Health Insurance Over View

by Lesley Politi on April 9, 2009

Most employers are not required by law to offer health-related benefits to their employees, although the practice of providing health-related benefits is fairly common in many companies and businesses. However, once an employer offers or provides health benefits — including medical, disability, dental, and life insurance — federal anti-discrimination laws and health plan enforcement regulations act to protect an employee’s rights under those health plans.


Anti-Discrimination in Employment Health Benefits


As mentioned above, most employers are not required to provide their employees with medical, disability, dental, or life insurance, but once such benefits are offered, the law requires that the employer adhere to federal laws prohibiting discrimination in employment. As with other areas of employment such as hiring, promotion, and termination, distinctions in health benefits coverage cannot be made on the basis of an employee or dependent’s gender, race, age, national origin, religion, or disability. As examples, an employer providing employees with health insurance may not, among other things:


* Provide lesser coverage or cease offering coverage to older workers, or workers who may become pregnant


* Treat pregnancy-related disabilities (including miscarriage, abortion, and post-childbirth recovery) different from other health conditions


* Refuse to provide coverage based on an employee or dependent’s actual disability, a perceived disability, or his or her genetic information


ERISA and Enforcement of Health Insurance Rights


Once an employer decides to offer health-related benefits, its plan must be run in accordance with certain standards designed to protect the interests of employees and other plan beneficiaries (such as family members) under a federal law known as the Employee Retirement Income Security Act (ERISA). Under ERISA, employers are required to take certain steps in connection with employee health benefit plans, including:


* Notifying employees (called “plan participants”) of plan eligibility standards, claim procedures, participant rights, and related changes to the plan; and


* Managing and investing plan funds according to the best interests of plan participants.


Legal Help for Employers: Health Benefits


Although most employers are not required by law to offer health-related benefits to their employees, when health benefits are provided an employer must comply with a number of federal anti-discrimination laws and health plan regulations.


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