Current through Register Vol. 41, No. 3, September 23, 2024
Note: This section addresses various aspects of employee
leave and may or may not be applicable to a local employer.
A. Leave of absence with full pay. As long as
an employee is still receiving full pay, health benefits coverage continues
with the employer making its contribution. Nothing special must be done to
maintain coverage.
Local employers are not required to contribute toward
coverage for any part-time employee granted any type of leave of
absence.
B. Virginia
Sickness and Disability Program, Long-Term Disability (VSDP-LTD)
1. Coverage with the employer contribution
continues to the end of the month in which the LTD benefits begin, unless
benefits begin on the first day of the month, in which case the employer
contribution will end on the last day of the preceding month. Thereafter,
employees may continue coverage by paying the entire cost of the
coverage.
2. Employees receiving
LTD benefits may enroll in the State Retiree Health Benefits Program upon
service retirement regardless of whether they have maintained health coverage
in the state program provided that the individuals have been continuously
covered and have had no break in long-term disability benefits prior to service
retirement. The LTD participant has 31 days from the date of retirement to
enroll in the State Retiree Health Benefits Program. Coverage in the retiree
group begins on the first day of the first full month of retirement.
C. Educational leave -- full or
partial pay. An official educational leave is a leave for educational reasons
with partial or full pay maintained for the leave, not for work rendered. It is
possible to maintain health coverage on an educational leave even when less
than full pay is given provided that at least half pay is given. Coverage may
continue for the duration of the leave up to 24 months.
D. Leave of absence without pay.
1. Coverage with the employer contribution
continues to the end of the month in which the leave without pay begins
provided the first day of the leave is after the first work day of the month.
If the person returns from leave the following month and works at least half of
the workdays in the month, coverage will be continuous. If the leave without
pay begins on or before the first work day of the month, coverage and the
employer contribution ceases on the last calendar day of the previous
month.
2. Employees who do not want
to continue coverage will be asked to sign a waiver.
E. Changing coverage while on leave. Coverage
changes may be made while on leave in the same manner that changes may be made
while actively employed. The same procedures and rules apply.
An employee enrolled in an alternative health benefits plan
who moves out of the plan's service area while on a leave of absence may change
to another plan offered by the department in his new location by taking an
enrollment action within 31 days of the date of the move.
F. Returning from leave without pay.
1. Employees who have maintained coverage
while on leave without pay. If the employee has maintained coverage while on
leave, the employee's coverage in the health benefits program (with the
employer making its contribution) will begin on the first of the month
following the date the employee returns to full-time employment. However, if
the return to work falls on the first day of the month then the employer
contributions may begin immediately. It is not necessary for the employee to
take a new enrollment action.
Employees may change from single to dual or family
membership within 31 days of returning from leave without pay if the employee
dropped dual or family membership during the leave or if there was a qualifying
mid-year event during the leave. A new enrollment action must be taken. In the
case of a qualifying mid-year event, the effective date would follow the rule
on initiating dual or family membership at the time of the particular
qualifying mid-year event.
2. Employees who have not maintained coverage
while on leave will be treated in the same manner as new employees, unless they
have exercised their rights under the Family Medical Leave Act. If these rights
are exercised, they will have all rights that are required by law.
a. It shall be necessary to take a new
enrollment action to receive coverage. The enrollment action shall indicate the
date the employee returned to work as the date that the employee's continuous
full-time employment commenced.
b.
The employee has a choice of type of membership and plan.
c. The usual deadlines for filing apply.
Coverage begins according to the rules and procedures for new
employees.
3. Employees
returning from military leave for active service. Employees returning from
military leave of 30 days or more have the same choice of coverage as a new
employee. If the employee returning from a military leave applies for coverage
within 31 days of discharge, the coverage will begin on either the first day of
the month of discharge or the first of the following month, whichever is
necessary to effect continuous coverage.
4. Taking a second leave without pay. If an
employee returns from a leave without pay and is employed full-time on every
scheduled work day for at least one full calendar month before taking another
leave without pay, the second leave will be treated as a new leave.
If there is less than one calendar month of full-time
employment between leaves without pay, the leaves will be treated as one,
regardless of the types of leave. The length of time that coverage may be
continued will depend on the current type of leave.
Statutory Authority: § 2.2-2818 of the Code of
Virginia.
