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CA SDI & Medical Insurance

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  • CA SDI & Medical Insurance

    I have been on CA SDI since August and will be for the next month. My employer has sent me a letter saying my health insurance will be terminated due to lack of hours worked and that I should contact the insurance company. One of my benefits is that my employer pay for half of the premium. Just because I'm on SDI can my employer refuse to pay their half and terminate my insurance?
    Last edited by Shercact; 10-24-2005, 12:44 PM. Reason: need to add state

  • #2
    You would need to provide more information.

    Are you on medical leave? Does the company continue to pay for the medical if you are on leave per the company's policy?

    You could possibly (depending on a variety of criteria including how many employees the company has, have you worked there for one year) qualify for the federal protections of FMLA and under this your employer would be required by law to keep your health benefits in place at the same amount that you would have been paying if you were working.

    Have you worked for the employer for 12 mos?
    Are there 50 employees within 75 miles of your location?

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    • #3
      I have worked there for 2 1/2 years and we have only 10 employees. I'm on state disability thru my doctors request. Plus we have no employee policy manual
      Last edited by Shercact; 10-24-2005, 01:46 PM.

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      • #4
        If there are only 10 employees FMLA does not apply.

        If FMLA does not apply, the employer is not under any obligation to continue your health insurance, regardless of whether you are still on the state disability plan or not.

        Since your employer has less than 20 employees, COBRA does not apply either. However, many states have continuation laws similar to COBRA. I don't know off hand about CA, but I suggest you contact the state DOL to see if your employer has any obligation to allow you to continue the insurance at your own expense.
        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
          If your employer provides group health coverage, they must offer CalCOBRA which essentially offers you the same continuation rights as COBRA. This affects employers who have 2 to 19 employees. (And actually all employers have to comply with SeniorCOBRA for employees over 60).

          Contact your employer and ask him/her to give you your CalCOBRA papers so that you may see how much it is to continue your health insurance through the group plan.

          I have in my records that the employer can charge you 110 percent of the actual coverage cost.

          You can call the California Department of Insurance (800-927-4357 / http://www.insurance.ca.gov/) if you have any problems.

          Comment

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