What Are Employee Health Insurance Laws?


Health insurance is one of the most expensive benefits offered by many employers. If you're an employee, there are certain procedures your employer must follow so you have the benefit of signing up for their group health insurance. The purpose of health insurance laws is to make certain that all employees receive fair treatment and an opportunity to participate in the company's plan. Most companies that offer insurance do it to help employees and keep a good workforce.


If your employer cuts back on your benefits because you’re older or there's a chance you'll cost him more money due to a disability, that's discrimination and against federal law. Your employer must treat all employees equally when it comes to group health insurance. If your benefits are cut, but so is everyone else's, there's no discrimination.

Pre-existing Conditions

HIPAA, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), guarantees that if you maintain health coverage between group insurance plans, you aren't subject to the pre-existing conditions clause of the policy. If your coverage lapses for less than 63 days, the law states it's continuous. The longest you must wait for coverage of pre-existing conditions is 12 months, but some state laws make the wait shorter.


Not all states require that your employer pay part of the insurance premium, but some of them do. Generally, insurance companies require employers to pay a portion, particularly if it's the state law. If you suspect your employer isn't paying his share, ask how much of the total premium you will pay if you leave the company and sign up for COBRA coverage. If you pay the same amount as the COBRA premium, it’s an indication that your employer isn't contributing.


You must receive notices about the company health insurance plan; the time to sign up and changes in the plan. If you're new to the job, the information should be in a new employee packet or on the company's human resources website.


COBRA, the Consolidated Omnibus Budget Reconciliation Act of 1985, guarantees your right to continue your group health insurance for 18 months, or longer in special circumstances, after you terminate employment. You aren't required to carry it, but the employer must make it available. This includes sending you notice about the plan continuation.

No Plan

Some state laws require that employers with 11 or more employees offer health insurance. Check with your state insurance department to see if that's the law in your state. If a group policy isn't offered in these states, the employer is subject to a fine and is required to implement a plan.

No Maternity?

The required inclusion of maternity coverage varies from state to state. Some states only require the employer add maternity coverage if they have a specific number of employees, such as 10. Check your state's insurance law to see what's required.

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