FAMILY AND MEDICAL LEAVE ACT (FMLA) APPROVED LEAVE OF ABSENCE

If your Employer grants you an approved family or medical leave of absence (approved FMLA leave) in accordance with Family and Medical Leave Act of 1993 (FMLA), you may, during the continuance of such approved FMLA leave, continue Health Expense Benefits for you and your eligible Dependents.

At the time you request the leave, you must agree to make any contributions required by your Employer to continue to make premium payments.

Coverage will not be continued beyond the first to occur of:

  1. the date you are required to make any contribution and you fail to do so;
  2. the date your Employer determines your approved FMLA leave is terminated;
  3. the date you give your Employer notice of intent not to return to active service; or
  4. the date the coverage involved discontinues as to your eligible class. However, coverage for health expenses may be available to you under another plan sponsored by your Employer.

Coverage for a Dependent will not be continued beyond the date it would otherwise terminate.

If Coverage terminates because your approved FMLA leave is deemed terminated by your Employer, you may, on the date of such termination, be eligible for COBRA on the same terms as though your employment terminated, other than for gross misconduct, on such date.

If you acquire a new Dependent while your Coverage is continued during an approved FMLA leave, the Dependent will be eligible for Coverage on the same terms as would be applicable if you were Actively At Work, not on an approved FMLA leave.

If you return to work for your Employer following the date your Employer determines the approved FMLA leave is terminated, your Coverage will be in force as though you had continued in active employment rather than going on an approved FMLA leave provided you make request for such Coverage within thirty-one (31) days of the date your Employer determines the approved FMLA leave to be terminated. If you do not make such request within thirty-one (31) days, Coverage will again be effective under the group contract according to Plan requirements for a rehired employee.

(In the case of conflicting information, your Schedule of Benefits takes precedence.)

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