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Aug14

Partial California Disability, PTO and Health Insurance

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Can an employee’s health insurance be cancelled if they are on disability? Can an employee collect both paid time off (PTO), sick pay, or vacation AND California State Disability Insurance? What if they are only partially disabled?

Employees on California Short Term Disability or SDI are responsible for making COBRA payments to ensure that their group health insurance remains in effect. The federal Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows employees to temporarily continue health benefits at group rates if they quit, are terminated, or on disability. In almost all cases, the employee must continue to make the required payments for their health insurance, in order to avoid cancellation. In most cases, the employee must pay the employer’s share of the health insurance premium, as well as their own.

Employees should be aware that it is perfectly legal for an employer to cancel their health insurance while they are on short-term disability, if the employee doesn’t make the required payments. 

Employees can use accrued vacation time and still receive SDI benefits. However, the employee is not eligible for SDI benefits during any period when they are being paid salary or sick leave.

Paid Time Off or PTO is considered sick leave wages under the SDI program. An employee who is receiving PTO equal to their regular salary is not entitled to SDI benefits.

However, an employee who is receiving sick pay or PTO equal to part of their salary, may be eligible for partial SDI under the law.

A full-time employee who is working only part-time on doctor’s orders is probably eligible to receive SDI.  The SDI program will pay benefits equal to the lost wages up to the employee’s maximum wage amount. If the employee was making $1000 per week during the base period, and is making only $600 per week now, then the benefit amount will be $400. That’s equal to the employee’s lost wages.

Employees should be aware, however, that they will not receive more than their maximum benefit amount. For an employee making $1000 per week, the maximum benefit amount is $550 per week. Even if the employee has lost wages of $600 per week or more, the benefit amount will not exceed $550 per week.

Part-time workers are eligible for SDI as long as they earn at least $300 before taxes in the base period, and meet other eligibility requirements.

This entry was posted on Tuesday, August 14th, 2007 at 5:38 pm and is filed under
Attendance Management, Benefits, Compensation, Hiring and Staffing, Human Resources Management, Labor Laws, Performance Management, Workplace Management.
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15 Responses to “Partial California Disability, PTO and Health Insurance”

  1. pamelakworkoutgirl Says:
    January 13th, 2008 at 5:06 am

    Hi everyone,

    Just wanted to introduce myself. This seems like a nice place and I look forward to hanging out here :)

    Pam
    http://sacredheartdietforreal.blogspot.com/

  2. Jackie Campbell Says:
    November 27th, 2008 at 12:44 pm

    I have two questions. The first breakdown I had I was working at [employer name deleted] and was hospitalized. I collected disability for six months. I was never aware that I could continue on long term care or even collect sdi.
    The second time I was on leave for my mental disability and they closed the plant down. I did not get my severance pay but did recieve my disability payments, very little and continued paying for my health insurance, and sons every month.
    I applied for SDI and was approved in 2 1/2 months so I had to wait for 3 1/2 months for my money, [second employer name deleted]quit paying me at the begging of March because SDI paid me in April for March so a whole month with no income. I did continue to recieve my health insurance thru the employer, but I paid for it every month. I was on short and long term disability with employer #2 for 3 or more years. In March 2006 I recieved a letter from employer #2 stating I had been terminated in September 2005, I had been hospitalized in Febuary of 2006 and they refused to pay my hospital bill. They had sent me a check for the 6 months insurance coverage I paid them not knowing they had terminated me. I did not cash the check and read somewhere that legally they had 30 days to offer me COBRA from the termination date, or a judge could order them to pay me $100 a day for every day past the 30 days and that would have been 5 months. I did not cash the check and notified employer #2, and told them what I had learned and again did not cash the check, the hospital claim of $16,000.00 went thru a 2nd time and they paid all my bills for that period. My company is gone, they closed the plant, I have no one to contact for anything. I just recieved another check for the same reason, terminated in 9/05 not told untill 3/06 so the check was for those six months that I paid them. Please help me, I do not want to get sued for the medical bills and who and where to I seek help.
    please pleaes help me.

  3. Jackie Campbell Says:
    November 27th, 2008 at 12:44 pm

    please contact me thru my email.
    thanks

  4. Caitlin Says:
    November 27th, 2008 at 12:45 pm

    Hi Jackie! This problem is far too complex for us to address in an online forum. We are going to suggest that you contact the legal aid society in your area, because you need to consult with a lawyer. You can also post your questions on our sister site at http://www.laborlawtalk.com. HTH, and thanks for reading the blogs!~ Caitlin

  5. Caitlin Says:
    November 27th, 2008 at 2:28 pm

    Hi Jackie! Unfortunately, we are not able to contact readers directly through email. We can only address comments posted on the forum. Cheers, Caitlin

  6. Jackie Campbell Says:
    November 29th, 2008 at 9:57 pm

    Hello all,

    If anyone could leave an address, phone number anything for me to try to resolve this problem, I do not know any attorneys or even what kind to talk to. I am in Louisville KY 40258… if any one has any idea who i could contact in my area. Please Please Please I am begging you… reply to this with any information that you can.

    again, thank you for your tine,
    jackie Campbell

  7. Caitlin Says:
    November 30th, 2008 at 9:29 am

    Hi again Jackie! The Legal Aid Society provides free or low cost legal services to the disadvantaged. The Louisville Legal Aid Society is at http://www.laslou.org/ HTH, Caitlin

  8. Pearle Cotilla Says:
    April 16th, 2010 at 12:26 am

    Just wanted to say you have a great site and thanks for posting!

  9. Caitlin Says:
    April 16th, 2010 at 9:06 am

    Thanks for reading, Pearle!~ Caitlin

  10. Douglass Nelmark Says:
    April 21st, 2010 at 4:02 pm

    Just wanted to say I really like your site and will definitely be back!

  11. Caitlin Says:
    April 22nd, 2010 at 11:00 am

    Thanks for reading, Douglass!~ Caitlin

  12. insanity Says:
    April 26th, 2010 at 11:12 am

    Great information here. Thanks for sharing again!

  13. Caitlin Says:
    April 27th, 2010 at 8:16 pm

    Thanks for reading the blogs, insanity!~ Caitlin

  14. carins urance Says:
    August 19th, 2010 at 3:10 am

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  15. Caitlin Says:
    August 19th, 2010 at 10:22 am

    Thanks for the kind words, carins! Please do not copy articles onto another website. You can quote up to 3 sentences as a teaser, and post a link. HTH, and thanks for reading the blogs!~ Caitlin

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