Group Administrator's Manual

The Family and Medical Leave Act of 1993 (Federal Law)

Employer Responsibilities

Groups That Are Subject To This Act

If your group has employed 50 or more employees for each working day during each of 20 or more calendar work weeks in the current or preceding calendar year, this act applies to your group.

Family Leave

If your group is subject to this act, you must grant an employee up to 12 weeks unpaid leave for the following reasons:

  • For the birth or placement of a child for adoption of foster care;
  • To care for an immediate family member (spouse, child, or parent) with a serious health condition; or,
  • To take medical leave when the employee is unable to work because of a serious health condition.

To be eligible for FMLA benefits, an employee must:

  • Work for a covered employer;
  • Have worked for the employer for at least a total of 12 months;
  • Have worked at least 1,250 hours over the prior 12 months; and,
  • Worked at a location where at least 50 employees are employed by the employer within 75 miles.

If an employee takes family leave under this act, the employer must keep paying the employee's healthcare coverage during the leave, just as if the employee were at work.

We suggest that the employer make sure that the employee's portion of the premium, if any, is paid during the leave, so that the employee's coverage continues unabated during the leave, even if the employee fails to pay his or her portion of the premium.

Keeping the employee's coverage in place and paying for it during the leave of absence will keep the employer in compliance with the requirement that the coverage resume unchanged when the employee returns from the leave. If the employee’s coverage were to lapse during the leave, he or she would have to reapply for coverage, subject to the group's probationary period.

In other words, if coverage lapses for non-payment during the leave, the coverage would not resume as it was before. The employer would, therefore, have to bear the cost of coverage condition or find alternative coverage for the employee.

If the employee does not return to work at the end of the family leave period, the employer may recover the unpaid premium, unless the employee is not returning to work due to serious illness or other circumstance beyond the employee's control.

For Additional Information: Contact the nearest office of the U.S. Department of Labor, Wage and Hour Division

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