When it comes to employee health insurance contributions while on leave, employers have options

Employers must maintain group health insurance coverage for employees taking FMLA leave. However, they have options around how they can require employees to pay their share of the premiums:

  1. Employers can schedule payroll deductions for the premiums and have the employee pay them back while they’re on leave via check.
  2. Employers can take premium deductions from a short-term disability benefit, if applicable.
  3. Employers may also be able to make any other kind of agreed-upon payment arrangement with their employee.

If pursuing the third option, Ryan Nelson, Certified Leave Management Specialist and Sr. Absence Management Solutions Practice Leader at Guardian, advises employers to include some type of notice in the agreement that if employees do not return to work, they are responsible for reimbursing the employer for those payments. “Employees are required to be given up to 30 days to make delinquent payments,” Nelson explained, “but if an employer has done everything it can to help that employee maintain their benefits and the employee chooses not to return to work, the employer does have some rights to recover those premiums.”

Manager training can mitigate the risk of lawsuits

The financial consequences of mismanaging FMLA can be significant; the average cost to defend an FMLA lawsuit is $80,000.2 “Individual managers can be named in these lawsuits. They can be sued if they’re perceived to have been a part of the poor practice,” said Nelson. “So, educating managers to ensure they understand what they can and cannot do or ask is beneficial to everybody in your organization. Oftentimes, the managers are on the front lines of absence management situations.”

Many managers haven’t experienced leaves themselves, Nelson adds, so ongoing training for managers, including examples of scenarios that may come up, can prove useful in supplementing basic FMLA training.

Document, document, document

The importance of consistent, clear policies around FMLA leave and communicating them well to employees cannot be overstated. But sometimes, despite taking those steps, employers may have good reason to suspect employees are abusing their FMLA. If so, Matthew Ceurvels, Absence Management Product Lead at Guardian, advises documenting the details, so you have proof of what’s taken place.

“You need to make sure you have documentation of the employee’s request for leave, any disciplinary actions taken, and any investigations that have occurred,” Ceurvels says. “But it all starts with having a process and making sure it's clear on utilization or usage requirements.”

Want to learn more?

Watch the replay of our Guardian Absence Management Academy webinar FMLA 101: Mastering the fundamentals which lays out the basics of what employers managing FMLA should be aware of, and to address frequently asked questions.

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1 Guardian webinar poll results, 2/22/23. (sample size: 1,488)

2 Sullivan, Ken. 8/2020. The Cost of Noncompliance When Managing Employee Absence. Society of Human Resource Management

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