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Maintaining Health Insurance Coverage on a City Employee's Dependants While the Employee is on FMLA Leave

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Reviewed Date: January 03, 2017

Original Author: 
Moore, Todd
Date Created: 
Nov 1, 1995


Subjects:
Family and Medical Leave Act of 1993
Insurance--Health
Personnel--Fringe benefits

Maintaining Health Insurance Coverage on a City Employee's Dependants While the Employee is on FMLA Leave

Summary: 
MTAS was asked whether the city must maintain health insurance coverage on a city employee's dependants while the employee is on FMLA leave.

Knowledgebase-Maintaining Health Insurance Coverage on a City Employee's Dependants While the Employee is on FMLA LeaveNovember 1, 1995

This letter is in response to your question regarding whether the city must maintain health insurance coverage on a city employee's dependants while the employee is on FMLA leave. You stated to me that currently the city pays seventy percent (70%) of the insurance premiums and the employee pays the remaining thirty percent (30%). The FMLA requires that the city continue its health insurance coverage of the employee and his or her dependants during the employee's leave period.

The FMLA provides that during a period of family or medical leave, an employer must maintain coverage under its "group health plan . . . at the level and under the conditions coverage would have been provided if the employee had continued in employment continuously for the duration of such leave" (29 C.F.R. §825.209(a)). This provision has been interpreted to mean that the same group health plan benefits provided to an employee prior to taking FMLA leave must be maintained during the leave. Therefore, since family member coverage is provided prior to the leave, it must be continued through the leave period.

As we discussed, the employee is required to continue to pay their percentage of the premium during the leave, or the city may pay the employee's portion and get reimbursed by the employee. Please let me know if I can be of any further assistance in this or any other matter.

Sincerely,

Todd Moore
MTAS Legal Consultant

TM/


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