kanyeba
12-29-2008, 09:51 AM
My employer offers paid maternity leave. However, I am on unpaid maternity leave because they said I do not qualify. I believe I am entitled to paid maternity leave with my employer, for the following reasons:
1. I have been a full time employee for over 2 years.
2. When I began employment I declined health benefit coverage because I was still under my mother’s AETNA plan from her employer
3. After my 21st birthday in June 2008 I moved from my mother’s AETNA coverage to our corporate AETNA health benefit plan.
4. When I met with my HR and Benefit advisor to enroll, I was told that my pregnancy and paid maternity leave would be covered no matter when I joined the benefit plan.
5. I had my baby in November 2008 and am on unpaid maternity leave because I was not enrolled in the benefit plan long enough to qualify for paid maternity leave which I believe is part of a disability set-up.
Do I have a case to appeal the corporation's decision to not provide paid maternity?
To the best of my knowledge, DC is not one of the very few jurisdictions where paid maternity leave is required by law. (Someone is free to correct me if I am wrong; Betty? Elle?) Therefore, it is entirely up to your employer's policy whether you qualify or not. Since we have not read your employer's policy we have no way of knowing if you should have qualified or not.
ElleMD
12-29-2008, 12:31 PM
No paid maternity leave is not required in DC at this time. If I understand correctly you were already pregnant when you joined the plan with your employer. If that is the case, I know of no plan that would cover your time off. It is simply unheard of for any plan to cover a pre-existing pregnancy immediately. Now if you had developed some sort of condition after signing up for the plan, that would be different, but no plan is going to cover a pregnancy that was already underway. In fact, most every plan I've ever seen has a 12 month exclusionary clause for pregnancy, lest someone sign up while attempting to get pregnant and then use the policy before a year is up.
kanyeba
12-29-2008, 01:04 PM
Thanks for such quick replies. I'm new to this forum but find it very helpful on helping me determine if I should appeal the corporations decision. The company is (deleted). The insurance picked up all the cost of the pregnancy, no problem. However, for the paid maternity benefit, I believe the issue is not with (the carrier) but rather with whoever handles the disability insurance for the corporation. Would love any further thoughts on this. Thanks !
Rangeman
12-29-2008, 01:19 PM
Your medical insurance coverage continued without lapse due to the portability clause in HIPAA.
Again any STD policy would not cover a pre-existing condition no matter what the condition.
That said STD policies are usually stand alone policies and you probably had the option to pick it up prior to being covered on their medical insurance plan. If you had then you probably would have been covered.
Your health insurance policy and any disability policy are two separate things with separate rules and separate eligibility requirements. Just because the health insurance policy (which is prohibited by law from excluding new employees or from considering pregnancy a pre-existing condition) covers the pregnancy does not mean that the disability policy (which is not prohibited by law from excluding pre-existing conditions or from establishing a waiting period) must do likewise. Even if they are with the same carrier, they are still two separate policies.
Betty3
12-29-2008, 05:35 PM
Agree with cbg & paid maternity leave is not required in DC.