The Essential Guide to Family & Medical Leave

chapter 9 | managing an employee’s leave | 191
What Is a Group Health Plan?
A group health plan is any plan of, or contributed to by, an employer to provide
health care to employees, former employees, and their families, including
self-insured plans, vision plans, dental coverage, and other health care
plans, whether they are components of a single health care plan or administered
separately.
A group health plan does not include an insurance program providing
health coverage under which employees purchase individual policies from
insurers if all of the following are true:
• The employer makes no contribution.
• Employee participation is voluntary.
• The employer’s role doesn’t go beyond allowing the insurer to publicize
its plan to employees, collecting premiums through payroll deductions,
and sending them to the insurer.
• The employer doesn’t receive any compensation or other benefit from the
program, other than reasonable payment for the cost of collecting and
remitting premiums.
• The employee’s premium does not increase if the employment
relationship ends.
Cafeteria Plans
Some companies provide benefits through a cafeteria plan: a benefit program
through which employees choose from a menu of benefits, such as health
coverage, life insurance, disability insurance, and so on. Employees are
allotted a certain number of dollars or “points” to spend on the options; if
they choose not to spend the entire amount, they can typically receive the
remainder as compensation.
Employers must continue making cafeteria plan payments towards group
health insurance premiums (including dental and vision benefits) while an
employee is on FMLA leave. If other benefits—such as life insurance or
child care coverage—are paid through a cafeteria plan, the employer must
continue the portion of the payment that goes towards these benefits only if