Employer can’t withhold health insurance

I started my first full-time job this March in California at a nonprofit. My contract states that I’m eligible for healthcare after one month in good standing. It is now August, and I’m sick. I requested information on my health insurance and was told that I was eligible but due to issues with my performance, they were “uncertain of my status.” This screams “illegal!!!” to me. Is it in fact illegal?

Worried Sick

Dear Worried Sick,

If you signed an employment contract, then you should pursue remedies under that contract.  For example, the contract might have required them to notify you within 30 days about your standing.  Common sense would suggest that certainly within six months, they would mention how you were doing especially if you weren’t doing well.  Nevertheless, an employment contract would spell that out.  They may have violated this contract, and you would need an attorney to pursue compensation for you.

If you did not sign an employment contract, then you are an employee at will.  You are entitled to rely upon what they told you about your health insurance.  Under the Affordable Care Act, they cannot have you work more than 90 days before you are eligible for the health plan.  If you are an employee at will, I would suggest that you contact California ‘s Department of Insurance consumer assistance for help.

In the meantime, get the medical care that you need and save all of the bills that you get.  I would think that you will be able to get them reimbursed by the company or by the plan, once they retroactively enroll you.  (Large companies and self-insured companies can generally retroactively enroll people when it is administrative error.)

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.