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is it illegal for your employer to knowingly deny you benefits?


squatch66

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with the way the economy has been my boss has been having to cut back everyone's hours. i am paying for insurance through the company and need to maintain a 32 hour work week in order to keep my benefits. lately the boss has been making people leave early to trim payroll even more. i have told him that i am paying for my benefits and reminded him of the 32 hour rule. i dont want to lose my benefits and i am wondering if it is legal to knowingly deny me benefits if i am paying for them.

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From what I know of the laws here he can cut your hrs how he wishes.

No idea on how your ins policy works,but it would seem strange to change your status for a short period to P/T.

Have you read the policy?

Are you paying for dependents rather than yourself?

If your company group plan refuses coverage if you are P/T COBRA ect is a option

http://www.dol.gov/ebsa/publications/work_changes.html

What if your health care coverage ends because you lose your job, have your hours reduced, or get laid off? Knowing your rights ahead of time can prevent these situations from meaning an end to health care coverage. Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), you, your spouse and dependent children, might be able to purchase extended health coverage for up to 18 months. In the case of individuals who qualify for Social Security disability benefits, special rules may allow for extending coverage an additional 11 months. Since your employer is not required to pay a portion of your premium, you may pay the entire amount, but the cost is usually less than if you obtained coverage on your own. Also, contact your state government to find out if you or your dependents are eligible for public health insurance, like Medicaid or the new State Children's Health Insurance Programs, or to get information on obtaining new coverage. Under the Health Insurance Portability and Accountability Act (HIPAA), you may also be eligible to enroll in your spouse's health plan under a special enrollment period.

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If there's no union to back you, as far as I know an employer can do just about what he wants.

No.

Under ERISA law your employer can only cut your benefits if he does the same thing across the board.

So if he takes away your health insurance, he has to take it away from everyone.

Now if you drop to 10 hours a week and everyone else gets the 32 that is required for benefits, he can take them from you.

Whatever the policy is it has to be applied company wide because of ERISA.

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There should be a option of extending coverage for a yr or more(HIPAA?)in such cases,in which he will pay the full cost.(which he claims to already do)

Reviewing his policy and following the link I provided should give a answer to his case,but I am fairly certain the option is offered under law here.

The company is not dropping benefits by changing hrs,it is his status as a employee that changes with the ins co.

added from the link

If the employer is too small to be subject to COBRA, state law may require the plan's insurer to provide some continuation coverage.

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your employer is cutting hours, they are not the ones denying benefits. That rule is from the insurance company. Going through the same thing with my employees now. Having to cut hours quite a bit all summer. Per our Comp/Benefits dept- the insurance rule is that if you go below 30 hrs per week average for one qtr (3 months), then they send a warning letter saying that if you don't bring your hours back up, they will cut your coverage. Then if you go below 30 hrs avg per week the next qtr, they will cut you. The rule is that you have to be below 30 hr avg for 2 consecutive qtrs.

I'm sure your company's insurance runs the same way. I'd contact the insurance company, or if you have a Benefits dept. they can explain all of that for you.

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your employer is cutting hours, they are not the ones denying benefits. That rule is from the insurance company. Going through the same thing with my employees now. Having to cut hours quite a bit all summer. Per our Comp/Benefits dept- the insurance rule is that if you go below 30 hrs per week average for one qtr (3 months), then they send a warning letter saying that if you don't bring your hours back up, they will cut your coverage. Then if you go below 30 hrs avg per week the next qtr, they will cut you. The rule is that you have to be below 30 hr avg for 2 consecutive qtrs.

I'm sure your company's insurance runs the same way. I'd contact the insurance company, or if you have a Benefits dept. they can explain all of that for you.

No the insurance company doesn't track your hours. I can cover my employee for 1 hour or 32 hours. The employer is kicking that off....not the insurance co.

And no TWA and ACW insurance isn't cheaper from private insurers NOW that Obama has pushed through a law that the employee only has to pay 30% of Cobra.

Sorry.

I own a company and am the benefits guy. New law allows cobra folks to pay like 30% of cobra and the company gets govt funding of the rest.

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You explained that well ljs

thank you, but see below, he disagrees:silly:

No the insurance company doesn't track your hours. I can cover my employee for 1 hour or 32 hours. The employer is kicking that off....not the insurance co.

right, I wasn't trying to say the insurance co tracks the hours, but that the company won't allow you to keep the benefits if you drop below as I explained. I believe it's due to cost and that if you drop below a certain avg weekly hour- then you are not considered full time. Part time people don't qualify for ins. or am I still way off?

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When i see jobs listed as part time, sometimes they say no benefits are available, I think if part time they dont HAVE to offer them to you, but I'm not sure about full time jobs.

Health ins is not required to be provided as a benefit(though most do for full time employees in some manner),the contract you are employed under determines that.

http://www.business.gov/business-law/employment/employee-benefits/

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Yes the employer can misreport the employees status if they so wish.

Cook the books if .

Haven't made up your mind if he is under COBRA yet?;)

Cook the books?

In MD I have to have 20 employees before Cobra is required.

There is no law that says an employee has to cover for 1, 5, 10, 15, 20, 32 hours.

It's not about misreporting. Sorry sir. It's just about making a rule and being equal for all.

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right, I wasn't trying to say the insurance co tracks the hours, but that the company won't allow you to keep the benefits if you drop below as I explained. I believe it's due to cost and that if you drop below a certain avg weekly hour- then you are not considered full time. Part time people don't qualify for ins. or am I still way off?

It's not the insurance companies decision. It's the company you work for.

ERISA laws apply to making all employees of a certain "status" equal.

If a part time employee gets benefits for an hour, then they all get benefits.

If it's 50 hours they all get benefits.

It has to be same for all.

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Seems we are arguing different points:)

I certainly agree the employer can offer ins coverage for whatever employee it wishes.....it simply depends on the company policy AND the ins policy.

From the OP it appears they cut them off at 32 hrs(subject to ljs's conditions of course)

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Seems we are arguing different points:)

I certainly agree the employer can offer ins coverage for whatever employee it wishes.....it simply depends on the company policy AND the ins policy.

From the OP it appears they cut them off at 32 hrs(subject to ljs's conditions of course)

Not arguing different points.

The ins policy DOES NOT decide anything. My policy will take all the enrollments I give them. The COMPANY policy decides who is covered....be it an hour a month or 150 hours a month. Health care could care less how many hours my employees bill. Don't be confused.

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Yes the ins policy does(if it does;))...though yours certainly may offer it to any

interestingly some states limit not the company offering coverage,but rather the insurer from doing so.

http://www.ins.state.ny.us/ogco2005/rg050707.htm

Dude you are making yourself look foolish. Not sure what the link means.

My insurance company, Blue Cross Blue Shield asks NO questions regarding how many hours my employees work and ASK for NO documentation regarding their hours.

They insure ANYONE i submit forward with the enrollment paperwork.

You are really grasping for straws.

ME, the employer, makes the rules as to who is covered, and if ME the employer VIOLATES ERISA law, I can be sued for unfair practices. ERISA REQUIRES ME the employer provide the SAME insurance to ALL my employees in the same class...which ESSENTIALLY is based on the NUMBER OF HOURS they work per week for my company.

Not sure what you are trying to IMPLY.

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