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Fringe Benefits : Employer Sponsored Pension and 401(k) Plans, Vacation Benefits, etc.
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  #1  
Old 08-08-2009, 12:16 PM
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Question

Charged for benefits while on maturinty leave


What is the name of your state (only U.S. law)? California


I am currently on STD for maturnity leave. I informed my employeer about 8 months prior to my due date. My HR represenitive sat down with me and told me all my forms would be filled out through my OB office and had absolutely no other information for me. I had my daughter 7/24/09 and on 8/2/09 sent email requesting information on adding my daughter to my health insurance plan and again on 8/5/09 because I had not heard back from her. She then responded via email stateing she sent me a text message informing me she mailed out the forms. To my surprise I recieved the mail on 8/6/09 but it was not just information on insurance for my daughter but a bill for me to pay my insurance for Aug. I have already had doctors appointments and so has my daughter. Is it legal for them to tell me this after the fact?? I read our employee hand book benefit and pregnancy section that states absolutly nothing about this. What are my rights or options??

Last edited by jejape; 08-08-2009 at 12:25 PM.
  #2  
Old 08-08-2009, 12:31 PM
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the bill you recieved; are you talking about your normal contribution or yours and the company's contribution?
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  #3  
Old 08-08-2009, 12:51 PM
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When was your last day at work?
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  #4  
Old 08-08-2009, 01:12 PM
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And was it FMLA leave?
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  #5  
Old 08-08-2009, 07:45 PM
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my last day officalday of work was 7/3/09 due to doctors orders. I am not on FMLA just STD right now. I had a c-section so I believe I am off for total of 8 weeks on disability. Oh and yes the bill is for both employeers and my contribution.
  #6  
Old 08-08-2009, 07:46 PM
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my last day officalday of work was 7/3/09 due to doctors orders.
And herein lies your problem. Who did you expect to pay for your medical insurance for August since you didn't work???? Please don't tell me you expected it to be free.
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  #7  
Old 08-08-2009, 07:53 PM
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Originally Posted by jejape View Post
my last day officalday of work was 7/3/09 due to doctors orders. I am not on FMLA just STD right now. I had a c-section so I believe I am off for total of 8 weeks on disability. Oh and yes the bill is for both employeers and my contribution.
how about this then:

are you eligible for FMLA?

and then back to the question about: are you speaking about your contribution or the company's contribution?
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  #8  
Old 08-08-2009, 10:46 PM
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If you are eligible for FMLA, you are on it. It has nothing to do with your STD, that is simply how you are being paid while you are on medical leave. FMLA protects your job and also regulates things like whether you can be charged for your insurance. The law says you CAN be billed for the amount that is normally deducted from your paychecks for premiums. It's not being deducted from your STD payments, because they are coming from the STD company, not your actual employer. But you do still owe the money, so as long as they aren't billing you more then you normally pay for your benefits, the bill is legit.

Make sure you get the enrollment paperwork for your baby done and returned well within the 30 day time limit, because if you miss that window, you won't be able to add her until open enrollment.
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  #9  
Old 08-08-2009, 11:32 PM
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Please answer the following questions. The answers will determine whether you can be charged the full amount for your insurance or whether you can only be charged the amount you normally pay:

1.) How many employees does your employer have within 75 miles of your location? If you do not know exactly, is it over or under 50?

2.) How long have you worked for this employer?

3.) In the 12 months immediately preceding your leave, did you work a minimum of 1,250 hours?
  #10  
Old 08-10-2009, 01:25 PM
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Just to make it clear I was not expecting to get anything for free. I now know after looking it up that the law does not require them to pay my benefits but that is their choice. My problem is legally do they have no obligation to inform me of this prior to the bill being due? I had no idea. It was not in any handbook nor was it given to me in any paperwork explaining. So since I already had doctors appointments I did not have a chance to make a decision if financially I would be able to afford this. As a matter of fact since I have been on disabilty I have had 3 diffrent employees call me with work related questions (as I am the Medical Supervisor of one of our 4 offices) as well as HR contact me re: a employee that quit and asking me to send her to employee reviews.

I do not think I am on FMLA. I believe until STD runs out I am only on STD and FMLA if I choose to take it will last maybe a week since I had a rough recovery. I have worked with the company for 6-7 years now, there are only aprox. 35 total employees, and I have worked well over 1250hrs. in last 12 months. I was the only one that could do the entire job for a while so I was working 12-15 hr days.
  #11  
Old 08-10-2009, 01:43 PM
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If there are only 35 employees within 75 miles of your location, then you do NOT qualify for FMLA and none of the associated protections apply.

I suggest you read what I said about FMLA again. IF you qualified, you would be on it, your employer would not have a choice, but all FMLA does is state that you can go out on medical leave (can be paid or unpaid, doesn't really matter) for up to 12 weeks in a 12 month period, and your employer must make sure that your job, or a substantially similar job, is available for you when you return. It also regulates how and how much you can be required to pay for your benefits while you are out, and requires that you not be penalized in any way for taking the leave. It can and would run CONCURRENTLY with any STD payments. It is even possible to exhaust your FMLA before your disability payments are exhausted, which means that you would continue to draw the benefit until you were cleared to return to work (or the benefits ran out), but that your employer would not have to take you back at that time.

Since FMLA does not apply though, none of that is strictly relevent. There are no laws regulating when they must notify you of this bill and no laws preventing them from charging you up to the full premium cost for the time that you are on leave. Have you spoken to them about a payment plan?
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  #12  
Old 08-10-2009, 01:49 PM
cbg cbg is offline
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FMLA is not optional. It is not up to you whether to take it or not take it. You do not get to wait until your STD benefits run out (and STD is NOT leave - it is how you get paid while you are on leave) and then take 12 weeks of FMLA. FMLA and STD run concurrently. If you, the employer, and the condition all qualify for FMLA, then the employer is required by law to put you on it at least provisionally. You don't get to "hold it" till later.

However, since there are only 35 employees, FMLA does not apply either now or after your STD benefits expire. That being the case, your employer may legally require you to pay the full amount of your health insurance.
  #13  
Old 08-11-2009, 12:43 AM
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Thank you very much for your information on this matter. It is not that I don't want to pay it I jsut felt like they didn't inform me correctly. I will discuss with them the options of payments. That is a very good idea. Bummer for me that my work did not have enough courtesy to warn me of their protocals. Any ways again thank you for your input.
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