Know your options

Question

Asked: Apr 24, 2010

Leave of Absence and COBRA, can someone give me advice?

I have just been taken off work for pnuemonia for two weeks. My employer informed me that after seven days off I would have to go to Cobra and that it was Federal Law. I have never heard of such a thing. I would like to know if this is accurate. They stated it was due to the fact that I had been insured with the company for less then a year.

Categories: In Illinois
Plan Types: In COBRA

Watch this Question | Email to a Friend

Answers

Your employer is probably referencing the Family and Medical Leave Act when he mentions that you have been insured with the company for less than one year. Under the FMLA, an employer is required to maintain coverage under the group health plan for any employee that takes leave due to a serious health condition. This must be granted for 12 weeks during any 12 month period. Since you have not worked for the company for 12 months, FMLA does not apply to your situation. Here is a link to some helpful FMLA Frequent Questions As for having to go on COBRA due to a leave of absence, this is done at the employer's discretion, but all employees working for that company must be treated equally in regards to this. In your employee handbook, there should be a section that addresses the continuation of employee benefits in the event of a leave of absence. The reason that an employer requires COBRA election during a leave of absence is because they do not want to be liable for the employer's contribution toward premium payment during your absence. The cost of paying your health insurance premium becomes your sole responsibility under COBRA. One week of absence is a bit on the low side for an employer to request a COBRA option. The standard seems to be 2 weeks, but this is determined by the employer if an employee does not qualify under FMLA, not by federal regulation. Once you are re-hired, there will likely be a waiting period before you can go off COBRA and have your employer begin making a contribution to your health insurance premium. This should also be addressed in your employee handbook. The waiting period for a re-hire is usually less than that of a new hire, and in many cases, the waiting period is waived completely if the re-hire is within a specific period of time.

Answered: May 02, 2010


In response to the answer provided by 214Brielle, one must be careful when leaping to the conclusion that being insured with the company less than a year means being being employed with the company for less then a year.

To be FMLA eligible, an employee must have been covered on the plan the day prior to the "qualifying event" and have worked for the employer for at least a year. FMLA eligibility is not based on having coverage for at least a year. Further, it is incorrect to assume that a person who has had coverage under the employer's plan for less than a year has been employed by said employer for less than a year. There are many reasons why an employee could be employed for over a year but only have coverage under the employer's plan for less than one year such as having previoiusly been covered under a spouse's plan.

The employer's representative should be told to stop phrasing FMLA as being based off of medical coverage on the employer's plan.

Otherwise, 214Brielle provided a solid explanation on FMLA.

Answered: Nov 09, 2010

 

Top Illinois Experts

RANK LEADER POINTS
1. Goquoteme 40
2. Phildaig 30
3. Insurancestore 20
4. 214bronson 10
5. Ihealthbrokers 10
6. Insuranceagentgirl 10
7. Phil_daigle 10
View More