Page 3 February 2019 Fact Sheet #20
Leave of Absence and Your Benefits
This fact sheet is a summary and not intended to provide all information.
Although every attempt at accuracy is made, it cannot be guaranteed.
Group Life Insurance
While employed, most ABP members are covered by
employer-paid life insurance. ABP members continue
to be insured for up to two years if on an approved
leave of absence without pay for personal illness.
ABP members on other types of leave of absence
withoutpaycontinuetobeinsuredforupto93days
when such leave is due to any reason other than ill-
ness (including child care).
Duringthis93-dayperiod,amembermayconvertex-
isting group life insurance coverage into an individual
whole life policy, without medical examination. For
more information, see the Conversion of Group Life
Insurance Fact Sheet.
Anofcialleaveofabsencerequiresdocumentation
that establishes the nature of the leave and the con-
tinuing relationship between the employer and the
member.
LEAVE OF ABSENCE AND HEALTH BENEFITS
Members of the PERS, TPAF, PFRS, SPRS, JRS,
DCRP, or ABP may continue coverage in the State
Health Benefits Program (SHBP) or School Employ-
ees’ Health Benefits Program (SEHBP) while on an
approved leave of absence provided that:
1.The member is eligible for, and enrolled in,
SHBP or SEHBP coverage prior to the leave of
absence; and
2. The employer participates in the SHBP or
SEHBP.
If the member is on an intermittent or a continuous
leave of absence with pay, there will be no impact
on the member’s SHBP or SEHBP coverage as long
as the member earns sufficient salary to make any
normallyrequiredhealthbenetspremiumpayments
during each month/pay period.
If the member is on an approved leave of absence
without pay, the continuation of health benefits is as
follows:
• Leave of absence for illness — If the member
is a State biweekly employee, SHBP coverage
will continue for the first six pay periods follow-
ing the last day the employee would normally
be covered. During this time, the member is re-
sponsibleforpayinganynormallyrequiredpre-
mium payments. Coverage may continue for an
additional20payperiodsprovidedtheemployee
pays the full cost of the coverage.
If the member is a State monthly employee, the
employer may pay for SHBP coverage for the
first three months following the last day the em-
ployee would normally be covered. During this
time, the member is responsible for paying any
normallyrequiredpremiumpayments. Coverage
may continue for an additional nine months pro-
vided the employee pays the full cost of the cov-
erage. If an employer does not extend coverage
for the initial three-month period, the employee
may only elect to continue coverage for a maxi-
mum of nine months.
If the member is an employee of a local govern-
ment or local education employer that partici-
pates in the SHBP or SEHBP, the employer may
pay for SHBP or SEHBP coverage for the first
three months following the last day the employee
would normally be covered. During this time the
member is responsible for paying any normal-
ly required premium payments. Coverage may
continue for an additional nine months provided
the employee pays the full cost of the coverage.
If an employer does not extend coverage for the
initial three-month period, the employee may
only elect to continue coverage for a maximum
of nine months. The employer may not discrimi-
nate against any eligible employee or groups of
employees.
Note: Certain local education employers may
adopttheprovisionsofP.L.1989,c.127(Chap-
ter127),whichpermitstheemployertocontinue
to pay for the coverage of an employee granted
an approved leave of absence (with or without
pay) for up to a two-year period, provided that
the employee has worked for the location for at
least three years.
• Leave of absence other than illness — A mem-
ber who is on an approved leave of absence for
reasons other than illness, family leave, or fur-
lough, may continue health coverage under the
SHBPorSEHBPforuptoninemonthsor20bi-
weekly pay periods. The full cost of the coverage
must be paid to the employer in advance. If the
employee remains on a leave beyond the time of
the coverage that has been purchased, Active
Group coverage will terminate; however, cover-
age may be be extended under the Consolidat-
edOmnibusBudgetReconciliationActof1985
(COBRA)foraperiodnottoexceed18months,
including the total leave time. Leave that quali-
fies under the Federal or State Family Leave Act
is not deducted from the total COBRA eligibility
period.
Because the member may pay some or all of the
cost of continued health benefits coverage while
on a leave of absence, a member may choose
to reduce his or her level of coverage for the du-
ration of the leave and increase it again upon
return from the leave. For example, a member
can reduce Family coverage to either Parent and
Child or Single coverage. Please note that it is
necessary to complete a Health Benefits Enroll-
ment and/or Change Form to decrease the cov-
erage and also to reinstate it when the member
returns to work.