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Human Resources Questions for Dentists: Must dentist pay same insurance during employee's leave of absence?

April 5, 2018
This dentist employer is wondering whether or not he must pay the same 80% of an employee's insurance while the employee is on a leave of absense. What do the HR experts have to say?

This article originally appeared in the Principles of Practice Management e-newsletter. Subscribe to this informative twice monthly practice management ENL here.

The human resources landscape is constantly changing. Dentists have ongoing questions about how to handle staff issues. Take one of this month's questions, for instance. Can this dentist legally refuse to pay for a holiday when an employee takes a day off before or after?


QUESTION: I have an employee going on a leave of absence. This employee has health insurance with me. I pay 80% of the premium, and the employee pays the remaining 20%. What happens with the employee’s health insurance when she goes on leave? Am I required to pay the premium per normal or can there be a different arrangement?

ANSWER: The first thing you need to consider is any leave of absence law that might be in place regarding the type of leave the employee is taking. Sometimes leave of absence laws require an employer to continue the health insurance arrangement, even during the leave.

For example, the federal Family and Medical Leave Act (FMLA), which applies to employers with 50+ employees, requires health insurance to be continued under the same conditions that existed at the time of the leave. Thus, if this is applicable, you will need to continue paying the premium at 80% during the employee’s leave.

In a situation in which an employer is not covered by any specific law regarding this, health insurance is provided and paid for through the last day of the month in which the leave of absence begins. At the start of the next month, either health insurance is discontinued or it is paid for entirely by the employee on leave through health care continuation coverage.

While employers could choose to continue to pay their portion of the premiums during the leave, this is not required and could be a risk. At any time, the employee could decide not to return to work. If this happens, recouping the expense could be nearly impossible and become a loss on the employer’s part.

QUESTION: I have a hygienist who occasionally works on a temporary basis. This hygienist has suggested that we trade for services. In this arrangement, I would provide dental services to her in exchange for her providing hygiene care to my patients. Is this legal?

ANSWER: In short, no, this is not legal. Workers must be paid at all times. They cannot trade services in lieu of compensation, even if they request, desire, or agree to sign something to that effect. All workers must be paid for their services at minimum wage or higher. The employer will be held responsible for any wage and hour issues that might arise from this, regardless of whether or not this arrangement was originally the worker’s idea.

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Human Resources Questions for Dentists is provided by Rebecca Boartfield and Tim Twigg of Bent Ericksen & Associates. Tim Twigg is president and Rebecca Boartfield is a human resources compliance consultant with Bent Ericksen & Associates. For 30 years, the company has been a leading authority in human resource and personnel issues, helping dentists deal successfully with the ever-changing and complex labor laws. To receive a complimentary copy of the company’s quarterly newsletter or to learn more about its services, call (800) 679-2760 or visit

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