Original Author: Moore, Todd
Date of Material: 11/01/1995
Family and Medical Leave Act of 1993
Maintaining Health Insurance Coverage on a City Employee's Dependents While the Employee is on FMLA Leave
Reviewed Date: 07/09/2021
MTAS was asked whether the city must maintain health insurance coverage on a city employee's dependents while the employee is on FMLA leave.
This letter is in response to your question regarding whether the city must maintain health insurance coverage on a city employee's dependents 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 dependents 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.
MTAS Legal Consultant