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If an employee is on a leave of absence (LOA) must the employer continue health insurance or is this a COBRA (Consolidated Omnibus Budget & Reconciliation Act of 1985) event?

| 07/04/2017 |

It depends. If the employee is on FMLA and CFRA leave simultaneously, the employer must continue health coverage under the same conditions (permitting the employee to pay the same dollar amount or the same percentage of the premium) as though the employee were still actively working, for up to a maximum of 12 weeks. After the 12 weeks of leave, if the employee does not return to work, then the employee and dependents (qualified beneficiaries) are entitled to 18 months of COBRA plus an additional 18 months of Cal-COBRA (for plans written, delivered and filed in California)..

In cases where CFRA follows FMLA (as in pregnancy disability followed by baby bonding), then COBRA (followed by Cal-COBRA) may begin at the end of FMLA and continue through any existing pregnancy disability leave and any subsequent CFRA leave.

Military Leave: If the service is for 30 or fewer days, the employee cannot be required to pay more than the normal employee share of any premium. When the leave is longer the employee’s insurance will continue for up to 24 months if the employee pays for the insurance. The employee cannot be charged more than 102% of the premium costs. This continued coverage will run concurrently with COBRA .

Note:
• California Family Rights Act leave (CFRA) and Pregnancy Disability Leave (PDL) are California leaves.
• Family Medical Leave Act (FMLA) is a Federal leave.
CFRA and FMLA are 12-week maximum leaves, whereas PDL is a maximum of 4 months.