Excluded from Health Benefits

[Dawnala]

What is the name of your state (only U.S. law)? FL

I currently reside in Florida. I am a remote, home-based employee for a company headquartered in Pennsylvania with business also conducted in Delaware. I have been employed with the organization for 2 years in November. I am the only employee not within commuting distance to DE or PA. Within the past week to 2 weeks the powers that be have decided to leave the PEO we worked with and bring most everything "in-house". That was not an issue until health benefits were discussed. They have chosen a BC/BS of DE plan that has no out-of-network benefits. I have sent emails asking if I should obtain my own insurance. I have also suggested they contribute the same amount they contribute to other employees' premiums to reimburse me for the health care coverage I purchase seperately. I have had only one response to those emails, which did not answer any of my questions nor give me any guidance as to what they would like for me to do; however, I am now receiving emails intimating that my remote position is posing problems for including me in day-to-day business. This has not been an issue previously. I have an impeccable record with consistently outstanding reviews (including a mid-year review with a raise), raises, and bonuses. Furthermore, I have made myself available via telephone, emails, conference calls, even flying to DE on the same day of notification. I feel as if my employer is forcing me to resign.

Questions:
1) Can my employer legally offer a company-wide benefit plan which excludes only me? 2) If so, are they legally required to provide equal premium contribution?
3) Should my employer terminate me, do I have any recourse?

Any advice is greatly appreciated!

 

[cbg]

1.) Yes. The only states where an employer is legally obligated to provide health insurance are Massachusetts and Hawaii. Additionally, contrary to what too many people believe, there is no law in any state other than the above two that says if insurance is offered to one employee it must be provided to all. It is legal to set up eligible classes of employees on any basis except for things like race, religion, gender etc. Geographic location is not a protected basis; therefore they may have an insurance plan that only covers certain regions of the country.

2.) No. At the present time, no law in any state requires that employees who do not take or who are not eligible for the insurance offered must be provided with any compensation towards premiums.

3.) Not on the basis of anything you have posted. If it's not working to have you work remotely any longer, they are not obligated to continue it.

 

[momm2500]

have you talked to the Blues or who told you that they do not cover out-of-network providers? have you received documentation regarding that? You should contact the blues and see if the plan allows benefits under the blue card program. that means you can go to any state and see any doctor that participates with the local blues plan. I would get all my basis covered before you make a rash decision and leave based on health care. I find it hard to believe that they have chosen BC/BS of DE when they have PA residents. Are you also stating that the PA residents have to use Delaware doctors? This does not sound right.

 

[cbg]

I don't find it difficult to believe at all.

First of all, it's by no means impossible that the BCBS/DE network includes PA providers. The BCBS/PA network includes Delaware and New Jersey providers.

Second, I don't know where in PA you are located, but I lived there for seven years, my parents still do, and going back and forth from Delaware to Pennsylvania is quite easy in that part of the state. In fact, if I go to visit my parents by train at Christmas because of the high cost of gas driving, I'll be getting off at the Wilmington DE station.

Finally, there are quite a few plans still in existance that do not provide out of network benefits.

By all means she can confirm the information if she wishes to but I do not find anything hard to believe in her explanation.