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S. Craig Panter
CABA

FMLA and the employee who does not come back

Oct 24, 2021
It is not uncommon for an employee to take extend leave under the FMLA and then, when the leave expires, decide not to return to work. If the employer has been paying the employee's  health insurance during the leave, can the employer get that money back?

The answer is found at 29 C.F.R. § 825.213, one of the regulations that implements the FMLA. Summarized, the regulation states:

(a) An employer may recover its share of health plan premiums during a period of unpaid FMLA leave if the employee fails to return to work after the employee's FMLA leave entitlement has been exhausted or expires, unless the reason the employee does not return is due to either:

(1) The continuation, recurrence, or onset of either a serious health condition of the employee or the employee's family member, or a serious injury or illness of a covered servicemember, which would otherwise entitle the employee to leave under FMLA; or

(2) Other circumstances beyond the employee's control.

Examples of "other circumstances" beyond the employee's control are necessarily broad.  They include, but are not limited to, situations as where a parent chooses to stay home with a newborn child who has a serious health condition; an employee's spouse is unexpectedly transferred to a job location more than 75 miles from the employee's worksite; a relative or individual other than a covered family member has a serious health condition and the employee is needed to provide care.

Other circumstances beyond the employee's control would not include a situation where an employee chooses not to return to work to stay home with a well, newborn child.

(3) When an employee fails to return to work for a reason covered by (a)(1) above, the employer may require medical certification of the condition.

(b) Under some circumstances an employer may elect to maintain other benefits, e.g., life insurance, disability insurance, etc., by paying the employee's (share of) premiums during periods of unpaid FMLA leave. If the employer elects to maintain such benefits during the leave, at the conclusion of leave, the employer is entitled to recover only the costs incurred for paying the employee's share of any premiums whether or not the employee returns to work.

(c) An employee who returns to work for at least 30 calendar days is considered to have returned to work.
An employee who transfers directly from taking FMLA leave to retirement, or who retires during the first 30 days after the employee returns to work, is deemed to have returned to work.

(d) When an employee elects or an employer requires paid leave to be substituted for FMLA leave, the employer may not recover its share of health insurance or other non-health benefit premiums for any period of FMLA leave covered by paid leave.

(e) The amount that self-insured employers may recover is limited to only the employer's share of allowable premiums as would be calculated under COBRA, excluding the two percent fee for administrative costs.

(f) When an employee fails to return to work, any health and non-health benefit premiums which this section of the regulations permits an employer to recover are a debt owed by the non-returning employee to the employer. To the extent recovery is allowed, the employer may recover the costs through deduction from any sums due to the employee (e.g., unpaid wages, vacation pay, profit sharing, etc.), provided such deductions do not otherwise violate applicable Federal or State wage payment or other laws. Alternatively, the employer may initiate legal action against the employee to recover such costs.

Panter Law Firm
7736 Old Canton Road, Suite B
Madison, MS 39110
601-607-3156

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