While an employee is on FMLA leave the employer is required to maintain the employee’s group health benefits on the same terms as if the employee continued to work. An employee, while on unpaid FMLA leave, needs to make arrangements with the employer to pay the employee's portion of group health benefits premiums.

This requirement includes all group health benefits the employee has prior to the date leave begins. For example, if the employee has family coverage, it must be maintained; if the employee has dental or eye care, it must be maintained; if the employee has coverage for mental health counseling or drug abuse treatment, it must be maintained during periods of FMLA leave.

If benefit plans change or premiums decrease or increase while the employee is on FMLA leave, the employee must be given the opportunity to elect the benefit plan change, and must pay the changed benefit premium.

If for some reason the employee is dropped from coverage of the group health benefit plan while on FMLA leave (the employee may elect not to continue coverage while on unpaid leave, or may fail to make premium co-payments as required) at the time the employee returns to work the employer must restore the group health benefit plan to the employee.

When restoring the group health benefit plan after the employee has taken FMLA leave, the employee may not be required to submit to a physical examination, be excluded for a new pre-existing condition, or be required to undergo a qualifying period.

The employer is not required to maintain a health insurance program the employee has purchased from an independent carrier where the employer's only role is to make payroll deductions for payment of employee's premiums.

See Regulations 29 CFR Part 825.209.

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