Companies will have to keep paying health benefit premiums for up to 1 year
As of Sept. 1, employers in Alberta have to comply with new rules for paying health benefits to injured workers and for re-employing them once they are fit to return to work.
The new benefit rules mean that employees off work with a work-related injury will continue to be covered under their employer’s health benefits plan. Employers will have to keep paying health benefit premiums for up to one year while workers are absent as a result of a workplace injury that occurred on or after Sept. 1.
Health benefits include things such as dental and vision care, medications and hospital, health and paramedic services. Not included are services covered under wellness benefits plans, such as yoga classes and fitness equipment, life and travel insurance and some over-the-counter medications.
The obligation applies to all employers with health benefit plans if they were making contributions for the worker at the time of a workplace accident, with some exceptions. For example, volunteer emergency response positions and students would be excluded from receiving these continued benefits.
If an employer’s plan requires employee contributions, injured workers will have to continue to pay their share. If they choose not to, their employer is not obligated to continue their benefits coverage.
The obligation to continue health benefits for one year will apply even if the worker’s employment terminates.
“Any time an employer is terminating a worker, they should contact WCB to discuss the circumstances surrounding the termination and their worker’s ongoing entitlement to employment health benefits, as well as other benefits, such as wage loss benefits,” said Cindi Schwartz, a corporate communications representative at the Workers Compensation Board of Alberta (WCB).
Employers that do not continue benefits coverage will be liable for any expenses the injured worker incurs that would have been covered under the plan. In addition, the WCB could levy an administrative penalty equal to the employee’s health benefit premiums for one year.
In case of any disagreements about benefits coverage, employers should keep accurate and up-to-date records related to the health benefits plan, said Schwartz.
“We suggest employers keep copies of the worker’s benefit plans at the time of the accident, confirmation of contributions made by the employer and the worker for those benefits, as well as any evidence they may have of a worker’s decision to end these benefits.”
Like the health benefits obligation, the re-employment requirement will apply to workers injured on the job as of Sept. 1. However, it will only cover employees who have worked for their employer for at least 12 continuous months at the time of the accident, whether full-time or part-time.
Once injured workers are medically and physically able to do the essential duties of their pre-injury job, their employer will have to offer to reinstate them in the job or in a comparable one that has at least the same earnings and benefits.
If an employee is medically and physically able to do suitable employment, but not the essential duties of the pre-incident job, the employer must offer the worker the first opportunity to accept suitable employment that becomes available.
The reinstatement requirements are similar to those in other provinces, but with some differences. One is that the reinstatement obligation in Alberta will apply to all employers. In other jurisdictions, small employers are generally excluded from re-employment requirements.
The second difference is that the reinstatement obligation will apply until the injured worker declines the employer’s offer to return to work or quits. In other jurisdictions, there is a time limit for the reinstatement requirement.
When employers reinstate injured workers, the new requirements will prevent them from terminating their employment within six months or while they are receiving workers’ compensation benefits, unless they can show a valid business reason not related to the workplace injury. If employers cannot show this, the WCB could levy a penalty up to the amount of the worker’s net salary for the year before the incident.
It is important that employers maintain proper records for reinstating injured workers, said Schwartz.
“Employers should keep written records of modified work they have available and the date they offered this and/or the worker’s regular job duties to the worker,” she said. “They should also ensure they are keeping accurate and timely performance management information in the event they need to provide evidence for a worker’s termination. If an employer is laying off an injured worker, they should also keep records of all other workers who are laid off to demonstrate why an injured worker was chosen for the layoff.”