Health Insurance Coverage for Employees

Many employers offer health insurance as an employee benefit. Your employer may subsidize some of your monthly costs, but no law requires the company to offer health insurance or make contributions. Once your employer makes health insurance available, however, you then have some legal right to it.

Your Health Insurance Must Continue During Certain Leaves

Employees often are entitled to take up to 12 weeks of unpaid leave under the Family and Medical Leave Act (FMLA), so they can take care of their own medical issues or those of their family members. If you take such a leave, your employer must continue your health insurance coverage.

In addition, the benefits can't be reduced and the employer can't stop paying its part of the premium if it was making payments right before you went on leave. If you don't receive the same exact health insurance coverage, you can take legal action against your employer for violating the FMLA.

Employers Must Continue Health Insurance After Termination

If you lose your job or if your hours are cut, a federal law commonly known as COBRA requires your employer to give you the option to continue your health insurance coverage, for a maximum of three years in some cases.

If your children, spouse, or other family members receive their health insurance through your plan, COBRA allows you to continue their coverage as well. It is illegal for your employer to deny you the continuing health insurance. However, you will be responsible for paying the entire premium.

You Can't Be Denied Insurance Because of a Medical Condition

It is a violation of federal law for your employer (or its insurance company) to either deny you coverage or require you to pay more because you're in poor health. This includes current or past physical and mental conditions.

Even if you have a history of frequently accessing medical care or if you engage in a dangerous hobby, those are not legal reasons for denying you access to health insurance through your employer.

Alternatively, some employers and insurers are offering health insurance discounts for employees who pass certain biometric tests (like weight, blood pressure, and cholesterol), or agree to participate in smoking cessation, weight-loss, or exercise programs.

Denying Health Insurance Can Be Illegal Discrimination

Your employer can't discriminate by denying certain employment benefits, such as health insurance, based on your disability, age (40 and older), ethnicity, gender, religion, or national origin. If your employer's policies allow all employees to obtain health insurance, but denies you coverage, this may be illegal. You don't have to tolerate it.

An Employment Lawyer Can Help

The law surrounding employee health insurance is complicated. Plus, the facts of each case are unique. This article provides a brief, general introduction to the topic. We hope you found it useful. For more detailed, specific information, please contact an employment lawyer.

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