Lost my health insurance - Affordable Care Act Question

[MSerforfun]

California

Hello. I work for a large retailer as a pharmacist. I have been with them for a little over a year. They told me that I need to work 1,560 hours (or 30 hours a week) during the measurement period to be eligible for benefits but I ended up short 27 hours and ended up with 1,533 hours. They sent me a letter notifying me that I am no longer eligible for health benefits alongside other benefits that they offer to pharmacists considered to be full time such as vacation, etc. I estimate the amount of benefits lost to be about $40,000.

I work different amount of hours every week and have been constantly asking them if I am in compliance with the 30 hours per week requirement. The answer was "Yes, you are in compliance" in some instances and in other instances, they referred me back to my district manager whom I contacted and was unable to tell me if I complied with the 30 hour requirement. I have that documented in writing.

On the flip side, my paychecks showed the total hours worked on a bi-weekly basis but there were hours that were not counted (i.e. meals premiums erroneously paid) and in addition, the checks being on bi-weekly basis, did not show the hours worked on daily basis. Therefore, there were days in the very first biweekly payment and the last biweekly payment that did fall within the measurement period.

Based on the fact that I consistently requested information about average hours worked and based on the fact that I received misstated information stating that I have complied with the 30 hours rule or in other instances was referred to others who didn't have the answer, what legal recourse do I have against this employer for cutting my benefits off?

Your help is greatly appreciated!

 

[cbg]

If they had told you that you were not working enough hours to qualify, what would you have done differently?

That's a real question.

 

[MSerforfun]

If they had told you that you were not working enough hours to qualify, what would you have done differently?

That's a real question.

Well actually, to top this off, I attempted to claim additional vacation hours as a retro pay for vacation that I have taken but did not claim during the measurement period because I thought I was way over the requirement. That request was denied for some reason.

In addition, had I known, I would also have worked additional hours to satisfy the requirement. I worked almost 200 days during that year, trust me, for three more days, I would have done it anyway.

Please help me, the insurance is a must for me and my three kids. I know I can buy it but that will put a massive strain on my financial situation.

 

[ShyCat]

I don't understand why you were unable to track your own hours worked to ensure you averaged the necessary amount.

 

[cbg]

Do you have control of how many hours you work?

Also ShyCat's question is important.

 

[MSerforfun]

I don't understand why you were unable to track your own hours worked to ensure you averaged the necessary amount.

Do you have control of how many hours you work?

Also ShyCat's question is important.

As a pharmacist your are scheduled to work specific days a week. The hours are logged in once you scan your card in and scan out. Sometimes I worked 10 hours a day and others, I worked 10 hours and five minutes, just depends on how my prescriptions I have to fill in. The scheduled hours though is typically 10 hours, so if you go over or under by ten minutes, no one will say anything.

I also work beyond my scheduled hours to cover other pharmacists that call in sick or are on vacation. There is a scheduler who sends me requests to see if I am available. I can say yes and I can say no, just depends on my daycare availability.

I am after all a new employee. I just didn't know I am supposed to keep track separately of the hours, minutes, seconds of my hours worked. Once you scan your card in and scan your card out, that's it, it goes into the payroll system and you won't see it until it shows up on the payroll system which shows biweekly hours worked in the aggregate. In addition, there are hours on the pay check that counted such as vacation/sick leave and holiday pay. There were hours that didn't count such as meals premium. It was a very confusing process. I guess my question is why can't the employer tell their employees that they are falling short of the 30 hour requirement especially that we are consistently asking for it?

Also that fact that I inquired about my average hours and was told that I satisfied the average hour requirement by this employer, isn't that a good ground for me to sue them for making that error and thereby causing me to lose my benefits?

Edit: I wanted to add that I do have lots of vacation that I can use to cough up for the deficit that I never claimed. There were days that I was scheduled to work but I didn't claim as vacation because I was under the impression that I met the requirement. Can i compel the employer to retro my pay for the unclaimed vacation and redo the calculation for benefit eligibility?

 

[cbg]

The only reason it's any kind of a case at all is that you asked them, but no, it's not a good case. It's a weak case at best. You are expected to take a certain amount of responsibility for knowing what your status. It is, after all, an individual mandate that you have health insurance. You don't get to just push the entire responsibility onto someone else and then sue them because you don't get the answer you want. Whose choice was it not to claim his vacation time that might have made a difference? It wasn't the employer's.

By your own words you did not get a response from the DM when you were referred there. That's not going to help any lawsuit you may bring.

Can you ASK them to recalculate based on the vacation you never claimed? Yes, you can.

Can you COMPEL them to? No, you can't.

I suppose it's possible that if you pay a lawyer to write them a nasty letter something might happen, but you're not in as strong a position as you think you are.