California Code of Regulations › Title 22 - Social Security › Division 1 - Employment Development Department › Subdivision 1 - Director of Employment Development › Division 1 - Unemployment and Disability Compensation › Part 2 - Disability Compensation › Chapter 6 - VOLUNTARY PLANS › Section 3254-4 - Termination of Family Temporary Disability Insurance Coverage Under a Voluntary Plan

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Once a 12-month period is established, liability for
						  Family Temporary Disability Insurance benefits may change during the 12-month
						  period by virtue of new employment and/or new plan coverage. Liability for
						  coverage during a single 12-month period may involve multiple plan
						  liabilities.
Liability for Family Temporary Disability Insurance
						  benefits remains with the plan or plans that covered the employee when the care
						  recipient period was established.
"Care recipient period" means all periods of family
						  care leave that an employee takes within a 12-month period, as defined in
						  Section 3301(d) -
						  1, to care for the same care
						  recipient.
(a) Coverage under a
						voluntary plan may be terminated prior to commencement of a period of family
						care leave by any one of the following conditions:
(1) Termination of the voluntary plan by the
						director in accordance with the provisions of Section
						3262 of the code and Section
						3262-1 of these
						regulations.
(2) Withdrawal of the
						voluntary plan by the employer or a majority of its employees in accordance
						with the provisions of subdivision (g) of Section
						3254 or subdivision (g) of Section
						3255 of the code.
(3) Withdrawal from the voluntary plan by a
						covered employee in accordance with the provisions of subdivision (g) of
						Section 3254-2 of these regulations or
						subdivision (a) of Section
						3271 of the code and subdivision
						(b) of Section
						3271-1 of these
						regulations.
(4) Termination of the
						employer-employee relationship. Except when subdivision (b) of this section
						applies, "termination of the employer-employee relationship" means that
						employment ceases with no mutual expectation or intention to continue the
						employment relationship. Reasons for termination of the employer-employee
						relationship include, but are not limited to, separation, dismissal,
						resignation, and retirement.
EXAMPLE 1. Separation. Claimant A, an operating
						  engineer, leaves work at the close of the shift on Friday when Claimant A and
						  other members of Claimant A's crew are informed by the employer that their
						  services are no longer needed because the job is being completed. For any new
						  projects the employer will request a general union dispatch of union members.
						  Claimant A is paid in full on that day. On Sunday, Claimant A's father suffers
						  a severe stroke that warrants Claimant A's immediate participation to provide
						  care. Claimant A establishes a Family Temporary Disability Insurance claim with
						  the voluntary plan. The medical certificate confirms that Claimant A's care is
						  warranted beginning Sunday due to his father's serious health condition.
Claimant A's inability to perform regular or customary
						  work due to the need to provide care is not in dispute. However, the employer
						  had terminated the employment relationship with Claimant A prior to the
						  commencement of the period of family care leave, and, therefore Family
						  Temporary Disability Insurance benefits are payable from the Disability Fund
						  rather than the voluntary plan.
EXAMPLE 2. Liability During a Twelve-Month Period.
						  Claimant B establishes a claim for Family Temporary Disability Insurance
						  benefits under the voluntary plan beginning January 3 to care for her seriously
						  ill daughter. The medical certificate confirms that Claimant B's care is
						  warranted beginning January 3 due to her daughter's serious health condition.
						  Claimant B serves a seven-day waiting period January 3 through January 9 and
						  receives two weeks of benefits under the voluntary plan through January 23.
						  Claimant B returns to work for the voluntary plan employer on January 24. She
						  leaves work at the close of the shift on January 28 when the employer informs
						  her that her services are no longer needed because the job is completed.
						  Claimant B is paid in full on January 28.
On January 30, her daughter's serious health condition
						  warrants further care. Claimant B establishes a Family Temporary Disability
						  Insurance claim with the voluntary plan to provide care for her daughter. The
						  medical certificate confirms that Claimant B's care is warranted beginning
						  January 30 due to her daughter's serious health condition.
The voluntary plan is liable for benefits commencing
						  January 30 because liability for Family Temporary Disability Insurance benefits
						  remains with the plan that covered the employee when the care recipient period
						  was established.
(5) Leave
						of absence without pay or a layoff without pay if the leave or layoff extends
						for a period of fifteen (15) full days before the period of family care leave
						commences. Except when subdivision (b) of this section applies, "leave of
						absence" and "layoff" mean that something other than a permanent termination of
						the employment relationship is indicated at the time an individual's work comes
						to an end, or the employment ceases because of factors beyond the employee's or
						the employer's control. A leave of absence from work is granted by the employer
						for many reasons. Reasons for a layoff include the following:
(A) Temporary disciplinary action.
(B) Lack of work. The term "lack of work"
						indicates termination of employment because the commodity or activity provided
						by the business is no longer in sufficient demand to require the services of
						the individual, however the individual would be subject to recall if more work
						developed; or because an on-call employee who accepts temporary assignments is
						laid off at the completion of an assignment with the expectation that another
						assignment will be provided in the future.
(C) Material shortage. The term "material
						shortage" indicates the lack of some component necessary to make a final
						product, i.e., in a steel mill--lack of coal, ore, etc.; in a cannery--lack of
						the products being canned, cans, etc.; in the automotive industry--lack of
						steel, parts, etc.
(D) Season of
						activity ends. The term "season of activity ends" indicates termination of
						employment because of the seasonal nature of the work, i.e., lumbering ceases
						because of weather; canning stops because crop not in season; fishing stops
						because the fish run ends; track closes because racing seasons ends.
EXAMPLE 1. Leave of Absence. Claimant A is granted an
						  indeterminate leave of absence without pay. On the 15th day following the last
						  day of work Claimant A's mother suffers a severe stroke that warrants Claimant
						  A's participation to provide care. The medical certificate confirms that
						  Claimant A's care is warranted due to her mother's serious health
						  condition.
A day is defined in Section
						  125-1 of these regulations as the
						  24-hour period beginning at midnight and ending the following midnight.
						  Therefore, a period of family care leave which occurs on the 15th day after
						  leaving work is not one that occurred 15 full days after the last day worked.
						  Family Temporary Disability Insurance benefits are payable under the voluntary
						  plan.