COBRA and Workers Comp

[Guest LLandau]

An employee (this is in California) will be out on workers' comp. leave for 12 weeks.

Q1: Does his beneficiaries have COBRA rights? What rights do they have?

Q2: What are the employer's responsibilities to the beneficiaries in this case?

[KIP KRAUS]

If you don't allow your employes to continue regular medical coverage during a WC case you should offer COBRA to him/her and eligible dependents.

[Sandra Pearce]

For most employers and employees a WC leave would also be a qualified FMLA leave and if this is the case the employee's benefits must be maintained. In other words during the 12 weeks of approved FMLA leave the employee should be able to continue coverage at the same rate as an active employee. The employer must notify the employee that the leave will be counted as FML and specifically state how benefits can be maintained; i.e., when premiums are due. While on an FML the employee must be given a notice 15 days prior to cancellation of coverage for non-payment. There would be no reason to have COBRA offered during the 12 week FMLA period. Even if the employee does not pay the employee portion of the premiums and coverage is cancelled for non-payment this is not a qualifying COBRA event.

[oriecat]

While on an FML the employee must be given a notice 15 days prior to cancellation of coverage for non-payment.

Do you have a source on this? I don't remember seeing anything like that before and would like to look into it more.

[Sandra Pearce]

FMLA Section 825.212 is the section regarding the consequences of an employee's failure to make timely premium payments.

[oriecat]

Thank you!!