Terminating coverage for employee out on disability who hasn’t paid premium

Q         An employee has been permanently disabled since 2012 and has been allowed by union contract to remain on the group insurance, provided the employee pays their share of the premium. The employee has become delinquent and has stated they don’t have the money to pay the amount due. Are we allowed to terminate the coverage?

A   Yes, assuming the union contract doesn’t state otherwise, you aren’t bound by Idaho or federal law to maintain employee coverage under these circumstances. Specifically, the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA) don’t require continued coverage in your situation. Employee coverage under the ADA is required only if continued coverage is provided for other employees on similar leave. Terminating coverage for this employee for failure to pay the premium isn’t an ADA violation if all similarly situated employees are held to the same standard.

While the FMLA has no bearing under these circumstances, it would require continued coverage during a qualified employee’s 12-week protected leave. Once the leave concludes, however, you are no longer obligated to maintain the coverage.