Reinstating NCFlex Benefits After an Unpaid Leave of Absence
As a reminder, there are plan rules regarding when an employee returns from a Leave of Absence (LOA) after benefits have been canceled in the enrollment system due to an unpaid LOA. If you are reviewing or approving benefits in the enrollment system for an employee who reinstates from leave (and benefits were canceled), please keep these things in mind.
If an employee reinstates within the same plan year in which benefits were stopped due to an unpaid LOA:
- They can choose whether to reinstate benefits (except HCFSA which is required). If they reinstate, they must reinstate the same benefits (coverage option and dependent level) as when they were stopped due to the LOA.
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For the Health Care FSA, an employee must re-enroll but has the choice of either the same yearly amount when they left or the same payroll period amount. This is only an option if they have not spent more than the new adjusted annual amount. An example can be found on page 20 of the NCFlex Admin Manual.
If an employee has not paid premiums while on LOA for Cancer and/or Group Term Life, they may be subject to EOI when they return.
For the NCFlex Voluntary Disability plan (non-University employees) premiums, these CAN NOT be paid while out on LOA. When an employee reinstates from LOA after benefits were cancelled and reinstate in the Disability plan, a representative with The Standard reviews the length of time an employee was out.
- An EOI is NOT needed no matter how long the employee was out, if the reason they are reinstating is a return from LOA and they reinstate the benefit within 30 days of their return. If an employee is prompted to complete an EOI, remind them it is not needed.
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If an employee reinstates within 90 days of their benefits being canceled, benefits are reinstated retro to when they were canceled and retro premiums are collected via payroll deduction.
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If the employee reinstates after 90 days of benefits being canceled, benefits are reinstated the first of the month following the reinstatement from LOA. There will be a gap in coverage.
- If an employee has applied and was/is in receipt of LTD benefits from The Standard, premiums are waived while LTD benefits are payable.
