My boyfriend works full-time for a non-profit in Jersey, and while other FT employees receive (intermittent) health insurance, they've managed to delay granting him coverage for almost 5 months. Is this legal? They claim it's one of his benefits, but keep "losing" his paperwork and never send it to Blue Cross. At one point they said his card was on the way from the insurance company, but further inquiries have been ignored.

People have suggested calling the DOL, but we want to know if this is an offense first. Can employers cover some full-time employees but not others? It's become apparent after so many months that this isn't a case of forgetfulness, or negligence: they are actively denying him a benefit he was promised when hired.

It depends.

It is a myth that if insurance is offered to one employee it must be offered to all. It is even a myth that if it is offered to one full time employee it must be offered to all. It is quite legal for an employer to establish classes of employees and only offer coverage to certain classes. Although a common class distinction is full time vs part time, it is not the only possibility. Even among full time employees, it would be legal to offer coverage to only certain departments; to office employees but not shop; to corporate employees but not field offices; to managers and above but not supervisors and below; only employees hired before a particular date; or any just about any other distinction that does not violate Title VII and related laws (race, religion, national origin, gender etc.)

However, once the eligible classes are established, every employee in an eligible class must be offered the insurance. There can legally be a waiting period but they cannot pick and choose among employees in an eligible class; the plan document will establish at what point eligible employees become eligible.

So if your boyfriend does not belong to an eligible class, then they are legal in not offering the insurance. If he is in an eligible class but has not yet fulfilled the plan-determined waiting period, they are legal. But if he is in an eligible class and has fulfilled the waiting period, then he might want to discuss his situation with the US DOL.

OK, that makes sense.

The company hasn't made any distinction between full-time employees that's known to us, but I'd imagine if they're standing by their claim that his health insurance has been "on the way" in some form or another for 5+ months, they are implicitly saying that he is eligible for health insurance.

Any clue how to reach the right people at the DOL? I spent some time on the website, but all the "file a complaint" forms seemed to be for people who were working in unsafe conditions, which is a little bit of an exaggeration in our case.

Also, what's the difference between reporting them to the state labor department vs the federal labor dept?

Thanks!

To answer the last question first, the answer is that the US DOL is the regulatory agency for ERISA (which this would fall under), not the state DOL.

I don't have a phone number or link but someone else may.

BTW, if he can get his hands on a copy of the SPD (Summary Plan Description) for the plan, which he should be able to get just by asking someone in HR, that will tell him straight out with no guessing or assuming involved, what are the eligible classes and what, if any, waiting period there is.

Thanks again for the info. The HR people probably won't be too helpful (they have been complicit in misplacing his paperwork more than once, and take a few weeks to respond to emails/calls. Unfortunately they're located at another location, not his office.) Anyway, I'll advise him to ask for the Summary Plan and see what he gets.

They told him he'd get insurance after a probationary period 90 days, and he completed that around Thanksgiving.

Sometimes I can't believe that they ask him to give up weekends to work with the kids, but they still stall on insuring him? So ridiculous, these people.

Anyway, I appreciate the info, again.

I don't have a phone number or link but someone else may.


The following is the right group of people but the page is more like their title page. This group of people also handles retirement plans and other things that you are not current interested in. Look around for anything talking about health plans, or just contact them.

http://www.dol.gov/ebsa/