Best Ohio FMLA Attorney Reply: What happens to my employee health insurance contribution if I am unable to pay while on unpaid FMLA leave? Can my employer bill me for my insurance contributions if I don’t return to work from FMLA leave?
As our employment law lawyers have previously discussed (see here and here), the Family Medical Leave Act (“FMLA”) provides a qualified employee twelve weeks or 1,250 hours of unpaid leave to care for a serious health condition of a spouse, child, or their own serious health condition. Employees may be able to help lower the financial burden of taking FMLA by electing to use accrued paid time off while on leave. What happens when an employee who is on unpaid leave cannot afford to pay their portion of the health insurance premium?
An employer is required to provide the same benefits to employees out on paid leave from work as employees who are on FMLA leave. However, the employee is still required to pay the employee contribution for health insurance coverage. Employers cannot discontinue family health insurance coverage while the employee is on leave. In light of the fact that many employers want to avoid any semblance of retaliation against employees who take leave, many employers pay the employee’s contribution while on leave and deduct the payments from their pay check when they return.
Employers have the right to terminate coverage for employees who are over thirty days late in payment of their contribution. The employer is only required send the employee a written notice of stating the health care coverage will be terminated and wait fifteen days after the notice was sent to terminate health coverage.
What happens if the employee, for a myriad of reasons, does not return from FMLA leave? Employers who have paid for both the employee and their contribution have a legal right under the FMLA to require the employee to repay the bill. You read that correctly, your employer may send you the entire bill for your insurance premiums if you do not return to work from leave. The only time FMLA provides an exception to this rule is if the employee’s failure to return is out of the employee’s control, including the FMLA qualifying medical condition (ex. Employee dies while out on FMLA, they won’t be able to collect the outstanding balance).
The United States Department of Labor provides this insight into this FMLA issue:
A covered employer is required to maintain group health insurance coverage, including family coverage, for an employee on FMLA leave on the same terms as if the employee continued to work.
Where appropriate, arrangements will need to be made for employees taking unpaid FMLA leave to pay their share of health insurance premiums. For example, if the group health plan involves co-payments by the employer and the employee, an employee on unpaid FMLA leave must make arrangements to pay his or her normal portion of the insurance premiums to maintain insurance coverage, as must the employer. Such payments may be made under any arrangement voluntarily agreed to by the employer and employee.
An employer’s obligation to maintain health benefits under FMLA stops if and when an employee informs the employer of an intent not to return to work at the end of the leave period, or if the employee fails to return to work when the FMLA leave entitlement is exhausted. The employer’s obligation also stops if the employee’s premium payment is more than 30 days late and the employer has given the employee written notice at least 15 days in advance advising that coverage will cease if payment is not received.
In some circumstances, the employer may recover premiums it paid to maintain health insurance coverage for an employee who fails to return to work from FMLA leave.
In conclusion, employees should always make arrangements to pay their contribution for health insurance when they leave for FMLA or make payment arrangements with the employer to deduct the contribution once they resume working. Failure to do so can have major financial consequences, which could include paying the entire bill for health coverage.
If you feel that you are being denied leave rights under the Family Medical Leave Act (FMLA) or are being retaliated against for taking medical leave, you should call the right attorney as quickly as possible to schedule a free and confidential consultation. The phone number to contact an Ohio attorney for FMLA help is 866-797-6040. While you focus on your family medical needs, let our FLMA attorneys focus on your medical leave rights.
This employment law website is an advertisement. The materials available at the top of this medical leave page and on this employment law website are for informational purposes only and not for the purpose of providing legal advice. If you are still asking, “how do I get medical leave under the FMLA?”, “what should I do when my job won’t give me medical leave?”, “can my boss deny me medical leave?”, “what should I do if I was fired in retaliation for taking FMLA leave?”, or “is my employer allowed to…?”, your best option is to contact an Ohio medical leave attorney to obtain advice with respect to FMLA questions or any particular employment law issue. Use and access to this employment law website or any of the links contained within the site do not create an attorney-client relationship. The legal opinions expressed at or through this site are the opinions of the individual lawyer and may not reflect the opinions of Spitz, The Employee’s Law Firm, Brian Spitz, or any individual attorney.