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8 years ago · by · 0 comments

FMLA and Continued Benefits

This question was recently asked of the ThinkHR Hotline team: What benefits must be continued while an employee is on Family and Medical Leave Act (FMLA) leave? What should we do with an employee who is not making his share of the copayments while out on leave?
Their expert answer: Family and Medical Leave Act (FMLA) regulations require that employers continue to provide group health benefits under the same terms and conditions as if the employee was actively at work. There is no requirement under the FMLA to continue other types of benefits offered by the employer. Whether or not an employee’s other benefits continue depend on an employer’s established policy. Any benefits that would be maintained if the employee was on another form of leave should be maintained while the employee is on FMLA leave.

Part of the requirement to continue health insurance benefits “under the same terms” means that both the employer and employee must continue to pay their portions of the group health insurance premium, unless the employer has a different policy for managing premium payments during leaves. The employer is required to notify the employee of the payment requirements while on leave, including the amount of the payment, date due, and where the payment should sent. If the employee fails to pay his or her portion of the premium, the employer may be able to suspend group health benefits for the remainder of the FMLA leave.

In order to suspend benefits for someone on FMLA leave, the employer must allow the employee a 30-day grace period to make payment after the original payment due date. The employee must receive written notice at least 15 days prior to the actual suspension, and the best employer practice is to send a pending suspension notice once the employee is 15 days past the payment date. One important item to note is that even if an employer suspends an employee’s health coverage under these terms, the employer is required to restore coverage without penalty or delay once the employee returns from FMLA leave to a level of coverage that is equal to what the employee had prior to the leave and had not missed premium payments. If the employee does not return from FMLA, the employee whose coverage was suspended for failure to pay premiums during the leave would be eligible for COBRA continuation coverage.

Don Phin, Esq. is VP of Strategic Business Solutions at ThinkHR, which helps companies resolve urgent workforce issues, mitigate risk and ensure HR compliance. Phin has more than three decades of experience as an HR expert, published author and speaker, and spent 17 years in employment practices litigation. For more information, visit www.ThinkHR.com.

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9 years ago · by · 0 comments

FMLA Leave Request Does Not Create Automatic OSHA Recordkeeping Obligation

PatientsIn Secretary of Labor v. United States Postal Service the question was whether an employee’s indication of an industrial injury on a FMLA request form triggered an OSHA recordkeeping obligation.  To make a long story short, that claimant complained she was having an allergic reaction to dust produced by machinery she worked with. Her doctor provided her a note stating she was not to return to work at that machine. She eventually filled out an FMLA leave request form.

As this was going on, her complaint and that of another employee triggered an OSHA investigation. None of the inspections or analysis generated by her physician or OSHA found any kind of violation of OSHA standards or the exact allergic substance she was reacting to.  The OSHA inspector was none the less concerned the company had not recorded her allergic reaction in the OSHA injury logs, a violation for which they were cited.

The Occupational Safety and Health Review Commission overturned a decision by the lower court and ruled due to privacy provisions associated with the FMLA, the employer was required to not share this information with the OSHA coordinator or the employee’s supervisor. The only time it would be appropriate to do so is for job accommodation purposes or emergency medical treatment.

The Commission also ruled the obligation to report an OSHA injury could come from someone’s position or other unique circumstances. According to the Commission no such facts existed to generate the obligation. Which is rather surprising given it was abundantly clear she claimed to be having allergic reactions to working around the machinery and told numerous people about it.

The court reminded employers they should separate FMLA files from the work comp or injury ones.

Take home lesson: do NOT share medical information across the organization unless that person has a “need to know”, there is an accommodation to consider, or there is some kind of emergency. Keep FMLA requests private and don’t automatically share the info with the OSHA
compliance team.

Don Phin, Esq. is VP of Strategic Business Solutions at ThinkHR, which helps companies resolve urgent workforce issues, mitigate risk and ensure HR compliance. Phin has more than three decades of experience as an HR expert, published author and speaker, and spent 17 years in employment practices litigation. For more information, visit www.ThinkHR.com.

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Scurich Insurance Services
Phone: (831) 661-5697
Fax: (831) 661-5741

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783 Rio Del Mar Blvd., Suite7,
Aptos, Ca 95003-4700

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PO Box 1170
Watsonville, CA 95077-1170

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