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Do you have to pay for health insurance while on workers’ comp? (2025 Expert Answers)

Whether or not your employer needs to provide you with health insurance while you are off on workers comp is a very complicated question to answer, and one you are going to need a lawyer for. While many states, including Alabama, Alaska, Colorado, Connecticut, Florida, Kansas, Maine, Rhode Island and Washington DC have laws mandating that employers either pay for health insurance for workers comp employees or compensate for lost health insurance benefits along with lost wages, ERISA or the Employee Retirement Income Security Act of 1974 preempts these state laws. Thus, you will need to determine if you and your employer are covered by ERISA.

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Employer Medical and Health Coverage of Stepchildren

Employer-provided health insurance does not always have to cover step-children, even though policies may generally cover biological and legally adopted children. Employer-provided health insurance only needs to cover those people that it specifically states it will cover, based upon company policy, employer plans, and state laws. When someone pays for “family coverage,” that coverage is necessarily based on a definition of “family” of legal relationships, such as those of blood, marriage, or adoption. If someone does not meet those specific definitions, they may not be covered by insurance, even if they are part of family” by modern —though non-legal —definitions.

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What can I do if my employer has not paid my insurance premiums and is now filing for bankruptcy?

If you pay health insurance premiums to your company, and the company declares bankruptcy – and so does not actually make the payments to the health insurance company – what happens may depend on the type of bankruptcy filed as well as the specifics of your health plan. In general, however, if your company declares bankruptcy, you will have your health insurance premiums paid or you will get a refund for the money withheld from you.

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