(a) In order to maintain, as nearly as possible, the income of employees who suffer employment-related injuries, any employer who provides accident and health insurance or life insurance coverage for any employee or makes payments or contributions at the regular hourly or weekly rate for full-time employees to an employee welfare plan, shall provide to the employee equivalent insurance coverage or welfare plan payments or contributions while the employee is eligible to receive or is receiving compensation pursuant to this chapter, or while the employee is receiving wages under a provision for sick leave payments for time lost due to an employment-related injury. As used in this section, “income” means all forms of remuneration to an individual from his employment, including wages, accident and health insurance coverage, life insurance coverage and employee welfare plan contributions and “employee welfare plan” means any plan established or maintained for employees or their families or dependents, or for both, for medical, surgical or hospital care benefits.
(b) An employer may provide such equivalent accident and health or life insurance coverage or welfare plan payments or contributions by: (1) Insuring his full liability under this section in any stock or mutual companies or associations that are or may be authorized to take such risks in this state; (2) creating an injured employee's plan as an extension of any existing plan for working employees; (3) self-insurance; or (4) by any combination of the methods provided in subdivisions (1) to (3), inclusive, of this subsection that he may choose.
(c) In the case of an employee welfare plan, an employer may provide equivalent protection by making payments or contributions for such hours of contributions established by the trustees of the employee welfare plan as necessary to maintain continuation of such insurance coverage when the amount is less than the amount of regular hourly or weekly contributions for full-time employees.
(d) In any case where compensation payments to an individual for total incapacity under the provisions of section 31-307 continue for more than one hundred four weeks, the cost of accident and health insurance or life insurance coverage after the one-hundred-fourth week shall be paid out of the Second Injury Fund in accordance with the provisions of section 31-349.
(e) Accident and health insurance coverage may include, but shall not be limited to, coverage provided by insurance or directly by the employer for the following health care services: Medical, surgical, dental, nursing and hospital care and treatment, drugs, diagnosis or treatment of mental conditions or alcoholism, and pregnancy and child care.
(P.A. 82-398, S. 3; P.A. 86-403, S. 99, 132; P.A. 91-32, S. 8, 41; 91-339, S. 12.)
History: P.A. 86-403 made technical change in Subsec. (b), substituting “mutual” for “municipal” companies; P.A. 91-32 added definition of “income” to Subsec. (a) and made technical changes; P.A. 91-339 changed “employee welfare fund” to “employee welfare plan”, added a definition of the latter term in Subsec. (a) and deleted the reference to Sec. 31-53 in Subsec. (a).
Cited. 214 C. 552; 219 C. 439; 223 C. 376. Court found no legislative intent to mandate transfer of liability for section's benefits to the fund as “compensation” under Sec. 31-349 in case of employee with preexisting impairment. 231 C. 287.
Cited. 16 CA 660. Dependents' benefits are part of workers' income to be maintained by employer. 24 CA 234. Cited. 40 CA 409; 44 CA 397. Board incorrectly interpreted section as requiring city to continue insurance coverage for plaintiff and his family once plaintiff's compensation payments under Sec. 7-433c ended; definition of “compensation” in Sec. 31-293 inapplicable to section as it existed on date of plaintiff's injury; payments by city for plaintiff's medical care did not constitute compensation payment required by statute or regulation and did not trigger benefits under section. 61 CA 9.
Subsec. (a):
Cited. 214 C. 394.
Term “compensation payments” as used in Subsec. as it existed on date of plaintiff's injury does not include payments for medical care after the indemnity compensation period has ceased. 61 CA 9. Term “compensation payments” as used in Subsec. does not include payments for medical care after the indemnity compensation period has ceased; plaintiff accordingly was not entitled to benefits pursuant to section. 81 CA 339.
Subsec. (b):
Authorizes employer to meet its workers' compensation obligations under chapter by enumerated methods, including self-insurance. 247 C. 442.