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Understanding Job-Based Health Insurance Coverage
Many employers in Boston provide their employees with job-based health insurance coverage through a group plan. This job-based health insurance coverage is regulated by the federal government. Along with health insurance, employers often offer life insurance, individual health insurance and property & casualty insurance, these types of insurance are regulated by the state governments.
Job-based group health insurance means that everybody in the country who receives their health insurance through a job-based group plan has the same rights and protections. These protections are set by federal statutes.
In 1974, the Employee Retirement Income Security Act, or ERISA, was enacted. This set up the regulation of employee benefits including retirement plans, pensions and group health insurance. Because of this statute, all employees that are covered under a group plan have the right to disclose their health plan information. This includes providing employees with information on the plan rules, cost of the insurance and documents on the operation of the plan. This means that all employees of a business that offers job-based insurance have the right to learn about what they offer and have available.
In 1985, the Consolidate Omnibus Budget Reconciliation Act was enacted to enhance job-based coverage. This act, better known as COBRA, requires employers that have 20 or more employees offer the continuation of health insurance coverage to employees leaving the job-based group health plan. COBRA must also be offered to the dependants if the employee has them. The qualifying events that require COBRA to be offered include:
- Termination of employment, except in the case of gross misconduct
- Reduction in hours worked so that the person no longer qualifies for the plan
- Employee qualifies for Medicare
- Divorce or legal separation
- Dependent child losing eligibility
If the employee and their family loses their health insurance coverage due to termination, or the employee loses full-time status in hours or simply quits, the COBRA coverage is available to the person for up to 18 months. Employees who elect to maintain their health insurance coverage through COBRA are required to pay 102% of the premium paid by the employer to the insurance company to maintain their coverage. This causes health insurance to be about double the cost that it was for the employee while they were employed.
If you're employed in Boston and you're company offers health insurance, you have the right to know the ins and outs of that plan as it pertains to you the employee. If you lose your job in Boston and were covered by the job-base group health insurance plan, then you have the right to maintain your coverage for 18 months after you quit or are terminated. It may be more expensive, but it does ensure you are covered for a medical emergency.
