Should LOA employees be given the same annual enrollment opportunities

[Guest kclark]

Must employees on FMLA or Non-FMLA be given the same opportunity as active employees to make election changes during the normal annual enrollment period while on LOA? Normally, it is my understanding that employees on LOA must wait to make changes upon their return to work.

[Mary C]

This comes back to the question of can a plan enforce an actively at work provision for enrollment/changes. HIPAA states that group health plans cannot discriminate on enrollments due to health status. There have been cases filed with the courts and ADA to see if an actively at work provision discriminates against employees on a medical LOA when it comes to enrollments and making changes active employees would be allowed to make. We allow employees on LOA to go ahead and make the changes for several reasons -- for example, their current HMO may no longer be offered.

[Guest kclark]

What if the plans remain the same and the enrollment would only be for people wanting to make changes to current plans? Also, most life insurance carriers require employees to be actively at work for any changes to be effective, wouldn't that make any annual enrollment changes to those plans a moot point?

Are you saying that the HIPAA provision regarding health status refers to annual enrollment as well as new enrollments......I never related the two. This gets confusing!

Any help would ge greatly appreciated!!!

[Lisa Hand]

Remember whether the LOA is an FMLA event or not impacts how you treat it. FMLA leaves give the participants additional options which should be communciated. There are specific regualtions on FMLA and its impact on Cafeteria Plans.

[Guest kclark]

From my understanding of FMLA regulations, it is stated that employees on FMLA must have the ability to continue their "current" benefit elections. I have read everything I could find on FMLA requirements regarding benefit plans, and could not find any as specific as how they must be treated in an annual enrollment selection.

I have consulted two different legal firms and got 2 different answers!

One has said that, clearly, current elections need to be continued. However, there may be individual company policies in place as to how employees on FMLA should be handled during annual enrollment.

The other has said, to be on the conservative side, they should be treated the same as active employees with regard to annual enrollment options.

It doesn't sound like there would be any discriminatory legal issues if they were not allowed to change elections until their return.

As you can see, that really helped!!!

One of my concerns is around the individual carriers, i.e., life insurance and LTD, stating that changes in elections are NOT effective until the employee returns to active status.

I guess I'm just interested in taking a mini poll as to how everyone else treats these employees.......I would greatly appreciate the help!

Thanks!

[Lisa Hand]

http://www.benefitslink.com/taxregs/1.125-3.shtml

This is the regulation issued on how FMLA works with Section 125 which should answer your questions as far as Section 125 and FMLA leave of absence.

[Guest kclark]

Thanks Lisa......this is great!

Kathy