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John, Employment Lawyer
Category: Employment Law
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Experience:  Exclusively practice labor and employment law.
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In the state of Alabama, can an employer of a small business

Customer Question

In the state of Alabama, can an employer of a small business (under 10 employees) "selectively" offer group health insurance to employees? I believe the answer is, Yes; but it appears not to be a blanket yes, but rather a yes But... The question is what is/are the "but" specifics?

For example, I believe full-time versus part-time is "ok", by employee classification is "ok", and the like.

That being the case, if employee "A" is in the same classification as others being offered health insurance benefits, but employee "A is not offered health insurance benefits, does employee "A" have a case against the employer or not?
Submitted: 8 months ago.
Category: Employment Law
Expert:  John replied 8 months ago.
Employee benefit plans are subject to three sets of discrimination rules: (1) the general employment laws, including ADEA, that prohibit an employer from discriminating with respect to any terms and conditions of employment on the basis of race, gender, age, national origin, religion, etc.; (2) the Internal Revenue Code’s prohibition of a retirement plan’s discriminating in favor of highly-compensated employees; and (3) Employee Retirement Income Security Act (ERISA’s) prohibition of a benefit plan’s discriminating against employees with respect to their benefit plan rights.

A in this case could have a claim if the plan defines him/her as an employee that should be covered by the terms of the plan but the the employer for whatever reason has not/ will not be offering the employee coverage. He/she could claim that he/she is entitled to such benefits as a matter of the plan language, but is being denied the same, which could be a claim under ERISA; assuming A is a person qualified for benefits under the plan. If this is the case A would have a potential claim to benefits under ERISA.

I believe this answers your question. However, if you need clarification or have follow-up questions regarding this matter, I will be happy to continue our conversation – simply reply to this answer. If you are otherwise satisfied with my response, please leave a positive rating as it is the only way I am able to get credit for my answers. Thank you, XXXXX XXXXX wish you all the best with this matter.

John, Employment Lawyer
Category: Employment Law
Satisfied Customers: 2653
Experience: Exclusively practice labor and employment law.
John and 3 other Employment Law Specialists are ready to help you
Customer: replied 8 months ago.

Thanks for your quick response. You have answered appropriately based on the information provided and I believe my intuition was correct even though I did not know the specific 3 items you have provided. Since this is a small business employer, they (like most) are not "up-to-speed" on such matters and hence, have no "formal" documents pertaining to their benefit plan (as they are required to have). Basically employee "A" was not offered coverage like the rest "just because". In that regard I believe the business is liable for damages that may occur as a result.


 


Thanks again.

Expert:  John replied 8 months ago.
Michael,

You're welcome. Every group health plan like this has a defined "group" in the plan that is to be covered. An employee of the "group" that is not allowed to get on the plan would have an ERISA claim. So, the first step in these matters is to get a hold of the plan and determine if coverage is mandated in the situation.

Hope this helps. Let me know if you have any further questions. Thanks.

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