Health Insurance and Medical Benefits

You know that many workers don't have health benefits through their employers, and you understand that employers generally don't have to give them. But you notice that your employer is giving health benefits to some favored employees, and not making any similar offers to you. You and your family can't go to the doctor's office because you can't afford to. You feel that this is unfair, and you may be right. Discrimination in health insurance or health benefits is illegal under the Employee Retirement Income Security Act (ERISA), and it is illegal in New York State and New York City for your employer to unfairly give health insurance or health benefits to some employees and not to others.

Your employer does not have to give you health benefits and may not have to provide a specific monetary amount of benefits if it does choose to have a plan. There is an incentive to give such plans, because they can provide pre-tax compensation and neither the employer nor the employee may have to pay payroll taxes. If your employer chooses to have a health plan, then it must give you a fair opportunity to participate based on prescribed rules. The Affordable Care Act, often referred to as Obamacare, will make additional health plan requirements of larger employers.

Your employer may misclassify you as an independent contractor, even though your employer is in control of your work and you are really an employee. The employer will give you a 1099, and make you get your own medical insurance, even though it gives medical insurance to other workers. An employer has an incentive to classify employees as an independent contractors because it will save money by not paying health insurance premiums for you, as it does for workers that it favors.

If you lose your job, and you had employer sponsored health insurance with an employer that has 20 or more than employees, you may be entitled to continue coverage under the employer’s health plan for 18 months, under The Consolidated Omnibus Budget Reconciliation Act (COBRA). However, you will have to pay the full amount of the insurance premium yourself, plus up to a 2% administration fee. These COBRA premiums can often be high, especially if you work for a large employer which has expensive health coverage. You may do better getting your own insurance, especially with the advent of The Affordable Care Act, which may give reasonable options at reasonable expense.

Once having established a health plan, your employer cannot discriminate against you by firing you to prevent you from participating in the plan. For example, your health deteriorates, and you need a lot of medical care whose expenses are covered by your employer’s health plan. Your employer thinks his premiums will go up, and fires you. Your employer cannot fire you because he does not want his premiums to rise. This kind of conduct would also be a violation of disability discrimination laws, since your benefits are being taken away because of your disability. Nor can your employer retaliate against you because you complain that you are not getting health coverage to which you are entitled under the employer’s health plan.

Contact us online or call us at (212) 949-1001 so that we can review if your New York City employer has subjected you to discrimination in health insurance and medical benefits.