can employer cancel family health coverage of full time employee?
State/Country relating to question: New Jersey
Hello,In order to assist you I will need a bit more information. Why was the coverage canceled? Did the employer end their health benefits plan, was the employee off of work for an extended period, or what? Thank you
i work for a dermatologist and he did not end everyones plan just mine. he said he can not afford my coverage anymore. i can pay for half or find it else where. He has not cancelled anyone elses
Hello again,Thank you for that information, however, it leads me to a few more questions so that I can help you. Can you tell me how many employees your employer has? Also is this policy not a "group" plan. In other words, did the doctor just agree to pay for each individual up to a certain amount? What do you think makes you different in his eyes? Are you full time and do the same job as the other workers who still have insurance?
the office has about 15 employees. it is a group insurance. he offers the insurance for the employee, but in my case since i do have a family i did take a pay cut when i was hired to get the family health plan. I have been working there for 7 years full time. He decided that it was to expensive since we moved into a new office and cannot afford my insurance unless i take another pay decrease of $4 an hour.
Hello again,Thank you for that information. There would be no way for me to say for sure exactly what is going on hear without all of the facts from both sides, but in general it is unlawful to exclude an employee who otherwise qualifies under a group health plan. The law that governs most employers is ERISA, which is the Federal law that governs fringe benefits, including group health insurance. I asked you about your job, because an employer can include or exclude certain classes of employees. For example, an employer could say all salaried workers get group health benefits, but hourly workers don't. Or all administrative workers receive benefits, but laborers don't. Those are just some examples. You can find more information at: http://www.state.nj.us/dobi/division_insurance/ihcseh/sehguide/whatis.htmlIn addition, an employer cannot discriminate against an employee is NJ simply because the person is a member of a protected class under employment discrimination laws. I can't guess what your employer's intentions or motivations are, but you have a few options. One is to contact a local Employment Law attorney who handles ERISA issues to assist you with this issue and deal with your employer. The other is to file a complaint with the Employee Benefits Security Administration of the U.S. DOL, which enforces ERISA. Assuming that you do not fall into the exceptions of coverage which are at the link I provided, you should be covered. The fact that it costs more for you is not a legitimate deciding factor for your employer. Here is an explanation as provided by the DOL:An employer is permitted to limit the offer of coverage to employees by class, subject to some limitations. Classes must be based on bona fide conditions of employment – for instance, hours worked per week, salary versus Hourly Wage, or union versus non-union.* But for purposes of meeting the participation requirement, all eligible employees are considered in the count. For example, if an employer with 30 eligible employees – 15 of whom work 35 hours per week and 15 of whom work 30 hours per week – wants to offer coverage only to employees working 35 hours per week, he may do so, but the group must meet the participation requirement based on 30 eligible employees. So, at least 23 employees must be covered under the employer’s group health plans(s) or another group health plan, Medicare, Medicaid or NJFamilyCare for the employer to meet the participation requirement.
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Licensed Attorney with 27 yrs. exp in Employment Law
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