A Personal Leave of Absence occurs when a member is absent from work for a fixed period of time by a legislative leave or by a mutual agreement between the employer and the member. The following information does not apply when an employee is on Medical Leave of Absence or Maternity\Paternity Leave.
Tip!
GroupSource recommends that employers establish certain guidelines for Personal Leaves of Absence. For example:
- Employers must determine whether or not to allow members to continue benefits coverage during a personal Leave of Absence.
- This decision should be made corporately and must be applied equally to all members.
If the employer allows members to continue benefits during a Leave of Absence or Layoff, the insurer has contractual provisions on how long an employee’s coverage can be extended. For assistance on how long coverage can be extended while an employee is away from work, please reach out to your Client Service contact.
If the employer does not allow members to continue benefits during the leave of absence, the member may be reinstated (starting the first date of re-employment), provided they return to work within 6 months, and GroupSource is notified within 31 days of re-employment.
If an employee is absent from work on a personal leave for longer than 6 months, he or she must be terminated from the group plan. Upon return to work, he or she is considered a new employee, meaning the Waiting Period must be served, the Pre-Existing Condition limitation starts over, and we will require a new signed Enrollment Card.
- Notify your GroupSource Billing Administrator (via WEBS, email, fax or mail) when an employee is on a Personal Leave of Absence.
- When entering on WEBS, please change the employee’s status from Active to Leave of Absence and indicate whether employee will maintain their benefits.
- Contact your Client Service Coordinator for information regarding an employee on Personal Leave of Absence.