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Who Pays Health Care Premiums in Short-Term Disability FMLA?

The Family Medical Leave Act, or FMLA, ensures that if you are off work as a result of an FMLA-covered condition, you have certain employment rights you will retain during your leave. If eligible, you are entitled to 12 or 26 weeks of FMLA leave in a 12-month period. If you have an illness or injury that requires you to be off on short-term disability, this would likely be considered an FMLA-qualifying condition.

  1. FMLA Protections

    • When you are on an FMLA-eligible leave, whether it's unpaid leave or you're paid using sick time, personal time, vacation time or your employer's short-term disability plan, you are entitled to certain job protections by the act. You must be able to return to a job similar to the job you held when you went on leave, but with the same pay and benefits. Your employer must maintain your health coverage.

    Health Care Premiums

    • Any health insurance benefits you enjoy while working must be maintained when you are on a qualified FMLA leave such as short-term disability. Your employer cannot diminish these benefits in any way, such as increasing your copay or coinsurance. If, when you are working, your employer pays your premium, he must continue to do so as long as you are on FMLA leave. If you pay all or part of your insurance premiums, you must continue these payments in the manner required by your employer. Before you go on leave, be sure you clearly understand how to pay your premiums to avoid any lapse in coverage.

    When Leave Ends

    • The first time you take FMLA leave, you have 12 weeks available to you -- 26 weeks if the leave involves a member of the military. As you use it, your allotment of available days decreases. Each time you go on leave, you are entitled to all the protections afforded by the law, regardless of the qualifying reason for which you took FMLA. If, while you are on FMLA leave, you exhaust your allotted days for the year but must remain off, you lose the protections of the FMLA law, including the payment of your insurance premiums and job protection, unless you are on an employer-provided short-term disability plan that also offers job protections.

    How Leave Is Calculated

    • Your employer can choose one of four ways to define the 12-month period that constitutes the basis for calculating your allotted leave time. He can use a calendar year; a fixed 12-month year such as a fiscal year; a 12-month period measured forward from your first day of leave; or a "rolling" 12-month period measured backward from the first day of leave. Make sure you know the method your employer uses, because it could impact your eligibility. If your leave is something that can be planned, such as undergoing some types of surgery, how leave is calculated can have an impact and is worth considering.

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