How Does New York's Paid Family Leave Affect Health Care?

Do premiums or contributions change during leave? What happens if an employee doesn't give proper notice? 

Here's how PFL impacts employee health care.

1. Health insurance stays in place during PFL.

Let's use an employee scenario to explore how PFL rules apply. Say your employee, Candace, makes a PFL claim so she can spend time bonding with her newborn son. Candace will remain covered by her health insurance during paid leave. She’ll keep paying her regular contributions and her premiums will be the same as they were before she took leave. Her employer can continue to collect her portion of her premium directly from her paycheck as usual.

2. Health-care changes affect employees on leave.

While Candace bonds with her son, her company increases all employee health insurance premiums. That means Candace will have to pay the increased premium. There is no difference because she's on leave.

Likewise, if Candace's company switches health plan providers or changes its plan, Candace can still start taking advantage of those changes as if she weren't on leave.

However, health plan changes don't take effect in one situation. If Candace opts out of her health care during her PFL, she's entitled to reinstate her same health plan after returning from leave — even if the plan has changed for other employees. This rule also applies if she loses her coverage because of late payments while on PFL.

3. What happens to late health-care payments?

Employers can start taking the following steps after an employee's payment is more than 30 days late:

• Send a written notice advising that coverage will be dropped on a specified date at least 15 days after the date of the letter, unless payment has been received by that date. This gives employees the option to pay any outstanding balance within those 15 days.
• Terminate the employee's health coverage after 30 days if the required 15-day notice has been provided.
• Retroactively end the employee’s health coverage. This only applies if the 15-day notice was given and if the employer has a policy in place for other unpaid leaves that allows the employer to end coverage retroactively to the date the unpaid premium was due.

For more details about New York Paid Family Leave, visit: ny.gov/programs/new-york-state-paid-family-leave.