Introduction
The Family and Medical Leave Act (FMLA) provides eligible employees with up to 12 weeks of unpaid, job-protected leave in any 12-month period for certain medical and family reasons. It also requires employers to maintain group health insurance coverage for their employees on FMLA leave in the same manner as if the employee had not taken leave.
Health insurance coverage is a key benefit for many employees, and understanding who pays health insurance premiums while on FMLA leave is important for employers and employees alike.
Exploring Who Pays Health Insurance Premiums During FMLA Leave
The FMLA does not require employers to pay health insurance premiums for employees on leave. However, the law does require employers to maintain the same coverage for employees on FMLA leave that they would have had if they had not taken leave.
What Employers Need to Know About Paying for Health Insurance During FMLA
Employers need to understand their obligations when it comes to providing health insurance coverage for employees on FMLA leave. Under the FMLA, employers must continue to provide health insurance coverage for an employee on FMLA leave in the same way they would have provided coverage if the employee had not taken leave.
For example, if an employee was paying for their own health insurance premium before taking leave, then the employer must allow them to continue to do so while on FMLA leave. On the other hand, if the employer was covering the cost of the employee’s health insurance premium prior to FMLA leave, then the employer must continue to do so while the employee is on leave.
The Department of Labor states: “If the employer pays for some or all of the cost of health insurance coverage for its employees, the employer must continue to make such payments while the employee is on FMLA leave.” 1
What Employees Should Understand About Health Insurance and FMLA
Employees should understand that they are responsible for any health insurance premiums they normally pay while they are on FMLA leave. The employer is not required to pay these premiums, even though they may be required to continue providing coverage.
Employees should also be aware that they may be responsible for any premiums that were not paid while they were on FMLA leave. For example, if an employee was paying for their own health insurance premium before taking leave, and failed to pay those premiums while on leave, the employer may require the employee to reimburse them for any unpaid premiums.
How to Manage Health Insurance Premiums During a Family and Medical Leave of Absence
Understanding the Impact of FMLA on Health Insurance Premiums
It is important for employers and employees to understand the impact that FMLA leave can have on health insurance premiums. Depending on the type of health insurance plan, there may be different rules and regulations that apply to health insurance coverage while an employee is on FMLA leave.
For example, some health insurance plans may require employees to pay the full cost of their health insurance premiums while on FMLA leave, while other plans may offer discounts or other incentives to help offset the cost of the premiums.
Options for Employees to Cover Health Insurance Premiums During FMLA
There are several options available to employees to help cover the cost of health insurance premiums while on FMLA leave. These options include:
- Using vacation or personal time to pay for health insurance premiums;
- Applying for state disability insurance;
- Using funds from a health savings account (HSA);
- Taking out a loan to cover health insurance premiums;
- Applying for COBRA health insurance; and
- Getting assistance from a charity or nonprofit organization.
These options may vary depending on the employer and the type of health insurance plan they offer.
Conclusion
Summary of Key Points
The Family and Medical Leave Act (FMLA) provides eligible employees with up to 12 weeks of unpaid, job-protected leave in any 12-month period for certain medical and family reasons. The FMLA does not require employers to pay health insurance premiums for employees on leave, but does require employers to maintain the same coverage for employees on FMLA leave that they would have had if they had not taken leave.
Employees should understand that they are responsible for any health insurance premiums they normally pay while they are on FMLA leave. There are several options available to employees to help cover the cost of health insurance premiums while on FMLA leave, including using vacation or personal time, applying for state disability insurance, using funds from a health savings account (HSA), taking out a loan to cover health insurance premiums, applying for COBRA health insurance, and getting assistance from a charity or nonprofit organization.
Resources for Further Information
The Department of Labor has more information about the Family and Medical Leave Act, including information about health insurance coverage during FMLA leave. 2
The Centers for Medicare and Medicaid Services also provides resources and information about health insurance and FMLA leave. 3
The US Department of Health and Human Services provides additional resources and information about health insurance and the Family and Medical Leave Act. 4
Finally, the Employee Benefits Security Administration provides resources and information about health insurance and FMLA leave. 5
By understanding who pays health insurance premiums while on FMLA leave and exploring options for managing health insurance premiums during a leave of absence, employers and employees can ensure that they comply with the requirements of the Family and Medical Leave Act.
References
1 U.S. Department of Labor. (n.d.). Questions and answers about the family and medical leave act. Retrieved from https://www.dol.gov/agencies/whd/fmla/faq
2 U.S. Department of Labor. (n.d.). Family and medical leave act. Retrieved from https://www.dol.gov/agencies/whd/fmla
3 Centers for Medicare & Medicaid Services. (n.d.). Family and medical leave act. Retrieved from https://www.cms.gov/Regulations-and-Guidance/Legislation/FMLA
4 U.S. Department of Health and Human Services. (n.d.). Family and medical leave act. Retrieved from https://www.hhs.gov/answers/family-and-medical-leave-act/index.html
5 Employee Benefits Security Administration. (n.d.). Family and medical leave act. Retrieved from https://www.dol.
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