medical insurance/employer discrimination

[erk1210]

What is the name of your state? Georgia

I have worked for the same company full time, full benefits and salaried for the past 8 years. My attendance was great and all of my reviews were great. I had a child 2 years ago and without any help to care for her when she is sick, I have to miss work. I was out 3 days in a row the week before last (notified my boss each day) and when I came back to work, they informed me that they were going to cut my hours to part time (20 hrs) and take away all of my benefits at the end of Feb, including the medical coverage I carry for myself, my child and my husband. Their reason was that my dept was slow and not profitable enough to keep me full time with benefits. I asked for part time (30 hrs) and benefits (they have done this for other part time employees) and they said no. I was told upon inquiring this that our group policy was going up in price considerably soon. Right before and during all of this, they hired 8 new laborers in my department. I am administrative. I believe they are trying to make me quit because I missed work to care for my child.

I also have narcolepsy and hypothyroidism and am being treated by my PCP. My husband sees a psychiatrist and a counselor (also covered under medical ins) and is being treated for possible bipolar disorder (not diagnosed yet). Not even to mention the medical needs of a 2 year old. Could the usage of my medical insurance cause the group policy to go up in price and can they cut my medical for this reason? A few years ago, there was a case involving the dismissal of a long term, full time, hourly employee that was diagnosed with cancer being dismissed. Would my familys' medical care be comparable to that of a cancer patient that also had to go out on employer provided short term disability?

Other than all of the above, there are other reasons I am seeking advice. I have 2 separate issues other than thinking there could be a discrimination issue because I am a mother and had to care for a sick child also because there is a ratio of 5 women to 10 men working in the office, all salaried employees covered under the same employee handbook and the men do not have to make up their hours if they miss time for anything. The women are required to make up lost hours. (Which I have a log book showing my time out and in representing made up time.) They don't have to adhere to dress code, we do. Is this discrimination?

And regarding COBRA, how long do I have before having to sign up for it? My insurance ends Feb 29, when would I have to enroll in COBRA to continue coverage until I get new employment. What if I can't find employment with benefits and COBRA runs out?? Would I have problems getting coverage for my family? My husband inquired at his work and even though he makes good money, the benefits for us would be roughy $600 per month. I was paying $89.00 twice per month and it included my addt'l life insurance (co. supplied the first $20,000 but the extra was deducted from check beginning in increments of $25,0000), my 401K, dental, etc. Would I still be able to pay the premiums on the addt'l life that I had been paying for out of my check?

As you can probably tell, this situation caught me entirely by surprise and I am not informed and I need to know what my rights are and what I may be able to do legally, if anything.

Thank you.

When I get new employment, would I have problems with underwriting due to my medical problems and my husbands or would it just be accepted because it is a group policy? Would my condition and my husbands be considered pre-existing?

I was also recently declined for life insurance. They used a swab test for HUV by a porta-med nurse at my house. I rec'd the letter saying I could have the info for my denial released to my PCP and he can tell me what the reasons were. I do not use drugs at all.

Tell me about the MIB.....I requested my info from them and it takes 60 days, but it tells who inquired, codes, etc. I don't know why I would have a file at the MIB. Would that cause a denial in medical coverage and life insurance coverage? Could it be from having to take Adderall for narcolepsy? I was completely honest regarding all doctors, treatments, etc, and they said it was OK that I had narcolepsy and knew what medication I took.

I know this is a lot of info and questions, I did not know where to post it all or how to break it down. Thank you.

Is there anything I can do?

 

[I AM ALWAYS LIABLE]

My response:

If your post has to be that long, then you need more than a "forum" to discuss your legal problems - - you need to discuss all of this, and the rest of your facts, with a local Employment Attorney.

Good luck.

IAAL

 

[erk1210]

Sorry. I haven't ever had to look for this type of advice.

For the time that it took for me to post all of that and for your instant reply of nothing but look elsewhere, I am discouraged.

Would it be asking too much for you to take any portion of my post and advise me accordingly? Or tell me where I can go to get this issue addressed - instead of a "local employment attorney".

 

[cbg]

"Could the usage of my medical insurance cause the group policy to go up in price"

Yes. I t can cause the price of your group policy to go up substantially, in fact.

"and can they cut my medical for this reason?"

No, they can't. But the burden of proof is on you to show that this is the reason, and not the reason that they gave you, which IS a legal reason to cut your benefits.

As far as COBRA goes, they have either 14 or 44 days from the last day of coverage (which may or may not be the last day of employment) to give you the information about your COBRA rights. Whether it is 14 or 44 depends upon whether they self-administer their COBRA or use a third party administrator, which obviously I don't know (and unless you work in HR, most likely you don't know either). You have 60 days from the date of the notice or the last day of coverage, whichever is later, to elect the coverage, and 45 days from the day you elect the coverage to send them the first payment.

However, they may (and most likely will) cancel your coverage on the last day of employment (or the last day of the month in which employment ended, whichever your policy states) and leave it cancelled until they actually have your check in their hand. At that time, they MUST reinstate your coverage retroactively to the day of cancellation so that there is no gap in coverage; however, it will be YOUR responsibility to contact any health providers who may have submitted bills for payment, and tell them that the coverage has been reinstated and they may resubmit. It is NOT the responsibility of either your employer or the insurance carrier to do that.

Georgia does not protect marital or family status and neither does Federal law, so even if you are correct and you were selected for the hours cut because of your children, that is not illegal. If you feel there is a gender discrimination issue, you are free to contact the EEOC.

A group policy cannot turn you down for health coverage regardless of your medical information. However, IF there is a gap in coverage, they MAY (I do not say WILL because all carriers do not) enforce a pre-existing condition clause for up to one year. If you have had creditable coverage as defined in the HIPAA statute for 12 months or more, with NO gap of 63 days or longer, they cannot impose a pre-ex clause.

That's as far as I'm prepared to go at this time.

 

[erk1210]

Thank you very much for your help. I have some idea of where I stand now.

 

[Bigfoot]

Regarding the MIB: When you applied for life insurance, your medical files were reviewed by the Medical Insurance Bureau. This info is what helped the underwriters in deciding to deny you life insurance coverage. Your narcolepsy condition would be of serious concern, because it means that you could easily fall asleep during any time and put your life (and others lives) in danger.

Your issue with regards to women making up time and male employees not having to make up time should be reviewed by your local labor board for possible discrimination-if you can prove it.

 

[erk1210]

Regarding the MIB: When you applied for life insurance, your medical files were reviewed by the Medical Insurance Bureau.


I realize the above. I wonder why I have MIB files when not everyone does have a file. I have requested my file, $9 and it takes 60 days to receive. When I applied for the life insurance, right up front I told her about narcolepsy. She checked with underwriting and said if I hadn't had an accident and I was medicated that I would be fine. While another company previously told me that I had to be problem-free for 2 years to be covered with narco. So maybe the agent this time gets commission on applications and didn't care and my denial was in fact from having narcolepsy.

By requesting my file, it will also show all inquiries.

Thanks for your reply.