I have an employee who went on unpaid pregnancy leave on 2/19/08. Upon review with our medical plan administrator, we advised that she not eligible for medical benefits due to the fact she is on unpaid leave. We notified her of this in writing on 2/25/08. She now states that labor code 2806 indictes we need to notify her if her medical benefits "are terminated" fifteen days prior to termination of coverage. In this case, we did not terminiate her, she became uneligible due to the fact she is not working the required hours. She has been forwarded California Cobra informtion to continue her benefits should she wish to do so. Please advise. Thank you.
Optional Information: sacrament, CaliforniaAlready Tried: Medical plan administrator, paralegal
How many employees do you have?How long has she worked for you? How many hours did she work last year?Was she receiving benefits (insurance) before she went on leave?BusinessDoc39510.797315706
8.0 total full time equivalent employees.
This employee has worked for approximately 1 1/2 years. She is an FTE for that entire time, however worked less than 40 hrs consistently per week but more than 32hrs due to over use of sick/vacation benefits.
Yes, she was receiving medical benefits prior to her pregnancy leave for approximately one year.
The California Fair Employment and Housing Act (FEHA) contains provisions which require employers to provide unpaid pregnancy disability leave. Disability leaves for pregnancy MUST be treated the same as any other disability leave. If you provide benefits for other causes of short term disability, you would be required to provide the same benefits during this employees pregnancy disability leave.The specific statute in the California Labor Code does not seem to apply, since this relates to a termination/cancellation of benefits for employees (or groups of employees), not for someone who is no longer qualified because of their employment status.2806. (a) No employer, whether private or public, shall discontinue coverage for medical, surgical, or hospital benefits for employees unless the employer has notified and advised all covered employees in writing of any discontinuation of coverage, inclusive of nonrenewal and cancellation, but not inclusive of employment termination or cases in which substitute coverage has been provided, at least 15 days in advance of such discontinuation. (b) If coverage is provided by a third party, failure of the employer to give the necessary notice shall not require the third party to continue the coverage beyond the date it would otherwise terminate. (c) This section shall not apply to any employee welfare benefit plan that is subject to the Employee Retirement Income Security Act of 1974.I do not believe that she would be eligible for continuation of coverage under COBRA, because only employers with 20 or more are mandated to comply with those provisions - However you should check with the insurance company if that option is available to her.As I stated above, I do not believe that you would be required to provide 15 days notice for this particular case (or in similar cases where an employee were to quit) - HOWEVER, since she is pregnant, and the wording of this section of the Labor Code is a bit nebulous - it would be prudent to contact the California Department of Labor for an official ruling. If it were determined by the DOL at some later time that you were in error, you could face huge financial liability (the cost of her pregnancy related care). An official ruling by the DOL would provide you an excellent defense against any complaints filed by the employee.
MBA, Physician, MRO, Consulting & teaching in business and HR management issues
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