While on leave without pay, you must take action in order to continue or cancel your University benefits. Your benefits deductions are normally taken out of your paychecks, but while you are on a leave without pay, your benefits can only continue if you arrange in advance to pay your benefits via check. The following explains the process of continuing or cancelling benefits while you are on leave without pay.
Benefits Continuation Election Form
Once the Leaves Office learns that you are going out on leave, you will receive a Benefits Continuation Election Form. The purpose of this form is to inform the Leaves Office of your intent to either continue or cancel your benefits while you are on leave.
If you fail to return the Benefits Continuation Election Form to the Leaves Office prior to the beginning of your leave, your insurance is subject to cancellation. If coverage is cancelled, you will need to re-enroll if you wish to reinstate coverage upon return from leave. It is solely your responsibility to contact the Leaves Office upon return from leave to initiate re-enrollment.
Benefits Premium Payments
In order to continue your benefits, you will owe a premium for each month that you will not receive a paycheck. You may pay the premiums for the entire leave in one lump sum or on a monthly basis. To ensure continued coverage, your Request to Continue/Cancel University Benefits Form must be received by the Leaves Office by the 10th of the month following the beginning of your leave without pay. For example, if your leave begins on June 15th, you will need to submit your payment by July 10th to cover your August benefits. If you elect to make payments on a monthly basis, it is your responsibility to ensure your payments reach the Leaves Office by the 10th of each subsequent month. If a payment is not received by the 10th of the month, coverage will be subject to cancellation. Note: Premiums are adjusted at the beginning of each calendar year. If your leave will extend beyond the end of the calendar year, you must contact the Leaves Office in November for an update on your new benefits premium amounts.
Type of Leave and Effect on Benefits
During Non-Work Related Disability
The University contribution to medical insurance will continue during your leave if you are receiving Short Term Disability benefits from Liberty Mutual (26 weeks maximum). You are responsible for the payment of the employee portion of your medical plan premium.
Medical, Dental, and Vision coverage will be maintained during any leave covered by FMLA (up to 12 work weeks) to the extent coverage would be maintained if you had been actively at work during the leave period. You are responsible for the payment of any employee portion of your medical plan premium. If your FMLA leave period ends and you are still out on unpaid leave, you are responsible for both the employee and the UC contribution for your Dental and Vision coverage, and your Medical coverage unless you are receiving Short Term Disability benefits from Liberty Mutual (26 weeks maximum).
During Other Leaves
To maintain any of your benefits, you are responsible for paying the entire premium amount (UC and employee contributions) by the 10th of every month preceding the month of coverage.
If Your Coverage is Cancelled
If coverage is cancelled, you will need to reenroll if you wish to reinstate coverage upon return from your leave. Please note that Supplemental Disability coverage must be cancelled while you are on leave without pay (unless the leave was an approved professional development leave). It is solely your responsibility to contact the Leaves Office upon return from leave to initiate re-enrollment in any insurance that was cancelled during your leave. Your eligibility period for reenrollment ends on the last working day of the 31 day period following your return from leave. As long as the Leaves Office receives your enrollment forms before the end of this period, your coverage will be effective retroactive to the date you return from leave.
If coverage is cancelled, coverage will end on the last day of the month for which a premium has been paid. Medical, Dental, Vision, Legal, Supplemental Life, Basic and Expanded Dependent Life, and AD&D premiums are paid in advance. For example, if you choose to cancel this coverage and you receive a paycheck on July 1, you will be covered through the end of July.
Other Payroll Deductions
For information on other payroll deduction items such as Parking, Gym Memberships, Credit Union, Auto/Home Insurance, or any other deductions that come out of your paycheck automatically, contact the appropriate vendor or office directly. If you have a 403(b) loan, you must contact Fidelity Investments Tax Exempt Services Company (FITSCo) at 1-866-682-7787 to make arrangements for repayment of the loan while off pay status. If you do not take action, the outstanding amount may be reported as a taxable distribution. It may also be subject to federal and state early distribution penalties.
The Consolidated Omnibus Reconciliation Act of 1985 (COBRA) requires the University of California to offer continuation of University sponsored medical, dental and optical insurance to qualified employees and family members enrolled in the plans at the time of certain qualifying events, such as a leave without pay. Except for approved FMLA leaves, the COBRA continuation period runs concurrently with, and not in addition to, any University continuation provisions. (For approved FMLA leaves, the COBRA continuation period begins when FMLA ends.) If you terminate employment at the end of the leave period, you may continue coverage for the remainder of the COBRA period by paying the entire premium plus 2% directly to the insurance provider. If you do not continue your insurance during a leave period, you will not be eligible for continued coverage under COBRA at the time of termination. If you wish to request a COBRA Continuation form or need assistance, please contact the Leaves Office.