Who Pays Your Health Insurance While on Workers’ Comp in Virginia?

A common concern among employees who are out on workers’ compensation is, “Will my employer continue my health insurance coverage while I’m unable to work? If so, who will pay my health insurance contributions?”

There are federal laws that may require your employer to continue your health insurance benefits for a certain period while you’re on worker’s comp. As to who pays for your health insurance, it is possible that you will have to pay your contributions directly or risk the cancellation of your health coverage.

Here’s how health insurance payments work while you’re on workers’ compensation. For legal advice on your specific case, consult our experienced workers’ comp attorney in Virginia.

Will My Employer Continue or Cancel My Health Insurance While I’m on Workers’ Comp?

There’s no Virginia law that requires employers to continue health insurance coverage for an employee on worker’s comp. There are, however, a couple of federal laws that may protect the employee’s rights during this time:

Family and Medical Leave Act (FMLA)

The FMLA is available to employees that meet these eligibility requirements:

• Has worked for the employer for at least 12 months
• Has worked for the employer for at least 1,250 hours in the last 12 months
• Works at a workplace with at least 50 employees in the locality.

FMLA-eligible employees can get a maximum of 12 weeks’ unpaid leave per year. During an FMLA leave, all benefits including health insurance will remain intact. You can apply to use your FMLA leave while you’re unable to work due to your job-related injury, so that you get to keep your health coverage for up to 12 weeks.

Premium cost sharing, however, remains the same during your FMLA leave, which means you’ll still have to pay your share of the premium. Prior to your injury, your premium contribution was likely deducted from your payroll. Now that you’re not working and aren’t receiving wages, you may need to pay your health insurance contribution directly. Failure to pay your portion of the premium will result in cancellation of the health coverage.

Consolidated Omnibus Budget Reconciliation Act (COBRA)

This law applies to companies with 20 or more employees with group health plans. COBRA requires your employer to give you options regarding your health insurance in the event there’s a change in your employment status (such as your temporary disability).

When you miss work due to your injury, your employer has to send you a notice allowing you to either continue your health insurance or have it canceled. If you choose to continue, you’ll have to pay the full membership cost to stay in the group health plan.

Besides these two federal statutes, another potential protection for your health insurance is your union’s collective bargaining agreement, if any exists. There may be a provision in the agreement regarding the continuation of your health insurance when you’re unable to work. An experienced worker’s compensation attorney can guide you through these legal frameworks and secure what you’re entitled to.

Will My Workers Comp Check Pay for My Health Insurance Premiums?

It’s best not to assume that your health premium can simply be taken out of your workers’ comp check. This is an arrangement you should discuss with your employer, and you should keep a record of all communications regarding this.

Talk to a Slominski Law, Trusted Virginia Workers’ Comp Lawyer

Attorney Jaleh K. Slominski has been serving Virginia workers for over 25 years, helping them navigate the complex laws surrounding workers’ compensation with highly favorable results. Ms. Slominski is experienced in maximizing workers’ comp claims and protecting the rights of each claimant. Talk to Attorney Slominski about your Virginia worker’s comp concern. Call (434) 384-9400 in Lynchburg or (540) 554-3762 in Roanoke to get your consultation.