DBCs & DHRMs: Employees Going on Leave

Please Note: This list is not intended to be all-inclusive, but covers major information needed for employees going on or returning from a leave of absence.

Important: see also Leave of Absence Premium Overpayment Information

At the Beginning of a Leave of Absence, please ensure that all the following steps have been covered with the employee.

Give employee the appropriate Benefits Checklist(s)

  • Disability Checklist (includes pregnancy disability)
    NOTE: For employees needing to apply for disability benefit payments, either the Department Benefits Counselor or the employee should call Campus Shared Services at 664-9000 (option 3) to request a disability packet.
  • Family and Medical Leave (FMLA) Checklist
  • Furlough Checklist
  • Leave Without Pay Checklist
  • Military Leave Checklist
  • Paid Leave Checklist
  • Sabbatical Leave Checklist
  • Temporary Layoff Checklist

If the employee will miss one or more paychecks during the leave of absence

  • Department completes the Request to Continue/Cancel University Coverage  (PDF) form and collects the first month's premium, if applicable.

    If one or more pay periods will be missed, the department should play an active role to assure that the employee chooses either to continue or to cancel benefits while on leave and completes the form. If benefits will be continued, the department must collect the first month's premiums from the employee. The form, and any premiums collected, should be sent to Payroll - Benefits Accounting Unit at 2195 Hearst Avenue #120 by the 10th of the month.
  • To cancel benefits: Send the completed form with the employee's signature to Payroll - Benefits Accounting Unit.
  • To continue benefits: Send the completed form with the first month's premiums (check or money order payable to UC Regents) to Payroll - Benefits Accounting Unit. The employee should contact Payroll - Benefits Accounting Unit ((510)-642-1336) to arrange for paying additional months of premiums directly to that office.
  • IMPORTANT: If no form/premium is received, or if at any point the employee misses a premium payment, the employee's benefits will be cancelled at the end of the month for which a premium was last paid.
  • FMLA and benefits: Be sure that leave is recorded accurately in HCM. This is important because this coding is used to know when to continue an employee's benefits while on FMLA.

    Health FSA and FMLA: If employee is enrolled in the Health Flexible Spending Account program (Health FSA) and is on FMLA leave, the employee must complete form UPAY 919 choosing to cancel or continue the Health FSA while on FMLA.
  • If an employee chooses to cancel coverage: coverage generally ends at the end of the month in which the employee was last paid, e.g., if an employee is last paid on 4/1 and a Health FSA contribution was made, coverage ends on 4/30. Expenses are not eligible after the coverage end date.
  • If an employee chooses to continue coverage while on FMLA, when Benefits receives the UPAY 919, they will enter a coverage end date that corresponds with the FMLA end date. Expenses incurred during the FMLA leave are considered eligible expenses. Upon return from a FMLA leave, the annual or monthly Health FSA contribution will be adjusted according to whether the employee chose to continue with the prorated option or continue with the "resume monthly contributions" option.
  • Employee leaving service area: Employees who elect to continue coverage in an HMO medical plan or the  DeltaCare dental plan and who are leaving the service area for more than 60 days during their leave of absence need to complete a UPAY 850 form to change to a medical and/or dental plan that will provide coverage in their new location. The form must be completed within 31 days of leaving the plan's service area and sent to Payroll - Benefits Accounting Unit for processing.
  • Life and AD&D conversion options: Refer the employee to the appropriate Benefits Checklist for information about these options. If the employee is interested in conversion information, contact HR Benefits.
  • Flexible Spending Accounts—Health and DepCare FSAs: Coverage is cancelled during leave (with the exception of an employee on a FMLA leave who chooses to continue the Health FSA as described above). Expenses incurred after the coverage end date are not eligible expenses. The coverage end date is generally the last day of the month for which the employee was last paid, e.g., if employee is last paid on 4/1 and a Health FSA contribution was made, coverage ends 4/30.

Tax-Deferred 403(b) Savings Plan

Employees going on leave may need to change or cancel their 403(b), 457(b) or other savings enrollment options. If you do nothing, your contributions will resume when you return from leave.

Other deductions

Employees who have other deductions such as Parking, Rec Sports, Credit Unions, or a 403(b) loan should contact each source and make arrangements for payment or cancel deductions if any pay periods are missed during the leave of absence.

UCRP Service Credit buyback information

At the beginning of the leave, give the employee the UCRP Buyback Booklet (Service Credit). In this way notification about the three-year buyback election deadline will have been provided as early as possible, giving the employee time to plan.

For questions about benefits during a leave of absence, contact HR Benefits.