Leave and Benefit Law Compliance

How do I know my employer obligations to offer job-protected leave to employees?

There are many federal and state job protected leave mandates including Family and Medical Leave (FMLA) and state mandated paid disability and paid family leave. Click here for more information.

If there are both federal and state mandates for the same leave situation, which law governs?

Generally, state mandates provide for the same or more than the Federal law whether it is duration or related benefits. When Federal and State mandates apply, both must be followed, or employers will face penalties from the agency that governs the specific law.

We have employees in multiple states, which leave law applies?

Employees working in different states are typically eligible for the leave available in that state. Employers must understand each specific state mandate and may need to comply with several different mandates.   Click here for more information.

Can we have employees use their vacation and sick time before utilizing any other leave?

These rules vary and are dependent on what leave law applies.   FMLA is an unpaid leave and employers may require an employee to utilize various paid time off while on leave.   However, if a paid leave also applies, this may not be allowed.   It is important the employers are aware of each individual state mandate to be in full compliance.

When an employee has a leave request, what information must be provided?

Employers must provide employees with all legally required notices (posters, certification forms, FAQs, etc.) outlining their rights and responsibilities related to each leave. Employers must also be aware of all leaves that apply, to comply with any federal and state communication requirements.   This information must also be provided within the timeframes required by each law.  FMLA packages must be sent to employees within 5 business days of the request.

If an employee gets injured while working, does FMLA still apply?

Yes! Federal FMLA is applicable to both on and off the job illness or injury and all notices and timeframes apply.

What benefits is an employer obligated to offer to employees by law?

Under Affordable Care Act regulations, medical coverage must be provided by applicable large employers (50 or more full time employees) to certain employees or face a large penalty for non-compliance.    Some states also have specific mandates related medical benefits and coverage offered.

I offer medical, dental, and vision plans to my employees on a pre-tax basis. When should I allow them to make changes?

Employers must allow employees to make changes to benefits once a year, during an annual Open Enrollment period, at a minimum.   There may be certain qualifying life events (birth or adoption of a child, marriage, divorce, etc.) that will allow employees to make mid-year benefit changes, outside of an Open Enrollment period.

When do benefits terminate for employees?

Benefits typically end at employment termination or other work events resulting in loss of benefits eligibility (ex. Reduction in hours). The end date for these benefits may be on the date of benefits eligibility loss (i.e. date of termination).   Coverage may also extend through the end of the month that the termination or other event occurs.   It is important that employer follow the plan provisions outlined in their plan documents.   Non-compliance/operating outside of plan provisions will result in penalties if audited.

What communications do employees need when benefits end?

Upon loss of coverage, employers must provide employees with a termination of benefits letter that outlines the benefits the employee was enrolled in before the loss, the dates the benefits end, and notice related to COBRA paperwork.

How do I know when to offer COBRA coverage?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) requires that employers provide an offer of continued health plan coverage to employees and other qualifying beneficiaries for up to 18 months following specific qualifying events that result in coverage loss.   Health plan coverage includes medical, prescription, dental, vision, FSA, HRA, and EAP plans.  Employers typically have 14 days following the qualifying event to send this notice to affected employees or beneficiaries.  Non-compliance/failure to send proper notice, in the prescribed time, can result in employee litigation and penalties for the employer.   Certain states also have “mini-COBRA” laws that may extend the Federal COBRA coverage.

When an employee enrolls in COBRA, does that fulfill my employer obligation?

There are several notice requirements and additional administration required once an employee enrolls for COBRA coverage.   This includes premium collection and billing, Open Enrollment and plan change notifications, annual required benefit notices, and applicable termination of COBRA coverage notices.  Failure to properly communicate with COBRA enrollees can result in litigation and penalties for the employer.