Blog - Month: November 2024
Legal Traps to Avoid When Dealing with FMLA Requests
When employee files a federal Family and Medical Leave Act request to either deal with a health issue or care for a loved one, their employer is often put in a tight spot, particularly if the person serves a vital role in their organization.
There are also a number of rules that employers need to follow to avoid running afoul of the law and there are plenty who have been sued for it, a prospect that can be costly.
If you are confused about navigating the FMLA, here’s a handy list of mistakes to avoid.
Firing – It would be a bad idea to fire an employee if they’re unable to return to work following the end of FMLA leave that is due to their serious health condition. Better to find out if the employee is entitled to any additional time off under employment laws or through company policies.
The Americans with Disabilities Act (ADA) may consider granting of additional leave “reasonable accommodation,” in legal terms.
That definition comes from determining whether the employee’s condition is a disability. Under the ADA, most serious health conditions as defined by the FMLA are considered disabilities. If you’re in doubt, ask your legal counsel for advice.
Then you have to figure out whether the requested time off is legally considered “reasonable.” Under the ADA, you as an employer don’t have to grant leave as an accommodation if it poses “hardship” or “undue hardship” to your organization.
Miscalculation – You are able to calculate FMLA leave by either calendar year, any fixed 12-month period, or the 12 months measured forward from when an employee’s FMLA leave begins. It can also be calculated backward from a 12-month period from the date an employee uses the leave.
Deadlines – Meeting FMLA deadlines for processing requests for leave under its guidelines is critical. Within five business days of learning an employee has requested FMLA leave, you must provide them with the “Notice of Eligibility Rights and Responsibilities Form,” or something similar that your company has prepared.
Next, if you require the employee to file a certification form, you must allow them 15 calendar days to do so. Then, within five business days of receiving the certification form, you must provide the employee with an FMLA designation form that tells them whether the request has been approved.
But if the certification form is incomplete or insufficient, you then must allow the worker seven calendar days to make necessary corrections. You must give written notice to employees of all deadlines, and the consequences of failing to meet them.
Reassignment – If you want to reassign an employee on FMLA leave for better efficiency, you can only do so for employees who need intermittent or reduced schedule leave.
Reassignments can be done for the employee, family or covered service member if such leaves are a planned medical treatment, a period of recovery from a serious health condition, or due to the birth of a child or placement of a child into adoption or foster care. Beyond that, the reassignment is to be only as long as is required by the leave period.
You are also prohibited from transferring employees to a position to discourage them from taking FMLA leave. That means you can’t demote them from marketing supervisor to customer service rep, even if their pay and benefits remain the same at the reassigned position.
Meanwhile, you may not require a transfer to another job when the employee’s need for an intermittent or reduced schedule is unforeseeable.
The takeaway
As you can see, the FMLA is a veritable minefield for employers and, if an employee requests leave under the law, you must make sure you don’t do anything to infringe on their rights, lest you open your organization to being sued.
Business Interruption the Fastest-Growing Cyberattack Cost
A new study has found that the fastest-growing cost associated with cyber incidents is business interruption, reinforcing the need for businesses to have in place robust response and data restoration measures, particularly after a ransomware attack.
Between 2019 and 2023, the average cyber insurance claim that involved business interruption ended up costing 450% more than claims that had no lost income, according to the 2024 NetDiligence Cyber Claims Study.”
Business interruption can occur if a cyberattack like ransomware fully or partially disables a company’s operations or if a vendor suffers a cyberattack that forces the client company to suffer a loss or inability to operate.
The latter, known as “contingent business interruption,” can occur if a cyberattack cripples a supplier’s factory from producing a part that’s crucial for another company’s production operation.
The study also found that if business interruption is involved, the cost of all parts of a claim, such as crisis services and recovery costs, also increase.
For claims with no business interruption losses, the average cost of a cyber claim for small and mid-sized enterprises (SMEs) between 2019 and 2023 was as follows:
- Crisis services: $96,000
- Regulatory and legal: $24,000
- Total incident cost: $205,000
However, for SME claims with a business interruption component during the same period, average costs were*:
- Business interruption: $487,000.
- Crisis services: $279,000
- Recovery expense: $115,000
- Total incident cost: $995,000
* There was no information on regulatory and legal costs for these types of claims.
