You’re injured, off work, are on reduced pay, and your employer pulls your health insurance. What do you do if you’re injured at work?
What Do I Do If My Employer Cancels My Health Insurance?
If you’ve suffered an injury, became disabled, had or adopted a child, or there is some other reason that results in extended time away from work, employers (that offer health insurance) may stop paying their end of your premium. If this is the case, there are two programs employees on leave can use to help cover those costs since most employers paying employees on leave only shell out two-thirds of the average weekly wage.
Employers can’t arbitrarily stop paying your health insurance premiums if you’re on extended leave. Unless there’s a caveat in your plan, or you were terminated without knowing about it, you should reach out to a worker's compensation lawyer to help you secure reimbursement.
One of the big questions is: “What if I have an employee who was injured outside of work and is on leave for a few weeks? Do I have to continue to pay their insurance premiums?” The answers vary, and depending on the situation said employer may be able to offer COBRA or FMLA, which we discuss below. If you lose coverage (or weren’t notified via ERISA which involves retired employees), you may have a lawsuit on your hands.
What is FMLA?
FMLA, or the Family and Medical Leave Act, that helps support employees when they have to go on an extended leave. FMLA is closely tied to federal, state, or local government agencies or with contractors (or private businesses) that are working for the government, such as a construction crew making interstate upgrades.
Specifics aside, FMLA is a federal law that supports employees that may have adopted or birthed a child, are on active military duty, require long-term medical care, or can’t work for an extended period of time. On the other hand, FMLA may apply if a parent or family member needs medical attention, but not your in-laws. The amount of time you receive FMLA isn’t set, but it has a cap. Another factor to keep in mind is that you need to have been with a company for 12 months (and worked 1,250 hours) to apply. If you’re having trouble with worker's compensation benefits, contact an FMLA attorney in St. Louis today for more information.
What is COBRA?
COBRA, or the Consolidated Omnibus Budget Reconciliation Act, also helps workers maintain their health insurance while off work due to injury, pregnancy, or other incidents. COBRA allows spouses, retirees, former employees, and dependents to stay on group health insurance rates for a certain period of time. It’s not free, but the premiums are usually more manageable.
COBRA may apply to employees that were either involuntarily or voluntarily terminated, had a reduction in hours, are divorced or deceased (from the spouse’s side), or from a dependent’s perspective lost child status. In short, COBRA (like FMLA) allows you to stay on an employer’s insurance plan but you still pay your premium and the employer’s premium. COBRA rights kick in if your company has more 20 or more employees. You have to be terminated or laid off to use COBRA in which case you’d pay 102 percent (taking into account administrative fees) of the premium.
“I Was Injured and My Insurance Was Canceled By an Employer”
If you were injured in a construction accident, a slip and fall, or some other mishap occurred while on the job, employers are not able to arbitrarily cancel your health insurance. If you’re taken off of a plan (and stop receiving health insurance benefits), that means your employment status has shifted. If you weren’t notified of this change, that can lead to serious legal repercussions.
Lost wages are a serious concern in Illinois and Missouri. If you’re being underpaid, you need to reach out to a worker's compensation lawyer as soon as possible. On the other hand, being on extended leave due to a work-related injury deserves continued health insurance benefits.
Contact a St. Louis Work Injury Lawyer Today
The St. Louis workers compensation lawyers at the Dixon Injury Firm provide dedicated legal representation to injury victims in the Greater St. Louis area and Southern Illinois. Feel free to contact us today for a free case review and consultation.