Insurance covering L&D even if I don't come back after leave? — The Bump
3rd Trimester

Insurance covering L&D even if I don't come back after leave?

I have health insurance through my work, but after having the baby (due may 15) I plan to stay home with lo. Now my husband just got hired at a new job with good benefits, starting monday, but theirs a 60 day waiting period before I we can be covered. He is not comfortable relying on that, since.. She can come early, you never know for sure. (although it should kick in April 28th if he is starting monday.) 
My husband is under the impression that after maternity leave, I must go back to work for two weeks in order for my insurance to cover L&D. 

But I found this under the termination section in my insurance packet... 
"The day of the month in which You are no longer a member of a covered class, as determined by the employer except as follows:    
 If You are temporarily absent from work due to an approved leave of absence for medical or other reasons, Your coverage under this Plan will continue during that leave for up to six consecutive months while on such leave, subject to the payment of any required contributions, provided the covered Employee otherwise complies with the employer’s leave of absence policies and procedures.  With the exception in the case of a temporary lay-off, this period shall run concurrently with any continuation of coverage taken under “Disability” and/or FMLA, provided that the applicable Employee contribution is paid when due."

So would you think it would be safe for me to not go back after my leave? I wouldn't mind going back just for the two weeks, but I plan to breast feed, and I work retail. I will not be able to get the breaks in order to do that well. And I don't want to mess my milk supply up..  

Re: Insurance covering L&D even if I don't come back after leave?

  • It may vary from company to company.  For me if I did not return to work for at least 30 days after paid leave I would owe the cost of the employer portion of the paid benefits for the time I was out.  The coverage would continue, I would just get a bill for what my employer paid towards my coverage for that time.

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  • I would talk to your HR and ask for Clarification and also get things sorted out with DH's. It wouldn't hurt to have some overlap in coverage anyhow. This way your bases would be covered either way.
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  • I have heard of people having to also pay for the employers contibution of benefits of you don't return.

    I'd be upfront and ask ( it's unprofessional to not give proper notice any way) or just go back for the two weeks.

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  • I would have to return for a day after maternity leave unless I want to pay them back for the leave. Materinity leave pay is not required..just that they hold their job. I only get paid 6 weeks so I want every dime of it. I would definitely go back to wokr just to have insurance coverage for birth especially with your husband starting a new job. Like others said it isn't nice when people do that to their companies and you will burn a few bridges but they see it all the time. Which is why my comapny is super anal with their leave policy. Too many women use the leave and come back for a day.

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  • I really want to give notice. My husband doesn't want me to say anything, because he is scared that I will jeopardize my benefits. My boss is really excited about my pregnancy, as is all of my coworkers. I really want to leave the right way. But I need to be sure I am insured through l&D, and the only reason I paid into insurance was for such a time as this. 

  • Plus I have about 4 weeks worth of sick leave and vacation pay saved up. 

    When one of my old coworkers left, my boss let him stay on the schedule two weeks after he left, to use up his vacation pay. So I really think she would be cool about it. But once Its out.. Its out and if she is not okay with it. I am screwed. 

  • Even if they are excited and supportive it still comes down to company policy about how it has to be handled. At my job, you gave to come back for 2 weeks or you repay the company for their portion of the insurance expense. Also as far as what your boss did for a previous co-worker, I wouldn't put a ton of stock in never know what could happen. She could leave the company, she could be monitored more closely now and not be able to do things like that anymore, etc. Overall though I would just avoid making assumptions in this case as they could prove to be very costly if they are incorrect.
  • Are you planning on telling work that you are not coming back after the baby?  I've had friends not tell their job that they are not coming back to keep benefits and use up sick leave pay.  They basically go back for half a day to collect their things when their sick leave runs out.  It isn't the kindest thing you could do to an employer - so I guess it depends on your relationship.

    If you are open about not returning, I would go to HR and ask exactly when your benefits would end.

    Regardless, if you are in the US, you should be eligible for COBRA...which is expensive, but probably worth it to keep the extra month of insurance.
    What she said. If you inform your employer that you will not be returning to work before you begin your maternity leave, this would be considered a voluntary leave and your benefits would be terminated on your last day of employment.
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