One of the most important things to consider when you or a loved one suddenly becomes disabled or seriously ill is how you pay for medical treatment when you or a loved cannot continue working.
Here are some strategies and answers to this question:
II. CAN MY EMPLOYER (BOSS) NOT PROVIDE ME WITH MEDICAL INSURANCE IF I AM OUT ON DISABILITY?
Unfortunately, there is good news and bad news. The good news is that under the Family & Medical Leave Act (FMLA), your employer (boss) must continue to provide you with health insurance benefits while you are out on FMLA leave. But if you pay for a portion of the health insurance while working, then you are still responsible for paying that amount while you are out on FMLA leave. This benefit will only last for 12 weeks then your employer can discontinue providing the benefits. Be advised that only certain employers are required to comply with FMLA, so before you take any action you need to make sure that the FMLA protects you.
Under the Americans with Disabilities Act as Amended (ADAAA), your employer is only required to continue to provide you with health insurance benefits if your employer does that for employees who are not disabled. Otherwise, generally your employer has no legal responsibility to continue providing you with the benefits.
III. HOW CAN I MAINTAIN MY COMPANY HEALTH BENEFITS IF I AM UNABLE TO WORK BECAUSE OF A DISABILITY OR ILLNESS?
If you are not protected by the FMLA or ADAAA, there are only a few ways to maintain your health insurance benefits at work. The strategies are as follows:
1) COBRA Health Insurance Coverage. You can continue your health insurance benefits while on disability through the Consolidated Omnibus Budget Reconciliation Act (COBRA). The law gives certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain specific events. Unfortunately, nearly every employer (boss) requires you to pay the entire premium for COBRA and COBRA coverage is usually more expensive than the current rate the active employees pay.
2) Form a Union at Work. It is possible for a Union to secure protections for your health insurance if you are unable to continue working. A Union has the ability to get your employer to contractually agree to provide you with health insurance for a period of time while you are out on disability.
3) Cobra Plus Disability Insurance. It would be wise to pay for disability insurance so that you can afford COBRA coverage while you are out on disability leave. As of February 2014, the NYS short term disability coverage that employer’s must provide only provides a maximum weekly gross benefit of $170.00 per week, and this benefit is taxed. So you can see that relying on the NYS disability insurance is a poor strategy. After 26 weeks of short term disability, you may qualify for Medicaid under Social Security, but generally, you must be suffering from a total disability. So if you don’t qualify you may be out of luck until you find a new job that provides benefits.
The real way to ensure that you are properly protected if you are unable to continue working is to plan in advance. The real answer is to purchase supplementary disability insurance so that you have a safe source of income in the event tragedy strikes. Unfortunately, many of us are unable to afford to pay for additional insurance on top of all of the other bills every month. Forming a union is one of the best strategies so that you and your coworkers can bargain with your employer to have him/her pay for the insurance.
Just remember the consequences are severe if you cannot secure medical insurance through your employer. NY state disability is extremely inadequate (Currently $170.00 per week maximum, which is before tax money!). So check your budget and see if you can afford a simple short term and long term disability insurance policy. If you can’t, contact El-Hag & Associates, P.C today if you and your coworkers are interested in forming a union to better secure your family!
To learn more about your rights under the wage and overtime laws, disability law, or family & medical leave law, visit:
El-Hag & Associates, P.C
777 Westchester Ave, Suite 101, White Plains, New York, 10604
• Http://www.Elhaglaw.com • [email protected] • (914) 218-6190 (office) • (914) 206 -4176 (fax)
** Disclaimer- This blog post is applicable to employees working in NY State. Some of the information is applicable outside of NY State, but you should check the laws of the state in which you work. Additionally, this information is not intended as legal advice. If you have legal questions CALL OUR OFFICE. We do not want you to take any action relying on this information without being fully informed. You need to make sure that your circumstances protect you under the law before you act.