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March 4, 2016 By nicole

Will my health insurance stop when I am out on workers’ comp?

Kevin* hurt his back lifting boxes at work and couldn’t do his job as a maintenance supervisor. He was concerned about losing his income and getting good treatment for his back. But Kevin was also concerned about keeping his health insurance. He has diabetes and high blood pressure, and his yearly medical exam is coming up. What if he has to pay for all of the tests his doctor has to run out-of-pocket?

Sometimes employees have to remain covered by their health insurance. Some employees are covered by the Family Medical Leave Act (FMLA), which requires that employers with more than 50 employees and government employers continue health insurance coverage when employees are out of work for up to 12 weeks. Those employees who need medical leave for themselves must have a serious health condition, requiring treatment and needing out of work for at least three days in a row, or have a chronic condition. The employer must pay the employer’s part of the premium during the FMLA period. The employer may require that the employee’s contribution be paid by the employee but it also can pay for the worker.

Even if the FMLA doesn’t require coverage to continue, employees in North Carolina are eligible to continue coverage for up to 18 months. But the employee must pay for the full premium.

Some employees who are covered under contracts, including Union contracts, are eligible to receive paid health insurance coverage for longer than required by law.

If you need help with a workers’ compensation question, or with FMLA, call the board-certified attorneys at Johnson and Groninger. Valerie Johnson is here to help.

Filed Under: Spinal Cord Injury, Work Injury, Workers' Compensation Tagged With: FMLA, insurance, workers' comp

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