Leave Without Pay (LWOP) Employees


Overview

When you go on an approved unpaid leave of absence, including personal leave of absence and worker's compensation, you are considered a leave without pay (LWOP) employee, and you are responsible for paying the full premiums for your benefits. Failure to pay your full premiums will result in your benefits being terminated. See below for what you need to be aware of when you go on LWOP.

What You Should Know About...

What Happens to My Co-share Payments?

Your State health plan co-shares (for medical/pharmacy, dental and vision coverage) are normally automatically deducted from paychecks on a biweekly basis. When you go on LWOP, you will receive invoices and you must make timely payments or risk termination of coverage with 30 days' notice:

  • First invoice You will receive an invoice from the State for your first missed co-share deduction. This first invoice will be mailed to you on the pay day for the missed co-share deduction. You must remit payment by the date indicated on your invoice.
  • Second invoice & delinquency notice If you do not timely submit payment for your first invoice, your account will be in delinquent status, and a delinquency notice will be mailed to you along with your second invoice on the following pay day.
  • Third invoice & termination notice If you fail to pay your first and second invoices in full by the time your third invoice develops, you will also receive a termination notice. The termination notice sets a health coverage termination date and gives you at least 30 days to pay your outstanding balance. You must pay your invoices in full before that date or your coverage will be terminated.
  • Termination grace period If your coverage is terminated, there is a one week grace period that follows. If you pay your entire outstanding balance and/or return to active status employment during this grace period, your coverage will be reinstated as though it was never terminated. If you did not pay your entire outstanding balance, or if you did not return to active employment during the grace period, your health coverage termination will be irrevocable, and you will not be eligible to re-enroll until you return to active status employment. At that time, you will have a 31-day status change window within which to re-enroll.
  • Re-enrollment Re-enrollment does not occur automatically. To re-enroll, you must complete and submit the Health Coverage Enrollment/Status Change Form to your HR office. If you fail to re-enroll during your 31-day status change window, you must wait until the next open enrollment period to re-enroll. You must address any outstanding co-share balance with your HR office before your re-enrollment is processed.
How Should I Pay My Co-shares?

It is strongly recommended that you use hand-written checks or money orders, as the State is not responsible for any delays due to bank-generated check processing (e.g., automated "bill pay").

Please write your employee number on your check, make it payable to “RI General Treasurer”, and mail it to:

  • Co-Share Processing Unit
    Office of Employee Benefits
    One Capitol Hill, 3rd Floor
    Providence, RI 02908

Alternatively, you may hand-deliver your payment to the “HEALTH INSURANCE CO-SHARE PAYMENTS” drop box in the HR reception area on the 3rd floor of the Department of Administration building at One Capitol Hill.

Who do I Contact With Questions?

Please call the number listed on your invoice/notice. If you do not have an invoice/notice, please contact the OEB.

  • If you miss two payroll contributions to your FSA due to LWOP, your FSA debit card will be suspended/deactivated.
  • Your FSA account will be reinstated when you return to work and resume receiving your paycheck; your per-pay-period contribution amount will remain the same as when you made your initial FSA election. If you need to adjust your initial election amount, please contact your HR office within 31 days of returning to work.
  • Your FSA card will be reactived within one pay period; any claims during this period may be submitted to Navia manually.
  • Please contact Navia if you need further assistance:
    • Visit www.naviabenefits.com
    • Email
    • Call Navia at (800) 669-3539

You must directly make your premium payments through HR if you want to maintain your life insurance coverage while on LWOP:

  • Your HR office will bill you directly for the first premium payment when you go on LWOP.
  • If you do not make the first payment, HR will stop your life insurance coverage as well as any subsequent billing.
  • Contact your HR office for instructions on continuing your premium payments.
  • Contact Aetna Life Insurance if you need to confirm your coverage status while on LWOP:
If You are Insured With Aflac
  • Short-term disability
    • When you miss your first payroll deduction while on LWOP, Aflac will bill you directly, and you will have 30 days to pay any premium accrued during this period. If you do not send in your premium within the first 30 days then your policy is terminated, and you will receive a termination letter from Aflac.
  • All other Aflac products
    • When you miss your first payroll deduction while on LWOP, Aflac will bill you directly, and you will have 45 days to pay any premium accrued during this period. If you do not send in your premium within the first 45 days then your policy is terminated, and you will receive a termination letter from Aflac.
  • Coverage reinstatement
    • You can always request to reinstate your policy; you will not have coverage between the terminated date and the reinstated date, and Aflac would not pay any claims generated during this period.
    • If you disagree with your policy termination, please write and state your reason to Aflac. If Aflac approves your policy reactivation, you must pay back any premiums due. Any claims during this period would be covered.
  • Contact
    • Please contact the Rhode Island AFLAC office at (401) 475-9936 and indicate that you are a State of Rhode Island employee.
If You are Insured With Colonial Life
  • Disability claim
    • It is your responsibility to initiate a disability claim directly with Colonial Life. This can be done online or via a paper claim form (obtain from Colonial).
    • The claim form have separate sections that need to be completed by you, your doctor, and your employer.
    • Your doctor must indicate on the form how long you will be out of work (in weeks). That amount of time (minus your chosen waiting period) will be used to calculate your benefit payments.
    • Most employees have a 6-month benefit duration and either a 7- or 14-day waiting period, although other options are available. For example, if your doctor says you will be out of work for 8 weeks, and you have a 6-month benefit duration, you still only get paid for the 8 weeks.
    • There is a continuation of benefits process that is used if your doctor adds more time to the initial suggested amount.
  • Premium payments
    • You are responsible for your premium payments while you are out on a disability claim.
    • You can make premium payments directly to Colonial or have your premiums taken from your claim payment.
    • All disability plans include a 90-day waiver of premium clause—i.e., after 90-days of being on disability claim, you are no longer responsible for your plan premiums until you return to work.
  • Contact
    • Please contact the RI District Colonial Life office at (866) 349-8011 or visit VisitYouville RI.

You must directly make your premium payments through HR if you want to maintain your legal coverage while on LWOP:

  • Your HR office will bill you directly for the first premium payment when you go on LWOP.
  • If you do not make the first payment, HR will stop your legal coverage as well as any subsequent billing.
  • Contact your HR office for instructions on continuing your premium payments.
  • Contact Hyatt Legal if you need to confirm your coverage status while on LWOP:
    • Visit info.legalplans.com and enter access code 7580001 for the Single Plan and 7590001 for the Family Plan
    • Call 1-800-821-6400, Monday–Friday, 8am–9pm EST