A recent case prompted me to inquire about a particular individual, and I thereby learned our policies. The issue is the degree to which a company offers employees financial support for health care insurance versus limiting the company's financial exposure after a long-term illness and absence from work. I am curious if our policies in this regard are similar to other corporations out there. Please offer comments on this matter.
The specific situation is the treatment of an employee (let's call him Sam) who is forced to miss an extended period of work because of illness. First, note that we offer long-term disability coverage, so that there is some wage support after sick time and other short-term support is exhausted. Our policy, though, is to remove Sam from the payroll for health benefit purposes after one year being out of work.
For example, let's say Sam elected the plan for receiving 60% of salary for long-term disability (LTD). He will continue to collect LTD until he is able to return to work or the age of 65.
For health insurance, Sam was on the company plan, with dual coverage. The total premium was $940.63. While on the payroll, BIDMC paid $ 725.91 (78%) and Sam paid $214.72 (22%) per month.
Upon leaving the payroll, Sam is eligible for COBRA coverage for a policy with all of the same benefits, but he loses the BIDMC contribution. The cost of COBRA will be $959.44 for dual coverage. (If he elects coverage for himself, the cost is $479.72.) He will be able to remain on COBRA for 36 months.
After 36 months, Sam would be eligible for insurance coverage offered through the Massachusetts Connector Authority.
I look for the experience from others of you out there. I notice, for example, that the Federal Government uses a similar one-year rule. In the Office of Personnel Management benefits
handbook, it says, "Your enrollment will terminate at the end of the pay period which includes the 365th day in consecutive leave without pay status." In contrast, if I am reading things correctly (and it is easy to interpret things wrong in the state jargon!), the Commonwealth of Massachusetts appears to have a
rule that "an employee is not entitled to more that 26 weeks of ... medical leave [for the employee's own serious health condition] in a 12-month period." During that leave, the state
continues to pay its share of health care insurance costs. After that, the COBRA policy kicks in and the employee pays the full amount of coverage.
The specific situation is the treatment of an employee (let's call him Sam) who is forced to miss an extended period of work because of illness. First, note that we offer long-term disability coverage, so that there is some wage support after sick time and other short-term support is exhausted. Our policy, though, is to remove Sam from the payroll for health benefit purposes after one year being out of work.
For example, let's say Sam elected the plan for receiving 60% of salary for long-term disability (LTD). He will continue to collect LTD until he is able to return to work or the age of 65.
For health insurance, Sam was on the company plan, with dual coverage. The total premium was $940.63. While on the payroll, BIDMC paid $ 725.91 (78%) and Sam paid $214.72 (22%) per month.
Upon leaving the payroll, Sam is eligible for COBRA coverage for a policy with all of the same benefits, but he loses the BIDMC contribution. The cost of COBRA will be $959.44 for dual coverage. (If he elects coverage for himself, the cost is $479.72.) He will be able to remain on COBRA for 36 months.
After 36 months, Sam would be eligible for insurance coverage offered through the Massachusetts Connector Authority.
I look for the experience from others of you out there. I notice, for example, that the Federal Government uses a similar one-year rule. In the Office of Personnel Management benefits handbook, it says, "Your enrollment will terminate at the end of the pay period which includes the 365th day in consecutive leave without pay status." In contrast, if I am reading things correctly (and it is easy to interpret things wrong in the state jargon!), the Commonwealth of Massachusetts appears to have a rule that "an employee is not entitled to more that 26 weeks of ... medical leave [for the employee's own serious health condition] in a 12-month period." During that leave, the state continues to pay its share of health care insurance costs. After that, the COBRA policy kicks in and the employee pays the full amount of coverage.