Another FMLA question-for those who took all 3 months

aetg · July 2014

Did you have to pay extra for your health insurance during that time or did your employer continue to pay their portion?

Here is what I have from the FMLA code which kind of implies that employers still have to pay their portion during the time you are gone, but I'm just not sure.

FWIW, I am definitely planning on coming back to work, just trying to figure out if I can swing the extra time off.

(c) MAINTENANCE OF HEALTH BENEFITS.--

(1) COVERAGE.--Except as provided in paragraph (2), during any period that an eligible employee takes leave under section 102, the employer shall maintain coverage under any "group health plan" (as defined in section 5000(b)(1) of the Internal Revenue Code of 1986) for the duration of such leave at the level and under the conditions coverage would have been provided if the employee had continued in employment continuously for the duration of such leave.
(2) FAILURE TO RETURN FROM LEAVE.--The employer may recover the premium that the employer paid for maintaining coverage for the employee under such group health plan during any period of unpaid leave under section 102 if--

(A) the employee fails to return from leave under section 102 after the period of leave to which the employee is entitled has expired; and
(B) the employee fails to return to work for a reason other than--

(i) the continuation, recurrence, or onset of a serious health condition that entitles the employee to leave under subparagraph (C) or (D) of section 102(a)(1) or under section 102(a)(3); or
(ii) other circumstances beyond the control of the employee.

MickeyM04 · July 2014

For both of my kids I took all 12 weeks and my health insurance was paid at its usual amount. I'm not sure if that's required though, as my employer also pays me at 100% of my salary for 11 of the 12 weeks, which is certainly above and beyond.

[Deleted User] · July 2014

I used a combo of vacation, sick leave and short term disability which left me with 2 unpaid weeks of leave. I had to pay my portion (what would normally be deducted from my paycheck) during those two weeks but my employer paid theirs.

Have you spoken with HR? That is ultimately the only way to get the answer as to what your company does.

vvvvvfee · July 2014

if you have enough sick/vacation time to get paid during your entire leave, you don't have to pay anything.

if you run out of sick/vacation time and are on unpaid FMLA leave, you only have to pay your deductible (what is usually taken out of your paycheck). your employer should still pay their portion. they will let you know what you owe and you'd write them a check.

also keep in mind that you should still be accruing sick/vacation time if you are getting paid while on leave. so take that into account when you are planning how long your paid leave will last.

ricekez · July 2014

I took all 12 weeks. I didn't get a paycheck in June, so my employer will charge me double premiums from my July paycheck to "recover" the unpaid June premium. That's all that will happen in my case. I didn't work in May, either, but I got an STD check and they took my May premiums from that.

aetg · July 2014

Thanks for the replies. I'm a teacher so I don't really get vacation time per set, but I hadn't considered sick leave so that's something to consider.

I will talk to hr soon, but I don't think k they come back til Aug

welly01 · July 2014

Other than STD, my ML was unpaid. I can't remember how many weeks I had to pay, but I owed all my regular health ins premiums (employee portion only I think) when I returned. (It was quite a shock to my previously uneducated self!). I don't even think they took it from the STD because it was paid by a different company, but I can't remember for sure now. I didn't get a full paycheck again for 8 weeks, since they spread it out for me.

It was a very unpleasant surprise and one I'll be budgeting better for the next time!

Jenn06L80 · July 2014

I took 20 weeks. I had to pay $485 a month - the cost of my portion of my benefits for anytime I wasn't getting a full paycheck. So the 8 weeks of disability after my C-section was $970. Then I had 6.5 weeks if ETO so my benefits were taken out of my paychecks normally. For the last 6 weeks I was completely unpaid and had to pay an additional $970 to cover benefits.

sweetsunnyc · July 2014

I would make an appt with your HR rep and discuss how it works.

I took the full 12 weeks with both of my daughters. With my last one, I was paid at 60 % my salary for 6 weeks, then my vacation time was used (sick did not apply) and then short term disability kicked in for the rest. I think that there was a total of one week that was unpaid, but I did not have to pat benefits out of my own pocket.

It was super confusing, so it might be best to just have a meeting with HR

Pips09 · July 2014

Every company I've ever worked with did this: You will still be responsible for your portion of the premiums. So if you miss a paycheck (or are paid from a third party vendor), you will owe your own portion (what would usually have been deducted).

You will need to ask your HR dept for the details.

Mustardseed2007 · July 2014

https://www.dol.gov/whd/regs/compliance/whdfs28a.pdf

See the above fact sheet regarding FMLA. It says the same thing as what you posted, but I think it's a little easier to understand.

Basically if your employer pays part of your health insurance, they continue to pay that part.

You continue to be responsible for your part of your premium.

How your part gets covered will vary from employer to employer and will depend on many things like whether part of your lead is paid, but what will not vary is that if your employer normally contributes to part of the cost of the health insurance premium (as most do) then they continue to pay that part.

ETA: For what it's worth, at our company 8 weeks of leave is paid by STD. You then have to use all the vacation and sick pay you have available. After that any remaining FMLA leave you take will be unpaid and you will need to write a check to the health insurance company for your part of the premium to continue coverage unless you make special arrangements to have double premiums taken out after you return or before you leave. They really try not to get their money after you return b/c some people don't return.

Want a personalized experience?

Another FMLA question-for those who took all 3 months

Re: Another FMLA question-for those who took all 3 months

Choose Another Board

Search Boards