Benefits for Employees on Leave of Absence
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Protected Leave of Absence (LOA) such as FML, CFRA, PDL
and Military Leave
Benefits will be maintained for employees who are placed on a
protected leave of absence. If an employee on protected leave does not
have enough earnings (hours worked, vacation, sick, catastrophic
leave, etc.) to process their benefit deductions, payroll adjustments
will be processed upon return from leave to restore flex credits and
collect any missed premium deductions.
Paid LOA
While an employee on LOA continues to have enough earnings to process benefit deductions, benefit coverage will be maintained.
Unprotected and Unpaid LOA
When an employee is placed on an unprotected and unpaid LOA, their benefits will be terminated on the last day of the month following their status change. The section below will provide an overview of options for continuation of coverage while on an unprotected and unpaid LOA.
After a department inputs their employee’s unprotected/unpaid leave status in PeopleSoft, the following will occur based on the employee’s current benefits:
Medical
Eligible employees will be offered the option to continue their medical coverage during their leave. The Employee Benefits Division’s will mail an offer of medical continuation to eligible employees with the following options:
- Elect to continue your existing County medical plan and pay the full premium.
- Elect the least expensive medical plan and receive partial County paid premium assistance.
Extended medical plan administration and payments are handled by ASI COBRA. The deadline to elect coverage is 30 days from the date on the offer letter.
Dental and Vision
Eligible employees will be offered the option to continue their
dental and/or vision coverage for up to 18 months at full cost plus a
2% administrative fee under COBRA. Continuation coverage details will
be mailed by ASI COBRA to eligible employees.
Life and Accidental Death & Dismemberment (AD&D) Insurance
Continuation of Life and AD&D insurance is offered to eligible employees and can be continued for up to 6 months under the County’s group plan. MetLife will mail continuation and payment information to eligible employees. The deadline to enroll is 30 days from the date on the offer letter.
- After 6 months MetLife will offer the employee an option to convert their County policy to an individual policy.
- If an employee is enrolled in Supplemental Life insurance and allows it to lapse for more than one month while on a LOA, the Supplemental Life insurance will not be restored upon return from leave. After their return to work, the employee will be emailed a Statement of Health for review by the underwriting department at MetLife. If MetLife approves the employee’s Statement of Health, the Supplemental Life insurance will be reinstated on the 1st of the month following the approval.
None of the above will happen until your department inputs your
unprotected/unpaid LOA in PeopleSoft. An update will be
automatically sent to Employee Benefits and the insurance
carriers after that occurs.
Spending Accounts
Health Care FSA (HCFSA)
- You will have access to any HCFSA balance to make claims with ASI Flex during your LOA.
- Any missed contributions during a leave will be processed upon return from leave.
- If you are on an unpaid leave of absence or paid
injury leave, you may be able to terminate or lower your HCFSA
election during your LOA by emailing your request to Employee
Benefits at DHRBenefits.FGG@sdcounty.ca.gov. If you elect to
terminate your HCFSA while on LOA:
- You would not be eligible to submit claims for expenses incurred during your LOA.
- Upon return, you can either increase your deduction to keep the annual pledge the same or keep the deduction the same and lower the annual pledge. Default will be to keep the per pay period amount the same and lower annual pledge unless employee requests otherwise.
- If you do not email your request to change your HCFSA prior to your LOA, the annual pledge will remain in place and contributions will be collected upon your return to work in order to meet that annual pledge.
Dependent Care FSA (DCFSA)
- Dependent care expenses that you incur during LOA will not be eligible for reimbursement due to IRS rules.
- All claims must be submitted by March 31st of the following year. If there are not enough funds in the account at the time that a claim is submitted, the claim will be held in pending status until the funds are contributed.
- If you are on an unpaid leave of absence, you may be able to
terminate or lower your DCFSA election during your LOA by emailing
your request to Employee Benefits at DHRBenefits.FGG@sdcounty.ca.gov
- Upon return, you can either increase your deduction to keep the annual pledge the same or keep the deduction the same and lower the annual pledge. Default will be to keep the per pay period amount the same and lower annual pledge unless employee requests otherwise.
- If you do not email your request to change your DCFSA prior to your LOA, the annual pledge will remain in place and contributions will be collected upon your return to work in order to meet that annual pledge.
Reinstatement of Terminated Benefits
If an employee’s benefits are terminated during an unpaid, unprotected LOA, benefits will be reinstated, after the department enters the return from leave (RFL) date in PeopleSoft:
Health plan coverages will be reinstated the first of the following month after the employee’s RFL date, as shown in the following examples:
- Employee returns to work on July 1. Health insurance is
effective August 1.
- Employee returns to work on July 15. Health insurance is effective August 1
- Employee returns to work on July 31. Health insurance is effective August 1.
Supplemental Life Insurance
If the employee was enrolled in supplemental life insurance prior to their unprotected and unpaid LOA, and did not pay their life premiums while on LOA, MetLife will require the employee to re-apply by completing a Statement of Health (SOH). The SOH will be emailed to the employee by MetLife.
- If coverage lapsed for less than one month, or if the employee paid their life insurance premiums while on leave of absence, supplemental life insurance will be reinstated the first of the month following the employee’s RFL date.
Making Changes to Your Benefits
If you experience a Qualifying Life Event while on a LOA, and need to make changes to your benefits, you must email Employee Benefits at DHRBenefits.FGG@sdcounty.ca.gov within 60 days of the event. Your requested benefit changes can be made while on LOA or will be applied upon RFL.
To start a benefit change due to a qualifying life event while you are on leave of absence, email the supporting documentation and the Enrollment/Change Form (link below) to DHRBenefits.FGG@sdcounty.ca.gov.