which must be continued on the same terms as if the employee had continued to work. For example, if an employee has family member coverage, they must continue to receive this during their FMLA leave.
Employees must continue to make any normal contributions to the cost of health insurance premiums during their FMLA leave. Employers can require employees to pay their share of the premium through payroll deductions or another agreed-upon method. Alternatively, the FMLA allows employees and employers to negotiate a different way to pay premiums, such as making one large payment instead of multiple smaller ones. If an employee chooses not to keep their group health plan coverage during FMLA leave, they have the right to be reinstated to the same coverage levels when they return to work.
In addition to health benefits, employers must also provide other benefits, such as life insurance, disability insurance, sick leave, vacation time, and retirement benefits, when the employee returns from FMLA leave. These benefits must be resumed at the same level as when the leave began, unless changes affected the entire workforce. Employees do not have to requalify for any benefits they had before taking FMLA leave.
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You must still accrue paid leave while on FMLA
The Family and Medical Leave Act (FMLA) provides job-protected leave for eligible employees of covered employers for qualifying family and medical reasons. FMLA leave is typically unpaid, but employees may choose to substitute accrued paid leave for their time off. This means that an employee can continue to accrue paid leave while on FMLA leave.
An employee may choose to substitute accrued paid leave for unpaid FMLA leave if they comply with the terms and conditions of the employer's applicable paid leave policy. The two types of leave run concurrently, with the employee receiving pay pursuant to the paid leave policy and receiving protection for the leave under the FMLA. An employee must notify the agency of their election to substitute paid leave for unpaid FMLA leave prior to the date the paid leave commences.
Employers may also require employees to use their accrued paid leave during FMLA leave. For example, an employer may have a policy that requires employees to use their paid vacation time when they take time off for any reason. In this case, the employee would continue to accrue paid leave while on FMLA leave.
It is important to note that the FMLA gives employers several options for collecting premium payments. One option is to require employees to pay their share of the premium through payroll deductions at the same time it would ordinarily be due. During paid leave, an employee's share of group health plan premiums must be paid by payroll deduction, or another such method normally used.
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Frequently asked questions
No, you are entitled to maintain your health benefits coverage. If you have health insurance through your employer's group health plan, you can continue your coverage during FMLA leave on the same terms as if you were working. However, you will need to continue making your normal contributions to the cost of health insurance premiums.
Your employer may deduct your share of the premium from your paycheck as usual. If you are not receiving a paycheck, you will need to make other arrangements to pay for your benefits. Your employer may require you to pay your share of the premium at the same time it would ordinarily be due through payroll deductions, or you can negotiate an alternative payment method.
Benefits such as life insurance, disability insurance, sick leave, vacation, educational benefits, pensions, retirement or 401(k) benefits, etc., must also be available when you return from FMLA leave. These benefits must be resumed at the same level as when your leave began, unless changes affected the entire workforce.
