Workers comp And Loss Of Personal Health Insurance?

Question

HI'

Has anyone had this issue before?

My husband has been employed through the union for near 13 years He was injured on the job and has since had surgery and is now in the process of going through Physical therapy.

He has really good health insurance for himself and our children however the way his insurance works is determined by the hours he has accumulated . They basically say ok you have x amount of hours so we will continue to insure your family until this certain date after which time you will be offered the option of paying your deductable, if he chooses not to pay it then he looses the insurance "$675.. Per Month"Of course we can not pay it!

Anyhow I was wondering if anyone else has had this issue before.He continues to pay his union dues and they are not doing anything for him and have not offered either since this all began.We have a lawyer but to be honest I'm concerned about him. Should the union be doing something?

Should the employer cover our health ins cost?

Answer 1

The union contract probably rules everything here.  If the union contract does not provide for maintaining the insurance during a temporary disability, if the contract says you have to pay, you have to pay.  Make sure you gave a copy of the contract to your attorney for his review, and ask him what alternatives there are to get this paid.

$675/month is very cheap for health ins, especially if it covers the family.  Private insurance for a single person is easily double that per month.  If your husband cannot work, you really have to, and you might need to take a second job for a while to help pay the bills.  Nasty situation, but you do need to hang onto that insurance unless a better health insurance deal for your family is available through your job.

Answer 2

Yes, it's pretty much standard that once you're not employed (ie, working enough hours for insurance coverage, or even gone down to part time), you aren't eligible for health insurance throught he group plan.  

They are offering you cobra coverage - and that's a GREAT price, normally family plans cost about $1200 a month.   So, if you want health insurance, you can either take - and pay for - the cobra coverage, or maybe YOU can get a job for group benefits.  Belonging to the union is DIFFERENT from actively working - which he isn't.  

Unions perpetuate themselves.  Personally, I believe they've outlived their usefullness.  

Unless the union contract says, the employer is on the hook for all benefits even after he isn't working any more (highly unlikely), the employer isn't on the hook for it.  A lawyer isn't going to be able to help you with this, unless your union contract says something different.  The benefits are through the employer, not the union - and he's not working any more.

Answer 3

That is typical of most union benefit plans - if you don't work the hours, you have to pay the full insurance premium.  Whether the WC carrier will cover his personal health insurance premiums is a good question.

Answer 4

First off, if he was injured on the job he should be claiming workers' comp.  second of all if he was injured on the job he shouldn't be using his own insurance to fund his therapy.

His insurance shouldn't be in question, its the employer who should be paying if he was injured on the job...let me repeat myself again.  If he was injured on the job, it is up to his employer and their insurance to pay for his therapy and surgery.

**If he is on workers' comp and not working, he can not and should not be loosing his personal insurance.  He is off because of the injury that was caused by his employer.  He needs to go to the union, as well as get a lawyer if he hasn't already.  If you live in CA, I can give you an 800 number that can give you some Information and Assistance to this problem.

**You also need to call the personal insurance, and explain your situation, if the HR nor the union has done so thus far.

Answer 5

I don't know about the rest of this but check with the Department of Human Services.  I think most states have very highly discounted insurance available for the children in low income homes.  In Iowa, where I live, you pay no moe than $20 a month for your children to free depending on your income.  That hopefully will reduce your worries about the children.

Answer 6

Something doesn't sound right with that....

If the surgury was a result of his work related injury, then the insurance company should be covering all his expenses and what not.

If its determined that he is no longer treating for a work related injury (but may not return to work) then he should file for disability.

He should contact his union steward and ask for their advice.

Good luck!