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What constitutes benefits eligibility in MA?

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  • What constitutes benefits eligibility in MA?

    My son's roommate has just enrolled in college part time. He has negotiated with his employer of 2 years to work 4 days - keeping Tuesdays available for classes. He was informed that going down to 4 days (32 hours) would make him ineligible to continue medical insurance benefits. I had thought (and I am probably mistaken) that 30 hours was considered a minimum amount to be included in medical insurance? He is an hourly paid employee and often works overtime which would bring him over 32 hours many weeks. The company is national and has offices in many states, but is headquartered in MA. Please advise. We have researched medical insurance through his college and it is very expensive. Thank you for your attention.

  • #2
    An employee is eligible for benefits at the time that the group insurance policy says they are eligible. At the present time there is no law in MA (or any other state except possibly Hawaii) that dictates that an employee automatically becomes eligible for benefits at any particular point. One employer may grant benefits to employees who work 24 hours a week; another might require that you work 40 hours a week to be granted benefits, and both are legal. It depends entirely on what the employer and the insurance carrier have established as the benefits-eligibility point for that employer.
    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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    • #3
      There are a few bills pending in the State House dealing with health insurance, some of which, if passed, will require employers to provide health insurance. Althought there are many different versions in the House, Senate and from the Governor's office, there is a lot of activity on the bills. So this all might change in the next year or two.

      Call your legislator if you want input.
      This post is by Philip Gordon, a Massachusetts employment attorney (www.gordonllp.com).

      This post is NOT legal advice. It is for general/educational information purposes only. You should not rely on this post if you are making decisions, and it does not create an attorney-client relationship. This post may be considered "advertising" under the MA professional rules for attorneys.

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      • #4
        I considered including that info, Phil, but decided against it since at the present time it's unclear what the eligibility requirements will be.
        The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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        • #5
          It's certainly an interesting time to be in the HR/benefits business around here.

          Would love to hear your insights and thoughts some time.
          This post is by Philip Gordon, a Massachusetts employment attorney (www.gordonllp.com).

          This post is NOT legal advice. It is for general/educational information purposes only. You should not rely on this post if you are making decisions, and it does not create an attorney-client relationship. This post may be considered "advertising" under the MA professional rules for attorneys.

          Comment


          • #6
            I'll catch up to you on a day when I don't have to be at a client site.
            The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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