Health Insurance Problem

[cenzo]

What is the name of your state? MA

Company employee handbook states an employee must be employed 32 1/2 hours per week to be eligible for health insurance. An employee was injured at home and was out of work for two weeks under a doctor's care in early February.The hourly employee elected not to be paid for the two weeks. The employee normally works 40 hours per week and is a full time employee and has worked for the company for three years as a full time employee and has had no problem with his eligibility for health insurance.

When the employee attempted to get a prescription filled during his time of injury, the pharmacist stated he had no insurance. It appears the company revoked his insurance for that period since the employee did not work the minimum of 32 1/2 hours per week during the time he was out of work with the injury. Since the injury the employee hasn't taken any non paid vacation and has not missed any work due to illnes or injury and has consistently worked more than 32 1/2 hours per week since February. Should the company have averaged his working hours over a previous period of time to see if the employee was in fact working the minimum number of hours per week to remain eligible for health benefits ?

Can the company revoke insurance as they did in this case ?

Where can I get information as to laws governing rights of employees for health insurance ?
( The employee handbook is not much help.)

Thank you in advance for your comments.

 

[Beth3]

Most group health Plan Documents I've see also state that a temporary change in hours does not result in an eligible employee being ineligible for participation nor an ineligible employee becoming eligible for participation.

The employee in question needs to get his or her hands on a copy of the actual Plan Document and see how it defines eligibility. What the employee handbook says isn't terribly relevant.