A personal Leave of Absence occurs when a member is absent from work for a fixed period of time by either legislation or by a mutual agreement between the employer and the member.
Tip!
GroupHEALTH recommends the employer consider establishing certain guidelines for personal Leave of Absence. For example:
- Employers must determine whether or not to allow members to continue benefits coverage during a personal Leave of Absence.
- This decision should be made corporately and must be applied equally to all members.
If the employer allows members to continue benefits during a Leave of Absence, the following guidelines apply:
- Members may continue coverage for all benefits (except Disability), provided premiums are paid, to a maximum of 6 months from their first date of absence.
- Disability benefits may continue for a maximum of one month from the end of the month in which employment was interrupted.
- It is at the employer’s discretion whether the member pays the full premium while on personal leave, or whether the employer/employee premium split remains in force.
- The member is responsible for remitting their portion of premium to the employer.
If the employer does not allow members to continue benefits during the leave of absence, the member may be reinstated (starting the first date of re-employment), provided they return to work within 12 months, and GroupHEALTH is notified within 31 days of re-employment.
Notify GroupHEALTH when a member is on a personal Leave of Absence. When entering the change in WEBS™, please indicate if the member will maintain their benefits.