FMLA Benefits Continuation & Health Insurance During FMLA Leave 3

Question 1

An employer's written policy terminates health coverage for all employees when premiums are 30 days overdue.
An employee on unpaid FMLA leave falls 30 days behind on premiums.
What must the employer do?

Accepted Answer

Provide at least 15 days' advance written notice before terminating coverage, even if the policy otherwise allows immediate termination

Answer

Apply the same policy immediately since it applies uniformly to all employees

Answer

Wait 60 days before terminating coverage for FMLA employees as a special protection

Answer

Continue coverage indefinitely regardless of non-payment during FMLA leave

Question 2

An employee on unpaid FMLA leave chooses to pay premiums upon return rather than during leave. The employer agrees to this arrangement. If the employee fails to return, how should the employer handle the unpaid premiums?

Accepted Answer

The employer may deduct the unpaid amounts from the employee's final paycheck, subject to applicable state wage payment laws

Answer

The employer must forgive the premiums because an agreement was made to defer payment

Answer

The employer must file a civil lawsuit to recover any deferred premiums

Answer

The employer can retain amounts from the employee's 401(k) plan to cover premiums

Question 3

Which of the following qualifies as a 'circumstance beyond the employee's control' that prevents an employer from recovering premiums when an employee does not return from FMLA leave?

Accepted Answer

A continuation or recurrence of the serious health condition that originally necessitated the FMLA leave

Answer

The employee received a higher-paying job offer from a competitor

Answer

The employee's dissatisfaction with company management or working conditions

Answer

The employee's decision to relocate to another state for family reasons

Question 4

Two spouses both employed by the same company each take FMLA leave simultaneously for their newborn child. What is the employer's obligation regarding each employee's health insurance continuation?

Accepted Answer

Both employees are each independently entitled to group health coverage continuation for the duration of their respective FMLA leaves

Answer

The employer need only maintain health insurance for the employee who is the primary insured

Answer

The couple's combined health insurance must be converted to a family COBRA plan

Answer

Only the employee taking parental FMLA leave is entitled to benefit continuation; the other must use PTO

Question 5

An employer switches from a fully insured group health plan to a self-insured plan while an employee is on FMLA leave. What is the employer's FMLA benefit continuation obligation?

Accepted Answer

The employee must be covered under the new self-insured plan on the same terms as active employees

Answer

The employee must be allowed to remain on the prior fully insured plan until they return

Answer

The plan change constitutes a COBRA qualifying event, and the employer's FMLA obligation ends

Answer

The employer must offer the employee a choice between the old and new plan arrangements

Question 6

An employee on FMLA leave misses an open enrollment period during which all active employees were required to select their health plan options for the coming year. What must the employer do?

Accepted Answer

The employer must provide the employee a meaningful opportunity to make open enrollment elections, either before the deadline or upon return, without losing coverage

Answer

The employee's coverage defaults to the prior year plan and no action is required until they return

Answer

The employee forfeits the right to change plans and must accept the employer-selected default option

Answer

COBRA is triggered by the employee's failure to elect during open enrollment

Question 7

An employee's FMLA leave overlaps with the employer's annual benefits waiting period for newly added coverage options. Can the employer impose the waiting period on the returning employee?

Accepted Answer

No, waiting periods that apply because of the employee's FMLA leave cannot be imposed upon return; coverage must be restored immediately

Answer

Yes, because the waiting period applies uniformly to all employees regardless of leave status

Answer

Yes, but only if the waiting period is fewer than 30 days long

Answer

No, but only for medical coverage; dental and vision waiting periods can still be imposed