Page:United States Statutes at Large Volume 110 Part 6.djvu/502

 110 STAT. 4324 CONCURRENT RESOLUTIONS—APR. 16, 1996 for maintaining coverage such as through pooled contributions by all employers party to the plan. (c) During the duration of an employee's FMLA leave, coverage by the group health plan, and benefits provided pursuant to the plan, must be maintained at the level of coverage and benefits which were applicable to the employee at the time FMLA leave commenced. (d) An employee using FMLA leave cannot be required to use "banked" hours or pay a greater premium than the employee would have been required to pay if the employee had been continuously employed. (e) As provided in § 825.209(f), group health plan coverage must be maintained for an employee on FMLA leave until: (1) the employee's FMLA leave entitlement is exhausted; (2) the employing office can show that the employee would have been laid off and the employment relationship terminated; or (3) the employee provides unequivocal notice of intent not to return to work. § 825.212 What are the consequences of an employee's failure to make timely health plan premium payments? (a)(1) In the absence of an established employing office policy providing a longer grace period, an employing office's obligations to maintain health insurance coverage cease under FMLA if an employee's premium payment is more than 30 days late. In order to drop the coverage for an employee whose premium payment is late, the employing office must provide written notice to the employee that the payment has not been received. Such notice must be mailed to the employee at least 15 days before coverage is to cease, advising that coverage will be dropped on a specified date at least 15 days after the date of the letter unless the payment has been received by that date. If the employing office has established policies regarding other forms of unpaid leave that provide for the employing office to cease coverage retroactively to the date the unpaid premium payment was due, the employing office may drop the employee from coverage retroactively in accordance with that policy, provided the 15-day notice was given. In the absence of such a policy, coverage for the employee may be terminated at the end of the 30-day grace period, where the required 15- day notice has been provided. (2) An employing office has no obligation regarding the maintenance of a health insurance policy which is not a "group health plan". See §825.209(a). (3) All other obligations of an employing office under FMLA would continue; for example, the employing office continues to have an obligation to reinstate an employee upon return from leave. (b) The employing office may recover the employee's share of any premium payments missed by the employee for any FMLA leave period during which the employing office maintains health coverage by paying the employee's share after the premium payment is missed. (c) If coverage lapses because an employee has not made required premium payments, upon the employee's return from FMLA leave the employing office must still restore the employee to coverage/benefits equivalent to those the employee would have had if leave had not been taken and the premium payments)

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