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Sep18

FMLA and Extension of Benefits

We do not run FMLA concurrently. When an employee exhausts disability his health care benefits are terminated. If the employee then applies for and is granted FMLA is he eligible for continued benefits even though he has otherwise exhausted them?

Health insurance, including family coverage, is required to be maintained for an employee on leave under the Family & Medical Leave Act (FMLA) on the same terms as if the employee continued to work and never took leave. Other benefits need not be maintained during unpaid FMLA leave. Furthermore, earned benefits such as paid leave or seniority need not continue to accrue while an employee is on leave as long as such benefits don’t accrue for employees on other types of unpaid leave.

Technically, if an employee isn’t entitled to health insurance when he applies and is granted FMLA leave, then there is no requirement to reinstate such benefits. However, there is concern with the practice of requiring employees to use non-FMLA disability leave first then granting FMLA leave only once the employee requests it or the non-FMLA leave is exhausted, especially since the employee is not entitled to continuation of benefits while on non-FMLA disability leave. It appears as though the mandate of continuing health insurance coverage while on FMLA leave is being purposefully avoided with this practice.

It’s more common to either run disability leaves concurrently with FMLA leave or use FMLA leave first, assuming the employee meets the criteria for having a serious health condition.

Keep in mind, under the Americans with Disabilities Act (ADA), an employer must continue health insurance coverage for an employee taking leave if the employer also provides such benefits for other employees in the same leave status. The coverage must be on the same terms normally provided to those in the same leave status.

Lastly, treating an employee unfavorably in any aspect of employment because of his covered disability under the ADA is considered discrimination. Even unintentional discrimination may be unlawful. Further, an employer is prohibited from interfering with, restraining, or denying the exercise of, or the attempt to exercise, any FMLA right. Violations can be costly. It’s in your best interest to ensure employees are able to use their full entitlements under both laws.

This entry was posted on Friday, September 18th, 2015 at 8:47 pm and is filed under
Benefits, Labor Laws.
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