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Phia Group Media


LOA = Continuation of Coverage, or does it? One of the “Gap Traps”

By: Kelly Dempsey, Esq.

It’s intuitive to think that a leave of absence (LOA) from employment is coupled with a continuation of health plan coverage (CoC), especially if the leave is illness related; but to the dismay of many, a CoC isn’t always coupled with a LOA. Many employers struggle to align their plan docs with their EE handbook which increases the potential for a gap in stop-loss coverage. While most federal and state laws do not require a CoC, employers can provide the benefit of continued coverage – but if the employer wants stop loss to help out, the terms of CoC need to be spelled out in the plan doc.