Employee Reference Page - Leave of Absence

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This reference page is intended to help employees understand protections, rights and responsibilities that may be available while on a leave of absence. Communication with your department and completion of the correct forms is critical while an employee is on a leave of absence.

When an employee is off work more than a few days, communication with their supervisor and/or department personnel representative is important to ensure the employee completes the appropriate forms. If you have any unanswered questions about the forms listed on this reference page, please call your department's designated personnel representative.

General Information on Protected Leave:

General Information on Non-Protected Leave Health Insurance

Employees on non-protected leave or who have exhausted protected leave status are eligible for Consolidated Omnibus Budget Reconciliation Act (COBRA) health care benefits. COBRA requires that most group health plans give employees and their families the opportunity to continue their health care coverage when there is a "qualifying event" that would result in a loss of coverage under an employer's plan. Depending on the type of qualifying event, "qualified beneficiaries" may include the employee (or retired employee) covered under the group health plan, the covered employee's spouse, and the dependent children of the covered employee.

Reasons that County employees and their eligible dependents qualify for this benefit include separating from County employment due to resignation, rejection during probation, dismissal, layoff, reduction of work hours, unpaid leave of absence, insufficient funds to pay health premiums or if no paycheck is issued to the employee.

IMPORTANT: When an employee and their eligible dependents qualify for COBRA benefits, the County's COBRA administrator, Administrative Solutions, Inc. (ASI), will mail a COBRA election form to the employee's home address. To elect continuation of coverage, employees MUST complete the "FEDERAL COBRA CONTINUATION COVERAGE ELECTION FORM" and return it to the ASI address provided on the election form. The employee may mail or hand-deliver the form (ASI is located at 555 West Shaw, Suite C-1 in Fresno). The completed ELECTION FORM must be received or postmarked within 60 days of the effective date of the employee's loss of coverage or the date on the notice, whichever is later.

IT IS THE EMPLOYEE'S RESPONSIBILITY TO COMPLETE AND RETURN FORMS AS INDICATED ABOVE.

County Forms & Procedures

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