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socrateaser, Lawyer
Category: California Employment Law
Satisfied Customers: 39171
Experience:  Retired (mostly)
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One more.... Our County (Lassen in California) is a member

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One more....
Our County (Lassen in California) is a member of CalPERS for retirement and medical benefits etc. Our previous CAO's contract provided 100% medical benefit, his replacement accepted a contract that has only a 50% medical benefit paid by county.

Question is: Can we leagally pay the replacement only 50% benefit while continuing to pay the past (retired) CAO 100% medical benefit... OR do we need to also pay the replacement CAO the equall (100% medical) benefit until such time we go thru the process to re-negotiate the contract for the former CAO to reduce the medical benefit to 50%

Thank you
Under ERISA Section 702 (29 U.S.C. 1182(b)(1)), "A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than such premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health status-related factor in relation to the individual or to an individual enrolled under the plan as a dependent of the individual."

Based upon the above-quoted law, and presuming that CalPers is apparently an ERISA-qualified plan (see DOL Adv. Op. 1999-10A) , if a current employee were in the same health status as a retiree, and the current employee were to pay more for health care benefit services than the retiree, this would appear to violate the provision that similarly situated individuals with respect to health status, pay the same premium amounts.

Hope this helps.

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