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employer says he has to take my health benefits

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bugman85

Junior Member
What is the name of your state (only U.S. law)? Pennsylvania

I recently decided to go back to school taking evening classes three nights a week. Classes start at 5pm and go until late in the evening. My job is day shift but the hours vary, meaning I might start at 430am and work my day from there or start at 8am and go from there. I asked to be done by 4pm so I can make it to class those three nights a week. Luckily my employer has been very accommodating for me which I really appreciate. However, here comes the issue. I am still available to work 40, 50, hours a week. Even though I don't think I worked over 45 in the last 2 years. My employer tells me that his full time policy is considered being available 4 days a week for 10 hours and 1 day for 8 hours. He doesn't say what hours of the day they must be(5am to 3pm or 10pm to 8pm). He says that since I can't offer him that and his other employees can that he legally has to take my benefits or he has to start offering them to part time people and his summer help. I can offer him that just not after 4pm 3 days a week. Now because of the nature of the business, work isn't always going to start at 430am. Some days can even start at 10. Now there are office people who work strict set schedules. I don't think he has a separate policy for these employees but he is always referring to, "my guys guarantee me 4 10 hour days and 1 8 hour day." All the office people are women so I take it he is talking about the technicians because they are all men.

I am trying to make sense of all this and just trying to understand. I am not complaining. He just keeps throwing out there that he needs to talk to his attorney and I am feeling maybe I should too just to make sure. This has been going on for a few months now. My guess he has already extensively researched this issue and wants me to voluntarily just give up my benefits.

Just a note, I am pretty sure I understand that there is no law dictating what is considered full time or part time and is up to the employer.
 


cbg

I'm a Northern Girl
There is no law in PA (or in most other states) determining what is full and what is part time; it is up to the employer.

That said, who is and is not eligible for health insurance benefits is determined by the health insurance plan document. Your employer is required by law to give you access to this. If you are eligible for benefits based on the plan document, then the employer must allow you to keep them. If you are not eligible for benefits based on the plan document, then your employer is right and he must remove them. He is required by a very big, very bulky Federal law called ERISA, to follow what is in the plan document.
 

Beth3

Senior Member
Yes, you definitely should.

I've never seen a group health Plan Document that describes who is eligible for participation based on their availability to work. Rather it is always stated in actual hours worked. For example, "Eligible employees are those who regularly work 40 hours per week" - not "Eligible employees are those who are available to work four 10 hour days." That would be highly unusual.
 
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bugman85

Junior Member
Thank you Beth.

I always knew the possibility that they might let me go or cut my hours and lose benefits. We talked about me just going part time. I was almost agreeable to that until I asked him what kind of hours he was looking to make me work. He said that if he can work me 50, 60, 70 hours that is what he will do (I have continued to work 40 hours a week since). That is when I reversed course and decided that I don't want to be part time and rather keep my benefits so let's keep doing what we are doing. A few weeks later he came to me with this 4 10 hour 1 8 hour day business. If it was okay three months ago, why is it a problem now? If I could find another job with benefits that is willing to accomodate school, I think I'd be working somewhere else. I do however like the job and my coworkers so I been trying hard to work with the employer. The pay is lousy so that is why I decided to go back to school. Even before I decided on school. At the end of 2010 after my review, which was very good and was very pleased with my sales percentage and work history. I asked him if there was anything I could do to earn some extra money. He gave me a short answer saying no I can't help you and it isn't in the budget. I talked it over with my fiancée and since I still haven't used my VA benefits for education, we both figured it was the best option.
 

Beth3

Senior Member
If it was okay three months ago, why is it a problem now?

I can only assume he's playing games with you for some reason.

Get your hands on a copy of the group health Plan Document or Insurance Certificate and look carefully to see how it defines eligible employees. If your employer does anything to violate the Plan Document (i.e. disqualifies you for participation even though you meet the criteria in the Document), you may file a complaint with the federal Department of Labor who has jurisdiction over qualifyed employer benefit plans (e.g. health insurance and retirement plans.)
 

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