COBRA

If you are on any type of short-term LWOP (two pay periods or less or up to 30 days), your existing coverage will continue. If for any reason you do not have a health benefit deduction(s) for a pay period, missed deductions will be taken from subsequent pay periods or billed directly to you, depending on your current employment status.

If you are billed directly for missed premium deductions due to an unpaid leave of absence, termination, etc., you must pay unpaid invoices immediately. If left unpaid, these bills will be referred to the State’s Central Collections Unit (CCU), where an additional 17% administrative fee will be added to the debt. 

For short-term LWOP (30 days or less), employees continue to receive their subsidy and are only responsible for their portion of the health insurance premiums. 

If you are on a long-term LWOP for more than two bi-weekly pay periods (more than 30 days), your leave is considered a long-term LWOP. If you are on an approved long-term LWOP, you may elect to continue or discontinue health insurance for the duration of the LWOP. 

If you are in an unpaid Leave Without Pay (LWOP) status, your employer subsidy will end in most cases. (Exceptions may include FMLA, Active Military, Total Temporary Disability, and or other reasons as specified in the Leave of Absence section of the State Health Benefits Guide).  Whether subsidized or unsubsidized, you must take action on the benefits event in SPS Workday.

Unsubsidized Rates: When your long-term LWOP begins, you are responsible for paying the full unsubsidized cost of coverage unless you elect to “decline” unsubsidized coverage during your LWOP period.

You must complete the UM LWOP event in your SPS account. You may continue any or all health benefits options, and you may reduce your coverage level when enrolling for LWOP benefits. Otherwise, you are subject to the same limitations in changing coverage as an active employee.

• Within 30 days of being in a LWOP status, you will receive a benefits event in the SPS Workday system. At that time, you can choose to:
  • Keep your benefits coverage 
  • Reduce coverage, or
  • Cancel your coverage during the LWOP period.
• If you keep coverage, it will be at the unsubsidized rate, meaning:
  • You pay the entire premium yourself.
  • You do not receive the employer's contribution/subsidy.
  • You cannot change plans until Open Enrollment each year (mid-October)
• Payments are made as a Direct Pay participant:
  • The State Employee Benefits Division sends monthly invoices ("payment coupons").
  • You must pay those premiums directly to the State.
  • Unpaid coupons/invoices will be referred to the State’s Central Collections Unit (CCU), where an additional 17% administrative fee will be added to the debt.
  • Details regarding making payments can be found here.  

Paying for Premiums

The employee is responsible for paying 100% of the premium directly to the State Employee Benefits Division on a monthly basis, unless the LWOP is due to a job-related accident or injury or approved family medical leave. An employee on long-term LWOP due to a job-related accident or injury or family medical leave is entitled to the University subsidy. -

Note:  If an employee chooses to terminate their benefits in their UM LWOP event in their SPS account, a COBRA notification is sent to the employee, directing them to the State Employee Benefits Division website to download and submit the necessary form. 

Returning from Long-Term LWOP

When you return from Long Term LWOP, please check your SPS account for the “Return from Leave Benefit Event”. This request for re-enrollment in employee pre-tax benefits must be completed within 60 days after your return to work, along with any required supporting documentation, such as military discharge orders. 

Failure to re-enroll may result in having to wait until the open enrollment period for a January 1 benefit start date.