February 13, 2006 FMLA2006-4-A
Dear Name*:
This is in response to your
letter requesting an advisory opinion under the Family and Medical Leave Act of
1993 (FMLA), 29 U.S.C. § 2601 et seq. Your letter concerns a client
company that is subject to collective bargaining agreements (CBAs), many of
which stipulate that in order for an employee to maintain group health
insurance benefits for the following calendar year, the employee must work a
specified number of hours in the preceding calendar year. You inquire whether
FMLA leave taken during the year must be credited towards qualification for the
following year's group health insurance benefits for employees subject to these
agreements, or whether the employer can lawfully deny these employees' group
health insurance benefits if the required hours are not worked because of FMLA
leave. You do not specify whether the CBAs treat other types of paid or unpaid
leave as hours worked.
In the scenario you
describe, employees of your client are subject to CBAs that require at least
1500 hours of work in a calendar year in order to maintain group health
insurance benefits for the following year. You ask us to assume that these
employees currently have group health insurance benefits and that those
benefits have been maintained for employees taking FMLA-qualifying leave in the
current calendar year. Because of the FMLA leave taken, however, these
employees will not work the 1500 hours required under the CBAs to qualify for
the following year's benefits.
The FMLA entitles eligible
employees of covered employers to take up to 12 weeks of unpaid, job-protected
leave each year with continuation of group health insurance coverage under
the same conditions as prior to leave for specified family and medical reasons.
We assume your inquiry relates to a company that is covered by the Act and to
eligible employees taking FMLA leave for a qualifying reason under the Act. See
29 U.S.C. §§ 2611-2612(a); 29 C.F.R. §§ 825.104-.112, 825.114.
The FMLA requires an employer
to maintain coverage under any group health plan (as defined in 26 U.S.C. §
5000(b)(1)) for the duration of the eligible employee's FMLA leave at the level
and under the conditions coverage would have been provided if the employee had
been employed continuously for the duration of such leave. See 29
U.S.C. § 2614(c). The legislative history further explains that "[n]othing in
[2614(c)] requires an employer to provide health benefits if it does not do so
at the time the employee commences leave. [Section 2614(c)] is strictly a
maintenance of benefits provision."
S. Rep. 103-3 at 31 (1993).
Pursuant to 29 U.S.C. §
2614(a)(2), "[t]he taking of leave under section [2612] shall not result in the
loss of any employment benefit accrued prior to the date on which the
leave commenced." (Emphasis added.) The FMLA goes on to clarify that a
restored employee is not entitled to "the accrual of any seniority or
employment benefits during any period of leave." Id. § 2614(a)(3)(A) (emphasis added). The regulations
provide that "if the benefit plan is predicated on a pre-established number of
hours worked each year and the employee does not have sufficient hours as a
result of taking unpaid FMLA leave, the benefit is lost." 29 C.F.R. §
825.215(d)(5).
Where an employee is covered
by a group health insurance plan at the time FMLA leave commences, the employer
"shall maintain coverage ? for the duration of such leave." 29 U.S.C. §
2614(c)(1). However, the FMLA does not require an employer to provide health
insurance coverage if such coverage is not provided to the employee when the
leave commences. As such, if the eligible employee is not entitled to group
health insurance coverage prior to the start of FMLA-qualifying leave because
he or she has not worked 1500 hours in the previous calendar year as required
by the CBA, the employer is not required to provide health insurance coverage
during the FMLA leave. Nor is the employer required to provide insurance
coverage to an employee who does not meet the 1500 hours requirement due to
FMLA leave the employee took in the prior year.
Moreover, the FMLA and its
regulations prohibit employers from interfering with, restraining, or denying
an employee's rights under this law. See 29 U.S.C. § 2615; 29 C.F.R. §
825.220. Specifically, 29 U.S.C. § 2652 and 29 C.F.R. § 825.700 describe the
interaction between the FMLA and employer plans and provide that nothing in the
FMLA diminishes an employer's obligation under a CBA to provide greater family
or medical leave rights to employees than the rights established under the
FMLA, nor may the rights established under the FMLA be diminished by a CBA.
Therefore, if the contract provides that other types of leave, paid or unpaid,
count as hours worked for purposes of determining eligibility for health
insurance in the following year, the FMLA leave of an equivalent type would
need to be treated in the same manner.
This opinion is based
exclusively on the facts and circumstances described in your request and is
given based on your representation, express or implied, that you have provided
a full and fair description of all the facts and circumstances that would be
pertinent to our consideration of the question presented. Existence of any
other factual or historical background not contained in your letter might
require a conclusion different from the one expressed herein. You have
represented that this opinion is not sought by a party to pending private
litigation concerning the issue addressed herein. You have also represented
that this opinion is not sought in connection with an investigation or
litigation between a client or firm and the Wage and Hour Division or the
Department of Labor.
Sincerely,
Alfred B. Robinson, Jr.
Acting Administrator
* Note: The actual
name(s) was removed to preserve privacy in accordance with 5 U.S.C. 552 (b)(7).