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Health Insurance Law

Health Insurance Law

Most employers are not required by law to offer health-related benefits to their employees, although the practice of providing health-related benefits is fairly common in many companies and businesses. It is viewed as a way to recruit and retain top talent, while also reducing absenteeism. However, once an employer offers or provides health benefits — including medical, disability, dental, and life insurance — federal anti-discrimination laws and health plan enforcement regulations act to protect an employee’s rights under those health plans. Since even employers with the best intentions may get tripped up by these laws, it’s important to do your research or consult with a lawyer before offering such benefits.

This article provides a general overview for employers who offer (or are considering offering) health insurance benefits to their employees.

Anti-Discrimination in Employment Health Benefits

As mentioned above, most employers are not required to provide their employees with medical, disability, dental, or life insurance. But once such benefits are offered, the law requires that the employer adhere to federal laws prohibiting discrimination in employment. As with other areas of employment such as hiring, promotion, and termination, distinctions in health benefits coverage cannot be made on the basis of an employee or dependent’s gender, race, age, national origin, religion, or disability. Many states and local municipalties also prohibit discrimination on the basis of sexual orientation or gender identity. As examples, an employer providing employees with health insurance may not, among other things:

  • Provide lesser coverage or cease offering coverage to older workers, or workers who may become pregnant
  • Treat pregnancy-related disabilities (including miscarriage, abortion, and post-childbirth recovery) different from other health conditions
  • Refuse to provide coverage based on an employee or dependent’s actual disability, a perceived disability, or his or her genetic information

COBRA Insurance Rights After Leaving a Job

Under federal law, employers are required to offer continuation of employer-sponsored health care plans for employees who are laid off or even fired for cause (unless it is considered “gross misconduct”). Employers do not have to subsidize the cost, however, so the premiums typically rise during this period of coverage. Under the provisions of the Consolidated Omnibus Budget Reconciliation Act (COBRA), employees may remain on the employer’s health care plan for up to 18 months (36 months for dependants). The law generally applies to employers with 20 or more employees.

ERISA and Enforcement of Health Insurance Rights

Once an employer decides to offer health-related benefits, its plan must be run in accordance with certain standards designed to protect the interests of employees and other plan beneficiaries (such as family members) under a federal law known as the Employee Retirement Income Security Act (ERISA). Under ERISA, employers are required to take certain steps in connection with employee health benefit plans, including:

  • Notifying employees (called “plan participants”) of plan eligibility standards, claim procedures, participant rights, and related changes to the plan; and
  • Managing and investing plan funds according to the best interests of plan participants.

Free Consultation with an Employer Lawyer

If you are here, you probably have a business law issue you need help with, call Ascent Law for your free business law consultation (801) 676-5506. We want to help you.

Michael R. Anderson, JD

Ascent Law LLC
8833 S. Redwood Road, Suite C
West Jordan, Utah
84088 United States

Telephone: (801) 676-5506

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About the Author

People who want a lot of Bull go to a Butcher. People who want results navigating a complex legal field go to a Lawyer that they can trust. That’s where I come in. I am Michael Anderson, an Attorney in the Salt Lake area focusing on the needs of the Average Joe wanting a better life for him and his family. I’m the Lawyer you can trust. I grew up in Utah and love it here. I am a Father to three, a Husband to one, and an Entrepreneur. I understand the feelings of joy each of those roles bring, and I understand the feeling of disappointment, fear, and regret when things go wrong. I attended the University of Utah where I received a B.A. degree in 2010 and a J.D. in 2014. I have focused my practice in Wills, Trusts, Real Estate, and Business Law. I love the thrill of helping clients secure their future, leaving a real legacy to their children. Unfortunately when problems arise with families. I also practice Family Law, with a focus on keeping relationships between the soon to be Ex’s civil for the benefit of their children and allowing both to walk away quickly with their heads held high. Before you worry too much about losing everything that you have worked for, before you permit yourself to be bullied by your soon to be ex, before you shed one more tear in silence, call me. I’m the Lawyer you can trust.