For large companies, the average business interruption cost was $26 million, with total incident costs averaging $36 million in 2019-2023.
What you can do
First: Ensure that you have in place systems, policies and training to reduce the chances of your organization being hit by a cyberattack.
One of the study authors noted that many companies he deals with are woefully unprepared for a cyber event-caused business interruption.
“We continue to see SME clients transform their businesses to be more reliant on digital systems while failing to understand the inherent risks that come from complex digital ecosystems,” said Alden Hutchison, principal of global consulting firm RSM US LLP.
“This becomes very evident during the recovery process for a client where it’s clear they haven’t planned for resilience in their digital platform nor practiced operating their business processes during a crisis scenario,” he explained.
Experts recommend:
Disconnecting all networks. As soon as a threat is discovered, disconnect every vulnerable device from your network in order to keep the attack from spreading.
Regular back-ups. Back up critical data to a secure, offsite location to enable swift recovery in case of a cyberattack. Even better: Download your data on a daily basis to a hard drive that is not connected to your database or the internet.
But beware: Ransomware can have dwell times as long as six months, so malware might have been included in your archival backups. Before restoring, run an anti-malware package on all systems and drives.
Detailed planning. Create a detailed plan outlining response procedures to a cyberattack, including roles, responsibilities, and data recovery and restoration strategies. Also, prioritize in advance what data or systems needs to be recovered first, and when.
Continuous monitoring. Continuously monitor network traffic for suspicious activity to detect potential threats early and before they spread and threaten to take your entire system down.
Cyber coverage
Finally, you should have in place a cyber insurance policy. Most policies include coverage for both business interruption due to an event on your systems and contingent business interruption for a cyber event at a vendor or supplier.
You can often work with us to tailor-make your cyber policy to ensure it would cover your business’s specific needs.
New Class-Action Lawsuits Target Group Health Plan Tobacco Surcharges
A new wave of class-action lawsuits is targeting employers that apply health insurance premium surcharges to employees who use tobacco, accusing them of discrimination and violating the Employee Retirement Income Security Act (ERISA), according to two new blogs by prominent law firms.
The lawsuits, according to a blog by Chicago-based Thompson Coburn LLP, assert that the surcharges are violations of fiduciary duty rules under ERISA, as well as discrimination regulations under the Health Insurance Portability and Accountability Act (HIPAA).
The law firm says these cases are being filed across the country on an almost daily basis and to date no courts have ruled to have the cases dismissed.
The fast-developing lawsuit trend is notable, considering that tobacco surcharges are widely used, and if any of the new lawsuits are successful, they could set a precedent that could expose thousands of employers to legal action. Most of the lawsuits are against self-insured plans, but even employers who purchase health insurance and also impose surcharges for tobacco use could be targeted as they are considered “fiduciaries” under ERISA.
The lawsuits hinge, in part, on a HIPAA prohibition on group health plans and wellness plans discriminating on the basis of health status. For example, health plans are barred by the law from charging higher premiums to group health plan participants with pre-existing conditions.
However, HIPAA has one exception to the rule: It allows plans to charge different premiums for employees who enroll in and adhere to “programs of health promotion and disease prevention.”
You can find HIPAA’s non-discrimination rules for wellness plans here.
The lawsuits target a common practice: requiring employees who use tobacco to pay higher health plan premiums than their colleagues who certify that they don’t use tobacco products (cigarettes, e-cigarettes, chewing tobacco and similar products).
Common themes
The lawsuits have two common themes. They allege that the plan:
- Did not provide an alternative standard for tobacco users to obtain a discount because the premium reductions for participating in the wellness plans are only available on a prospective basis, in violation of ERISA Section 702, and
- Failed to provide information on the existence of such alternatives in “all plan materials.”
The lawsuits typically seek several of the following remedies:
- Declaratory and injunctive relief.
- An order instructing the employers to reimburse all persons who paid the surcharges, with interest.
- Disgorgement of any benefits of profits the businesses received as a result of the surcharges.
- Restitution of all surcharge amounts charged.
It should be noted that as of the end of October 2024, no court has ruled on a motion to dismiss a case, according to the blog. At least one case has settled as a class action and the employer and plaintiffs in another class-action case had informed the court that they were working on a settlement agreement and would both ask the court to dismiss the case.
