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  1. #1
    Join Date
    Sep 2012
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    Default Employer Supplied Health and Dental Insurance During Worker's Comp

    I am out on a WC claim due to injuring my hand at work.

    I do participate in my employers Health & Dental insurance plans. These plans not only cover me but my wife and kids.

    Am I still responsible for paying my portion of the premiums for this medical and dental for myself for unrelated medical issues, and my family when I am out of work.

  2. #2
    Join Date
    Oct 2006
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    9,078

    Default Re: Employer Supplied Health and Dental Insurance when Out on WC

    Quote Quoting rmcmm36 View Post
    I am out on a WC claim due to injuring my hand at work.

    I do participate in my employers Health & Dental insurance plans. These plans not only cover me but my wife and kids.

    Am I still responsible for paying my portion of the premiums for this medical and dental for myself for unrelated medical issues, and my family when I am out of work.
    workers comp benefits are limited by law and do not include insurance premium payments. if your employment is covered by the Family and Medical Leave Act you should be offered COBRA for the time there will be no payroll deduction for your share of the coverage.
    more on FMLA here
    http://www.dol.gov/whd/fmla/

  3. #3
    Join Date
    Sep 2012
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    2

    Default Re: Employer Supplied Health and Dental Insurance when Out on WC

    Maybe I need to explain further. My employer has offered to let me keep my insurance benefits out of pocket while I am out as long as I make the same premium payments I was making when I was working.

    Not COBRA but a continuation of the exiting medical and dental.

    - - - Updated - - -

    I guess the question is. Being that I was injured on the job. Is my employer required to continue the medical and dental benefits for myself and my family? Or am I still on the hook for my part of the premium?

  4. #4
    Join Date
    Jun 2011
    Posts
    203

    Default Re: Employer Supplied Health and Dental Insurance when Out on WC

    yes you still have to pay those premiums. If you are lucky, your employer will cover them till you get back to work and then deduct a little out of each check till you are paid up. Mine did

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Employer Supplied Health and Dental Insurance when Out on WC

    Quote Quoting rmcmm36 View Post
    Maybe I need to explain further. My employer has offered to let me keep my insurance benefits out of pocket while I am out as long as I make the same premium payments I was making when I was working.

    Not COBRA but a continuation of the exiting medical and dental.

    - - - Updated - - -
    I guess the question is. Being that I was injured on the job. Is my employer required to continue the medical and dental benefits for myself and my family? Or am I still on the hook for my part of the premium?
    Your ER would be required to continue GHP coverage up to 12 weeks IF you are covered under FMLA...you continue to pay your share as you always have.


    Your ER is not required to allow continuation past the 12 weeks, but must offer COBRA, you pay those premiums.
    Most carriers that write GHP only allow full time (working) EE's to participate, full time is generally defined as 32+ hours per week. As you are not working, that does not apply to you, unless FMLA coverage is in effect.

  6. #6
    Join Date
    Feb 2007
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    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,744

    Default Re: Employer Supplied Health and Dental Insurance when Out on WC

    I think BvIA explained it accurately. I always encourage my clients to keep the health insurance in place even though it is tough to pay it. If a family member has a significant medical problem and you are not insured, then your financial situation will get a lot worse very quickly. And some treatment will simply not be provided if you don't have insurance or a large pot of personal money to give the provider.

    Anything could happen--for example, the 12 year old child of a friend of mine got bitten by a mosquito recently and ended up in intensive care for a week. Without insurance, you would be paying off that bill for the rest of your life!
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney and Board Certified Specialist in NC Workers' Compensation Law

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