ARTICLE
16 May 2025

Court Dismisses Employee's FMLA Claim For Failure To Pay Health Plan Premiums

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Hall Benefits Law

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Strategically designed, legally compliant benefit plans are the cornerstone of long-term business stability and growth. As such, HBL provides comprehensive legal guidance on benefits in M&A, ESOPs, executive compensation, health and welfare benefits, retirement plans, and ERISA litigation matters. Responsive, relationship-driven counsel is the calling card of the Firm.
In Kliskey v. Making Opportunity Count, Inc., 2025 WL 959257 (D. Mass. 2025), Carol Kliskey claimed that Making Opportunity Count, Inc. (MOC), her former employer and a private non-profit organization...
United States Employment and HR

In Kliskey v. Making Opportunity Count, Inc., 2025 WL 959257 (D. Mass. 2025), Carol Kliskey claimed that Making Opportunity Count, Inc. (MOC), her former employer and a private non-profit organization, violated the Family and Medical Leave Act (FMLA) and the Massachusetts Paid Family and Medical Leave Act. The alleged FMLA violations included terminating her health insurance in retaliation for taking leave under the FMLA. MOC disputed Kliskey's claims, alleging that she voluntarily resigned due to her inability to return to work at the end of her leave. However, a federal district court found that the employer's denial of the former employee's allegations was immaterial because the employee's claim failed as a matter of law.

More specifically, the employee admitted failing to pay her share of the health plan premiums. Consistent with the FMLA, the employer's leave policy stated that employees on leave were responsible for paying their share of the premiums. Since the former employee's leave was unpaid, she was responsible for arranging to continue her plan premium contributions during her leave. Since she failed to do so, the employer was entitled to terminate her health plan coverage.

The FMLA generally applies to private-sector employers with 50 or more employees, as well as public agencies and local educational agencies, regardless of the number of their employees. Under the FMLA, covered employers must maintain the same group health plan coverage for employees during their FMLA leave as if they were not on leave. Accordingly, employers must continue to pay the same share of health premiums for employees on leave under FMLA as they would if they were not.

However, suppose employees on leave drop their health plan coverage, such as by failing to pay their share of the premiums by any applicable deadlines. In that case, the employer can legally cancel their health plan coverage. Likewise, the employer's duty to maintain health plan coverage for employees ends if they fail to return to work or advise the employer that they do not intend to work at the end of their leave. The only requirement for employers before terminating health plan coverage in this situation is to provide written notice to affected employees at least 15 days before ending health plan coverage for their failure to make their share of premium payments.

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