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

FMLA regulations require a minimum 15-day advance written warning before terminating health coverage for non-payment during leave, even when the employer's general policy allows for earlier termination.

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

Unpaid premiums may be recovered through the employee's final paycheck, provided this does not violate applicable state wage payment laws; this is often the most practical recovery method.

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

A continuation or recurrence of the qualifying serious health condition that made FMLA leave necessary is explicitly recognized as a circumstance beyond the employee's control, shielding them from premium recovery.

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

Each employee has independent FMLA rights, including separate health benefit continuation rights, regardless of whether their spouse also works for the same employer.

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

Regardless of the type of health plan (insured vs. self-insured), the employer must provide the absent employee coverage under whatever plan is in place for active employees on the same terms.

(FMLA) Certified Family and Medical Leave Act Administrator Practice Test

(FMLA) Certified Family and Medical Leave Act Administrator Practice Test

FMLA Benefits Continuation & Health Insurance During FMLA Leave 3