Determining if an employer has to continue its employees' health insurance during a period of extended leave comes down to a variety of factors, the National Law Review reports.
Here is what you need to know:
1. Whether to continue or put the policy on hold relies on the circumstances of the leave, the size of the employer, the terms of the health plan and what federal law dictates. There are three questions ASC leaders needs to ask themselves when considering this: Does the family and medical leave act apply?; If FMLA does not apply, does COBRA or a similar state law trigger? and is there another source of payment?
2. For companies with more than 50 employees, the FMLA applies to eligible employees. Eligible employees who take an extended absence can continue to utilize employer sponsored healthcare, and the employer must continue to pay its share of the premiums while the employee is on leave. However, if an employee exhausts FMLA leave or is ineligible for FMLA leave, the employer no longer needs to pay its share of the premium.
3. COBRA gives employees the opportunity to continue care, at their own expense, when there is a "qualifying event." Qualifying events consist of resignation and termination of employment, a reduction of hours or a leave of absence which would cause the employee to lose coverage. Employers with less than 20 full and part-time employees are not subject to COBRA on a federal level, but may be subject to state COBRA laws.
4. If a company doesn't need to continue coverage under FMLA or COBRA, there are still some times when an employer must provide coverage. For example, if an employee was injured at work, the employer must continue its health plan while the employee is on worker's comp.
5. If an employer's obligation to provide coverage ceases, funding from short and long-term disability could provide the employee an option to provide healthcare funding.
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