55.38 - Continuation of Benefits during Leave With or Without Pay and Reduction in Appointment
December 2018 (rewrite)
A. General. Leave without pay (LWOP) and reductions in appointment (i.e. from 100% time to 75% time) affect benefit amounts, eligibility and cost to the employee. The employee and/or the department are responsible to take certain actions in advance of the change in status. Group health benefits typically include medical with prescription drug coverage, some level of vision benefit and dental, life, dependent life, accidental death and dismemberment, and disability (not available on LWOP).
Note: coverage may be continued while on sabbatical leave as long as the salary is at least 50 percent of the full-time annual rate or while on other approved leave with or without pay and benefits. Scope and coverage of each benefit is governed by contracts and plan documents in effect at the time.
A-1. Reasons for Reduction in Appointment or Placement in LWOP With or Without Benefits Status. Employees on regular appointment may have their appointment percentage reduced, or be placed on LWOP with or without benefits, for a variety of reasons including but not limited to:
i. When requested by the employee for a specific amount of time, and approved by the dean or director.
ii. When unable to work because of illness and annual leave, sick leave or shared leave are not available, or when on approved Family and Medical Leave.
A-2. Effect of Leave Without Pay or Reduction in Appointment on Other Benefits. Because employees who are on LWOP or whose appointment is reduced to less than 100% time may have other benefits affected, any employee contemplating a major change in employment status should consult with Benefit Services in Human Resources regarding effects of the changes on benefits.
i. Health Insurance.
a. LWOP. Eligibility for group medical/dental benefits are generally continued for up to one year. Thereafter an employee may continue to be enrolled in the health plan at his or her own expense for the duration of approved LWOP. To continue employee and dependent benefits (if applicable), employees must make arrangements through Benefit Services to pay contributions while on leave.
b. Reduction in appointment percentage. Reduction in appointment may affect the contribution amount required by employees. Please contact Benefit Services for specific contribution amounts based on appointment percentages. Employee contribution amounts can also be found on the benefit website.
(1) For an employee with an 87.5% appointment or greater, UI will continue to pay the same employer contribution for health benefits and the employee will continue to pay the full employee contribution amounts.
(2) For an employee whose appointment is less than 87.5% and at least 50%, the UI will pay a prorated employer contribution amount for health benefits based on the appointment and the employee will pay the remaining contribution amount according to established rate contributions as outlined on the benefits website.
ii. Group Term Life Insurance.
a. LWOP. For the first six bi-weeks of LWOP, group term life insurance benefits are continued in the full amount of annual salary immediately prior to the LWOP; contributions are paid by UI. After six bi-weeks of LWOP, the employees may continue group term life insurance benefits for up to one year from the date LWOP began, by paying the contributions. An employee may continue enrollment in optional life insurance plans for the duration of LWOP (up to one year) but must make arrangements through HR to pay insurance contributions quarterly, in advance to the University.
b. Reduction in appointment percentage. Group term life insurance benefits continue, the amount of insurance coverage coincides with the reduced annual salary paid. In particular, faculty on sabbatical for a full year at half pay have their group term life insurance coverage reduced proportionately; i.e., the amount of paid sabbatical salary rounded up to the next $1,000.
iii. Supplemental Term Life Insurance.
a. LWOP. All supplemental (voluntary buy-up) life insurance contributions continue while on leave unless the employee fails to make contributions as billed from Benefit Services, or designee, or elects to drop the insurance during an appropriate enrollment window. When reinstated to active duty, coverage may be elected based on the governing plan documents in effect at the time.
b. Reduction in appointment percentage. Contributions for supplemental life insurance benefits continue to be deducted through payroll deduction and the amount of insurance coverage coincides with the reduced annual salary paid.
iv. Short- and Long Term Disability Insurance.
a. LWOP. Disability benefits cease when an employee goes on LWOP with or without benefits, but are reinstated when an employee returns to active status.
b. Reduction in appointment percentage. Disability insurance benefits continue, the amount of insurance coverage coincides with the reduced annual salary paid. In particular, faculty on sabbatical for a full year at half pay have their disability coverage reduced proportionately; i.e., 60% of sabbatical salary.
v. Additional Benefits that Cease during a Period of Leave without Pay include tax-sheltered annuities, retirement and Social Security contributions. Accrual of annual and/or sick leave is also suspended. Call Benefit Services, 208-885-3697, for details on the Comprehensive Omnibus Reconciliation Act of 1986 (COBRA), pre-tax spending accounts, continuation of medical benefits and the Employee Assistance Program (EAP).
