Question:

I run a local grocery store with 40 employees. One of our clerks is pregnant. She is due in July and previously said she wanted to work until the birth. Now she tells me her doctor is ordering bed rest due to her pregnancy. The employee is worried about keeping her health insurance coverage if she takes leave. What should I tell her?

Answer:

Under California law, the employee may keep her health insurance coverage under the same terms and conditions as if she continued working, even though she will be on leave due to the bed rest ordered by her health care provider. The Fair Employment and Housing Act allows up to four months of pregnancy disability leave (PDL) to employees who are actually disabled due to their pregnancy, and a new law provides for continuation of health insurance coverage during such leave up to a maximum of four months.

This new law, Government Code § 12945, requires an employer to maintain and pay for coverage under a group health plan for an employee who takes PDL at the same level and under the same conditions as if the employee had continued working. Coverage must be maintained for the entire duration of the PDL, which could be as long as four months over a 12-month period.

Employers may choose to provide health insurance coverage for longer than four months. Be sure to review any policy documents the store has to see whether greater benefits have been promised to your employees. You should also confirm that your store’s policy meets the minimum requirements for PDL, including reinstatement to the same or comparable job when approved PDL ends.

An employer may recover the cost for any premium paid to maintain health insurance coverage if the employee does not return after the leave, except when the employee does not return because of a qualifying health condition or other circumstance beyond the employee’s control.

California’s law on PDL covers employers with as few as five employees, such as your store. The federal Family and Medical Leave Act (FMLA) and the California Family Rights Act (CFRA), which apply to employers with at least 50 employees, have their own requirements on maintaining health coverage. Unlike FMLA and CFRA, which require that the employee have worked 1,250 hours and 12 months for the employer, PDL has no length of service requirement.

While an employer is not normally obligated to pay an employee during PDL, state disability insurance may provide a partial wage replacement. The usual disability period for a pregnancy without complications is four to six weeks although employees may take up to four months PDL if they are actually disabled by pregnancy or a related medical condition.

The California Fair Employment and Housing Commission is proposing new PDL regulations, and is accepting written comments until April 19, 2012. The regulations will cover continuation of benefits, calculation of the leave period, medical certification, and other practical aspects of PDL. For general information about PDL and the proposed PDL regulations, visit
www.fehc.ca.gov/act/pregnancyregulations.asp.
– – – – – – – – – – – – – – – – – – – – – – – – – –
Back to Menu- Work Place Law 2012 Articles