Determine What Employee Health Benefits You Are Entitled To
Are you a full-time employee, but not so sure what health insurance benefits you are entitled to? Healthcare is currently in a state of flux, and many things may change after almost immediately after this article is written. But here are some of things to consider in regards to
employee health insurance, and what you are entitled to.
Companies are not required by law to provide employee health benefits... yet. However, the Employee Retirement Income Security Act of 1974 (ERISA) does regulate the operation of your employee health benefits plan if your employer chooses to offer one.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits a company from refusing employee health insurance coverage due to an employee's pre-existing medical conditions in some circumstances. It also prohibits employee health benefits plans from certain types of discrimination on the basis of health status, genetic information, or disability.
What if You Lose Your Job?
COBRA, or the Consolidated Omnibus Budget Reconciliation Act of 1985, extends employee health benefits for people who leave their place of employment. COBRA is an employer-sponsored group employee health benefits plan that is offered for a limited time.
Pregnancy Benefits
The Newborns’ and Mothers’ Health Protection Act of 1996 provides that employers who offer maternity coverage pay for at least a 48-hour hospital stay following childbirth. In the case of caesarean section, they must provide a 96-hour stay.
Mental Health Benefits
It used to be that mental health was something that just wasn’t recognized, diagnosed, or treated. But in recent decades, society has come to see it as an integral part of our overall health. The Mental Health Parity Act (MHPA), passed into law on September 26, 1996, provides that limits on dollar amounts for mental health benefits must equal the dollar limits on medical and surgical employee health benefits. However, some exemptions are provided.
What Else Am I Entitled to From My Employee Health Insurance?
Plans vary from provider to provider. One way for you to determine all the details of what you are entitled to from your employee health insurance plan is to go over your Health Insurance Explanation of Benefits (EOB), a document sent to all patients explaining what was covered.
Of course, the EOB explains your coverage after the fact. To avoid complications and financial headaches, consult the health insurance handbook given to you by the insurance company.