FMLA Coverage and Eligibility
The Family and Medical Leave Act (FMLA) applies to employers with 50 or more employees within 75 miles of the worksite. Eligible employees must have worked for the employer for at least 12 months, have worked at least 1,250 hours in the prior 12 months, and work at a location where the employer has at least 50 employees within 75 miles.
Qualifying Reasons for FMLA Leave
- Serious health condition of the employee
- Serious health condition of a spouse, child, or parent
- Birth of a child and care of the newborn
- Adoption or foster care placement of a child
- Qualifying exigency related to a family member's military service
- Care for a covered servicemember with a serious injury or illness (up to 26 weeks)
Health Plan Continuation During FMLA
Employers must maintain group health plan coverage during FMLA leave on the same terms as if the employee had continued working. This means the employer must continue to pay its share of the premium and the employee must continue to pay their share. If the employee fails to pay their share, the employer can terminate coverage — but must provide notice before doing so.
Watch Out
Many employers incorrectly terminate health coverage when an employee goes on FMLA leave. This is a FMLA violation. The employer must continue coverage on the same terms as active employees. If the employee is on unpaid FMLA leave, the employer can require the employee to pay their share of the premium — but must give the employee at least 15 days notice before terminating coverage for non-payment.