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Health Insurance qulification, need advise

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  • Health Insurance qulification, need advise

    Hi,

    My husband works in a small, private own company in Southern California. He started working on 07/09/2007. The HR told him that his probation time is 90 business days, after that he will be qualify for Health Insurance.
    Around the middle of October, my husband started to get ill, so he needed to ask for unpaid sick leaves. Now we found out that his medical condition is pretty serious, he called his company and ask when he can join the company's health insurance, the manager told him that since he does not finish his 90 working days probation, they can not cover him...I also asked my employer if I can add my husband under my health care even now is not the open enrollment period, the HR told me that the only condition is my husband gets fired, and the previous health carrier provides a letter shows that his health insurance gets terminated, but his employer does not provide him any health coverage at this point....and judging from the current situation, most likely, my husband's employer is going to let him go...I wonder if someone can give me some advise:

    1. Is there any other way I can add my husband under my health care?

    2. I know different company has different policy, but should unpaid sick leave be counted/not counted as probation time? (I really don't know how to ask this question...)

    I am really confused and worried right now, please give me some advise of what I should do. Thank you very much.

  • #2
    1.) If your portion of the premium is taken out pre-tax or if there is a pre-tax option, it would be a violation of the law for the employer to add your husband to the policy outside of a qualifying event or open enrollment. (A qualifying event would have been when he initially lost his former health insurance; otherwise it is something like a marriage, birth, death or divorce. Depending on exactly how the plan is worded there are one or two other possibilities, but having been diagnosed with a serious illness is not one. Under the law any enrollment changes must be made within 30 days of a qualifying event.) If your portion of the premium is taken out post tax and there is no pre tax option, it would not violate the law for your employer to allow him to be added now, but they cannot be compelled to allow it outside of open enrollment either. Nothing in the law is going to force them to add him outside of open enrollment.

    2.) This is not a matter determined by law, but by company policy. (It's also possible, for purposes of benefits, that the insurance policy may specify one way or the other.) However, few employers are going to count an extended absence against a probationary period since doing so defeats the entire purpose of having a probationary period at all.

    I hope your husband recovers. I know these are not the answers you want to hear. Good luck to you.
    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
      I'm sorry, but I must be missing something. Has he been fired? Are you sure the waiting period for benefits is 90 working days, not 90 calendar days? I've been around not a few years in this business, and I've never seen a waiting period for benefits expressed in working days.
      I don't respond to Private Messages unless the moderator specifically refers you to me for that purpose. Thank you.

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      • #4
        To pattmd:
        Heres how it works here, it may be the same for the posters husband.
        The probation period is 90 calendar days. However, if someone is out, the days out extend the probation period. So, if your 90 days ends on Nov 23 and you've missed 5 days, the probation period is extended by those 5 days.
        I find that the harder I work, the more luck I seem to have.
        Thomas Jefferson

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        • #5
          Ah, could be that is the case here, too, I've just never heard of that. I'm still not clear on whether the OP's husband has been fired, though, are you?
          I don't respond to Private Messages unless the moderator specifically refers you to me for that purpose. Thank you.

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          • #6
            Thank you all so much for reading my post.

            To Pattymd:
            I am sure the waiting period for my husband's employer is 90 working days, and he has not been fired...

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            • #7
              So, there's just a delay then in his waiting period. I understand; I didn't get that from your original post.
              I don't respond to Private Messages unless the moderator specifically refers you to me for that purpose. Thank you.

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