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Joseph
Joseph, Lawyer
Category: California Employment Law
Satisfied Customers: 5043
Experience:  Extensive experience representing employees and management
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We have a long term employee who has been out on disability

Customer Question

We have a long term employee who has been out on disability for over 5 months. She was going to come back but due to her health issues, is unable to return as planned. As her employer we have been providing health benefits and paying her full premium, although she is supposed to be paying her portion, she has been unable to. What are our employer requirements for continuing health coverage for her? We are in CA. We want her to come back but if she can't must we continue to pay her health insurance? For how long? Thanks
Submitted: 1 year ago.
Category: California Employment Law
Expert:  Joseph replied 1 year ago.
Hello and welcome to JustAnswer.

I'm sorry to hear about your situation and hope I can help.

Since your employee is not on FMLA leave or another protected from of leave, you are not required to maintain her health insurance while she is out on disability.

If she remains on disability and is unable to return to work, you can cancel her health insurance.

Under California and federal law, you have to notify her of her right to obtain continued health insurance under COBRA, paying the full premium price for her health insurance.

You aren't required to maintain her health insurance for any additional length of time since she is not on any form of protected leave.
Customer: replied 1 year ago.

Thank you for your help. Just to clarify our requirements. Do we have to wait for her to tell us she cannot come back due to illness or can we just inform her that her insurance will end and she can choose Cobra if she wants to?

Expert:  Joseph replied 1 year ago.
You can cancel her health insurance before she informs you she is unable to return to work.

However, in order for her to be eligible for COBRA benefits you would need to technically terminate her, and then hire her back if she is eventually able to return to work.
Joseph, Lawyer
Satisfied Customers: 5043
Experience: Extensive experience representing employees and management
Joseph and other California Employment Law Specialists are ready to help you
Customer: replied 1 year ago.

Joseph, although we would not pursue this, do we have a right to ask her to pay for the employee's portion of her premiums since she has been out?


 


The agreement is employer pays 75% of premium and employee pays for 25%, which she has been unable to do, (although she had planned on paying her share). Thanks, Jane

Expert:  Joseph replied 1 year ago.
Hell Jane,

No, unfortunately, since you have already paid for the health insurance, you wouldn't have the right to require that the employee pay back a portion of the health insurance since she's been out, but you can always require that she at least pay a portion of her health insurnace premiums.
Customer: replied 1 year ago.

That was the agreement, that she will continue to pay her 25% portion. But since she is no longer getting a paycheck from us, we could not deduct from her check (as we do with other employees) and she agreed to send her payments to us.

Expert:  Joseph replied 1 year ago.
In that case, you can require that she repay the 25% that she was responsible for. If she refuses to repay you, you could file suit against her for that amount.

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