In addition to these private actions, the Department of Labor has sued several employers targeting premium surcharges, including in 2023 when it brought action against a firm whose health plan was charging tobacco users a $20 per month surcharge, according to a blog by Washington, D.C.-based Groom Law Group.
The takeaway
Thompson Coburn said in its blog that these types of cases are snowballing: “Given the number of complaints being filed weekly — at times daily — it is highly possible that any group health plan that applies tobacco surcharges as discussed faces the possibility of a class action lawsuit.”
The law firm recommends that businesses consider reviewing their health plans to ensure that they comply with HIPAA’s non-discrimination rules for wellness plans, which allow tobacco surcharges when applied properly, such as charging different premiums for workers who enroll in and adhere to a program that’s focused on promoting health and preventing disease.
This is a newly evolving threat to employers. We’ll provide future updates after courts rule on the merits of the cases, which will provide more guidance on when tobacco surcharges can be applied.
Leave Protections Expanded for Employee Victims of Violence
Gov. Gavin Newsom has signed into law a bill that provides a right to paid time off and other protections for employees who are victims of violence, including threats, assaults, stalking and domestic abuse.
AB 2499 makes significant changes to California’s “jury, court and victim time off” law by expanding instances when a victim of a “qualifying act of violence” can take time off, and provides protections against retaliation for taking that paid time off. The law already requires that employers provide time off for workers who are on juries or have to appear in court.
The new law also requires employers to provide reasonable accommodation to employees who are victims of violence, in a process that’s akin to the Americans with Disabilities Act’s interactive process.
Current law
Under current law, employers are barred from discriminating or retaliating against a worker based on their status as a victim of crime or abuse, for taking time off for jury duty or to comply with a subpoena or other court order.
As well, firms with 25 or more workers may not discriminate or retaliating against an employee who is a victim of crime or abuse from taking time off:
- To seek medical attention for injuries related to the crime or abuse,
- To obtain services as a result of the crime or abuse, or
- To participate in actions to increase their safety from possible future crimes or abuse.
Changes under AB 2499
AB 2499 replaces the term “victim of crime or abuse” with an individual against whom a “qualifying act of violence” (QAV) is committed, which includes:
- Domestic violence,
- Sexual assault,
- Stalking, or
- An act, conduct or pattern of conduct in which an individual:
- Causes bodily injury or death to another,
- Exhibits or uses a firearm or other dangerous weapon against another, or
- Uses or makes a reasonably perceived or actual threat against another to cause physical injury or death.
The law also extends protections to employees who need to take time off if they have a family member who is the victim of a QAV. “Family” includes:
- A child, parent, grandparent, grandchild, sibling, spouse or domestic partner; or
- A “designated person” who is blood-related or whose association with the employee is equivalent to a family relationship.
It also bars employers with 25 or more employees from discriminating or retaliating against a victim of QAV or whose family member is a victim, for taking time off to:
- Obtain relief, including restraining orders.
- Obtain medical attention after a QAV.
- Seek assistance from a victim services organization.
- Seek mental health services related to a QAV.
- Recover from QAV-related injuries.
Reasonable accommodation
Under an ADA-like component to the new law, employers are required to engage in an interactive process to determine effective accommodations if an employee:
- Discloses the fact they or a family member is a victim of a QAV, and
- Requests accommodation for safety reasons.
Some examples of reasonable accommodations include:
- Work transfers or reassignments,
- Modified schedules,
- Changed workstation or telephone,
- Lock installation, and
- Temporary time off.
However, organizations won’t be required to provide accommodation if it would pose an undue hardship to them, including if it would violate their duty to maintain a safe workplace.
Notification and paid time off
The new law allows victims to use paid vacation or sick time during any QAV-related leave they take.
If the leave is granted as an accommodation under the Family and Medical Leave Act, the paid leave must run concurrently. Employers may restrict leave to the following:
- Twelve weeks for an employee who is a victim.
- Ten days if a worker’s family member is a victim.
- Five days if a worker’s family member is a victim and needs help relocating.
The takeaway
California employers will be required to provide notice to their employees that informs them of their rights under the law when they are hired and if an employee informs the organization that they are a QAV victim.
This is one of those laws that should spur you to seek legal counsel if confronted with a request for time off, and especially if the affected worker requests reasonable accommodation.