B. Process. Authorization for reduction of appointment, or LWOP must be approved by the dean or director unless such reduction or leave is authorized by FSH 3710. An employee may also be placed on LWOP automatically if he or she is absent from work for an extended period of time and does not have available accrued or other approved leave appropriate to the reason for the absence.
C-1. Employees desiring reduction in appointment or leave for an extended period should consult initially with their supervisor or departmental designee for such matters. When leave is approved, the employee should consult with Benefit Services to make arrangements regarding continuation of benefits and payment. Procedures applicable to continuation of specific benefits follow:
i. Health Insurance. Health insurance coverage for the employee continues for 12 months of LWOP with benefits at the rate of coverage in effect when the period of leave begins. If the LWOP is not with benefits, the employee may transition to COBRA.
If health insurance coverage is discontinued, reinstatement in the program at a later date may be accomplished either (a) during a regular open enrollment, or (b) at any other time according to plan documents at the time the employee returns to active paid status. When an employee re-enrolls, the employee may be subject to certain restrictions in effect at the time of re-enrollment such as longer waiting periods. Please see the current plan documents available from Benefit Services.
ii. Life Insurance. Basic group life insurance, dependent life insurance, and accidental death and dismemberment insurance coverage are continued according to the plan documents in effect at the time of the leave. Please consult with Benefit Services for specific details.
iii. Disability Income Protection. Disability insurance cannot be continued while on leave without pay.
iv. Optional Deductions. Most optional deductions, including retirement participation, cease when an employee is no longer receiving a pay check. If eligible, employees may continue to participate in Supplemental Life Insurance as described above (A-2 (iii) a.) and Flexible Spending Accounts by making the payment arrangements with Benefit Services and continuing to stay current with monthly contributions while on LWOP.
C-2. Employee Procedures when Returning from Leave Without Pay Status. When returning from a period of leave without pay, the employee is responsible for contacting Benefit Services to verify that all benefit and tax information is current. Any adjustments and/or applications for benefits discontinued during the period of LWOP may be addressed at this time.
C-3. Academic Year Employee Procedures for Summer Leave Without Pay. Permanently appointed academic year employees not receiving salary checks during the summer months from their regular appointment, will be placed in a 20-pay calendar for benefits. The benefits for the full 12 months will be deducted from the 20-pays received.
C-4. Departmental Procedures. Departments will submit the appropriate EPAF to enter reduction in appointment or LWOP for the duration of the leave or the reduction in appointment, or until the end of the fiscal year. If LWOP or reduction in appointment extends into the following fiscal year, the timekeeper will need to re-enter the employee’s status into Banner HRIS to continue into the following fiscal year.
Exception. When LWOP results from being absent from work with no remaining annual leave, sick leave, shared leave or compensatory time, and when no other leave has been approved, the Banner Payroll process will automatically dock pay for the employee for the bi-weekly pay cycle affected. Departments need to work with Benefit Services to ensure proper benefit contributions are processed for any employee on LWOP.
D. Information. Because other benefits may also be affected for employees who are placed on LWOP or whose appointment is reduced to less than 100% time, any employee contemplating a major change in employment status should first consult with Benefit Services, if possible, regarding effects of the changes on benefits.
D-1. Call Benefit Services for details regarding the Comprehensive Omnibus Budget Reconciliation Act of 1986 (COBRA) or, continuation of core and voluntary benefits.
D-2. All benefits are explained at Employee Benefits Orientation. For information on Sick/Annual Leave [see FSH 3710].