Open enrollment and Leaves of Absence

[Guest sgriff]

Can an employee on a Non-FMLA leave of absence be prohibited from making election changes during the normal annual enrollment period while on leave of absence?

Please Note: I am not interested in how this question relates to FMLA or COBRA requirements.

Would HIPAA apply? Any help would be much appreciated.

Thanks.

[papogi]

While it might seem that HIPAA actively-at-work and non-confinement rules could apply here, I don't see anywhere in the regs that it specifically addresses this. You don't state if the LOA is due to a health reason, and this might affect HIPAA's influence here. You could argue that the LOA employees already have coverage, and HIPAA does not say that they must have the ability to change their elections. But what if someone does not have the coverage now, and they want to elect it during open enrollment? Again, it does not appear that HIPAA addresses this specifically, but it seems to me that allowing the employee to begin coverage at open enrollment is consistent with the intent of the legislation, if the cause for the LOA is a health reason. If the LOA is due to a health condition, I don't see how you could treat the employee differently from an active employee under the intent of HIPAA, even though it is not addressed specifically. I think you could run into problems. If the LOA is not health related, HIPAA would not help, and you might get away with this if it is documented, but there might be employee relations issues.

[Guest sgriff]

Thanks.

You are right, if it is due to a health reason, I believe HIPAA would not permit us to treat loa employees differently than active at work employees. But, if the loa employee is on leave due to a non-medical/health reason, I really could not find anything telling me I could not exclude them from open enrollment until they return to work.

[Jbentz]

Can I ask what the benefits are in waiting until they return to work? Also, will the carriers accept the changes?