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- Family and Medical Leave Act Advisor

Employee Payment of Group Health Benefit Premiums

Any share of group health plan premiums that had been paid by the employee prior to FMLA leave must continue to be paid by the employee during the FMLA leave period. If premiums are raised or lowered, the employee would be required to pay the new premium rates.

Maintenance of health insurance policies that are not a part of the employer's group health plan are the sole responsibility of the employee. The employee and the insurer should make necessary arrangements for payment of premiums during periods of unpaid FMLA leave.

If the FMLA leave is substituted paid leave, the employee's share of premiums must be paid by the method normally used during any paid leave, presumably as a payroll deduction. Similarly, an employee who is receiving payments as a result of a workers' compensation injury must make arrangements with the employer for payment of group health plan benefits when simultaneously taking FMLA leave.

If FMLA leave is unpaid, the employer has a number of options for obtaining payment from the employee. The employer must provide the employee with advance written notice and the terms and conditions under which these payments must be made. The employer may require employees to pay their share of premium payments in any of the following ways:

  • Payment would be due at the same time as it would be made if by payroll deduction;
  • Payment would be due on the same schedule as payments are under COBRA;
  • Payment would be prepaid pursuant to a "cafeteria" plan at the employee's option;
  • The employer's existing rules for payment by employees on "leave without pay" would be followed, provided that such rules do not require prepayment of the premiums that will become due during a period of unpaid FMLA leave or payment of higher premiums than if the employee had not taken leave; or
  • Another system voluntarily agreed to between the employer and the employee.

An employer may not require more of an employee using unpaid FMLA leave than of other employees on leave without pay.

You may also wish to review the consequences of an employee's failure to pay health plan premium payments

Continue to Maintenance of Benefits under Multi-Employer Health Plans or Return to Employer Rights and Responsibilities Menu.

For more information on this aspect of the FMLA, see the FMLA regulations: ยง 825.210