Health Insurance and Benefits: Your Rights
Employers are generally not required by law to offer health-related benefits to their employees, although the practice of providing health-related benefits is fairly common in many companies and businesses. In addition to a helping employers recruit and retain top talent, employee healthcare benefits ensure greater productivity and fewer sick days. However, once an employer offers or provides health benefits -- including medical, disability, dental, and life insurance -- federal anti-discrimination laws and health plan enforcement regulations act to protect an employee's rights under those health plans.
The following article provides an overview of your rights as an employee with regard to employer-sponsored health insurance benefits.
Anti-Discrimination in Employment Health Benefits
As mentioned above, most employers are not required to provide their employees with medical, disability, dental, or life insurance, but once such benefits are offered, the law requires that the employer adhere to federal laws prohibiting discrimination in employment. As with other areas of employment such as hiring, promotion, and termination, distinctions in health benefits coverage cannot be made on the basis of an employee or dependent's gender, race, age, national origin, religion, or disability. As examples, an employer providing employees with health insurance may not, among other things:
- Provide lesser coverage or cease offering coverage to older workers, or workers who may become pregnant
- Treat pregnancy-related disabilities (including miscarriage, abortion, and post-childbirth recovery) different from other health conditions
- Refuse to provide coverage based on an employee or dependent's actual disability, a perceived disability, or his or her genetic information
ERISA and Enforcement of Health Insurance Rights
Once an employer decides to offer health-related benefits, its plan must be run in accordance with certain standards designed to protect the interests of employees and other plan beneficiaries (such as family members) under a federal law known as the Employee Retirement Income Security Act (ERISA). Under ERISA, employers are required to take certain steps in connection with employee health benefit plans, including:
- Notifying employees (called "plan participants") of plan eligibility standards, claim procedures, participant rights, and related changes to the plan; and
- Managing and investing plan funds according to the best interests of plan participants.
Family and Medical Leave
While taking a leave of absence for a medical reason is not a "benefit," per se, it's important to point out that federal law protects workers from being terminated or otherwise treated adversely when taking protected leave. The federal Family and Medical Leave Act applies to employers with at least 50 employees; furthermore, eligible employees are those who have worked with the same employer for at least 12 months and 1,250 hours. Keep in mind that only unpaid leave is protected by federal law, although a handful of states (including California) offer partially paid leave as well.
Health Benefits and Employee Rights: Get Legal Help
Although most employers are not required by law to offer health-related benefits to their employees, when health benefits are provided an employer must comply with a number of federal anti-discrimination laws and health plan regulations. If you're an employee with questions about your rights under an employment health plan, or if you believe that your employer may be violating regulations in connection with a health plan, you should consider speaking with a local employment lawyer.