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Health Insurance Canceled While Off for a Work-Related Injury

Can my employer cancel my health insurance or require me to pay it while I’m off for a work comp injury?

Many Missouri workers who are off work due to work injuries have a common concern about their employers canceling their health insurance while they are off. Many ask, “Can my employer cancel my health insurance or require me to pay it while recovering from a work comp injury?”

Answer: a company must continue your health insurance while you are on leave, but they can require you to pay your premium.

FMLA after work injury

30 YEARS EXPERIENCE

OVER $100 MILLION COLLECTED

ONLY WORK COMP

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While most states prevent employers from retaliating against an employee who has filed a workers’ compensation claim, most do not address the continuation of benefits in the event of an extended absence due to a work-related disability or injury. As a result, some employers will choose to stop paying for health coverage.

However, two federal programs mandate the continuation of health coverage. One is the Family and Medical Leave Act (FMLA), and the second is COBRA. Both of these programs can help workers who have been injured and cannot work, and they can keep their health coverage if they can pay the cost themselves.

What is FMLA?

The Family and Medical Leave Act (FMLA) is designed to provide employees with up to 12 weeks of unpaid leave per year. While certain criteria must be met, an employee may benefit from this program for the following reasons:

  • the birth and care of their newborn baby
  • for placement of a child for adoption or foster care with the employee
  • care for immediate family members such as a child or spouse
  • medical leave when the employee is unable to work due to an injury or serious health condition

The injured employee must notify his employer that he is using his FMLA leave while on disability. The employer must maintain the same level of health insurance benefits the worker had while he was employed. If the worker must be off work longer than the allotted 12 weeks, the employer may cancel the health insurance benefits.

What is COBRA?

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. It was established in 1985 and requires employers who have group health plans to offer their employees the opportunity to temporarily continue their health coverage when they would otherwise not be able to. This may be due to a layoff, termination, or other change to their employment status.

An injured worker may choose to use COBRA when they expect to be out of work longer than the 12 weeks provided by the FMLA leave. The employee will be required to pay the entire cost of membership in the plan, and the employer may be required to provide this continued coverage for up to 18 months.

St. Louis Work Injury Lawyer

If you or a loved one have been injured on the job and are having difficulties getting the benefits you need, contact the Law Office of James M. Hoffmann today. When we take your case, we prioritize recovering benefits, putting decades of experience, a proven record of success, and a client-focused approach behind your workers’ compensation case.

Our St Louis Workers’ Compensation Attorneys can provide the necessary information to make the right choices to receive the best medical care, benefits, and income.

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