Discovering that your employer holds insurance premiums from your paycheck without actually providing health insurance coverage can be frustrating and legally questionable. It’s essential to know your rights and the steps you can take to protect yourself.
Under the Affordable Care Act (ACA), employers with 50 or more full-time employees are required to provide access to affordable health insurance coverage. Failing to meet this obligation can lead to penalties for the employer and potential financial harm to employees.
If you’re unsure about your health plan status, start by checking your insurance card. Review the plan details, such as deductibles and in-network providers, to determine whether your insurance is active. If the information seems unclear or unavailable, it’s time to investigate further.
Employer Responsibilities and Penalties
Employers bear significant responsibilities when it comes to offering health insurance coverage. If they fail to meet these requirements, they face financial consequences:
Offering Minimum Essential Coverage: Employers must report the health plans offered to employees and ensure they meet ACA standards. Minimum essential coverage includes basic medical services that all full-time employees should receive.
Shared Responsibility Payment: Employers who do not provide affordable health insurance to full-time employees may owe an employer shared responsibility payment. This penalty is calculated monthly and depends on the number of employees or those receiving a premium tax credit.
Transparency and Reporting: Employers must issue notices to employees outlining their health insurance coverage options and report this information to the IRS. Failure to do so can result in fines and further legal repercussions.
If your employer’s actions violate these obligations, they may be held accountable for financial and legal damages.
Exploring Alternative Health Plan Options
If your employer does not resolve the issue, it’s critical to secure alternative health insurance to protect yourself. The Health Insurance Marketplace offers various health plans to meet individual needs:
Health Insurance Marketplace: Through the ACA’s marketplace, you can find affordable health plans that fit your budget. Many individuals qualify for subsidies or tax credits to help pay for premiums.
COBRA Coverage: If you recently left your job or lost employer-provided insurance, COBRA allows you to continue your previous health plan, though it often comes at a higher cost.
Private Insurance Plans: You can also explore private insurance providers to find suitable health plans tailored to your medical needs and budget.
Taking these steps ensures you remain covered, reducing the risk of unexpected medical expenses.
Taking Action and Seeking Support
If you suspect your employer holds premiums without providing health insurance, act quickly:
Contact Your Employer: Speak with your HR department or employer directly. Provide specific details about the missing coverage and request immediate resolution. Keep records of all communications for future reference.
File a Complaint with the Department of Labor: If your employer fails to address the issue, reach out to the U.S. Department of Labor’s Employee Benefits Security Administration. They can investigate your case and determine whether your employer violated federal laws.
Consult an Attorney: A personal injury or employment lawyer can offer guidance and, if necessary, file a lawsuit to recover damages. Many attorneys work on a contingency basis, so you may not have to pay upfront legal fees.
Explore Other Resources: Your state’s insurance department can provide additional support and information regarding your rights and options.
Conclusion
No employee should endure the financial and emotional strain of missing health insurance coverage due to an employer’s negligence. By understanding your rights and taking prompt action, you can resolve the issue and secure the health coverage you need.
At Bourassa Law Group, we are committed to protecting workers’ rights. If your employer is holding insurance premiums without providing coverage, contact us today. Let our experienced attorneys guide you through the process and help you seek the justice and compensation you deserve. Your well-being is our priority.
1-800-870-8910