Cancellation of healthcare before birth of baby

[lintycat]

The very small company (about 5 employees) where I have worked for 5 years, does not offer a maternity leave. I have a due date of September 25th. I was asked what my last day would be, implying that I am not being asked back after the birth of my baby. I have an impeccable work record, I do not take days off, come in late, leave early or take vacation time. There really is no reason I would not be asked to stay except for financial on my employer's end.

I gave a tentative date of September 5th, but put nothing in writing. I was told my healthcare would run out September 15th, thus creating a situation where the birth of my baby and my hospital stay would not be covered. Our insurance runs from the 15th of one month to the 14th of the next and we pre-pay a month at a time.

What can I do?

I have 2 weeks of vacation time that I did not use in 2008. (My year rolls over from hire date which was September 5th, five years ago). I also have 2 weeks from 2007. Company policy states that you have 1 year to use unused vacation time from the year before.

Company policy also states that you are given 3 weeks for vacation after you have been with the company for 5 years.

What am I entitled to and how can I keep from losing my insurance for the birth of my baby?

I know they cannot fire me for being pregnant, but I'm afraid they will find some other nonsensical reason if i stir the pot too much. I just really, really do not want to lose my insurance.

Help!!

Thanks so much!

 

[presutin]

Hmmm - this sounds a little suspicious. I would consult with an experienced local employment attorney. Good luck!

 

[cbg]

I'm a bit confused. If you gave a final date of 9-5 and your insurance runs from the 15th to the 14th, why SHOULD it continue beyond the 15th?

Outside of FMLA, which does not apply here, an employer is not required by law to continue the health insurance for employees on extended leave. Have other employees who had an extended medical leave for reasons unconnected with pregnancy had their insurance continued?

BTW, even though COBRA does not apply due to the small size of the company, CA has a state law which mirrors COBRA and which applies to employers with 2-19 employees. They will be required to offer you continuation of your coverage at your expense.

 

[lintycat]

Let me clarify. I thought I was being asked how much time I'd like to take off before the birth of my baby. It was never made clear that I was choosing my last day with the company EVER.

I carefully explained that the 5th was a tentative date and that I wanted to do what was in the best interest of the company. I explained I did not want to leave any unfinished work (I am a graphic designer), that would be difficult for the next person to pick up on.

I am extremely dedicated to my clients and would never, ever want to leave anyone in the lurch, but right now I am a high risk patient and didn't want to say I could stay any longer than that, only to have to have an emergency situation with my baby unfold, thus causing chaos at work.

Then, out of nowhere I get an email asking to justify the vacation time I had taken in 2008 (I took none) and was told my health insurance would run out September 15th.

In hindsight, it seems like my employer is trying to trick me into "quitting". Like I said, I never said I didn't want to come back. I'm just confused because out company handbook says nothing about maternity leave. How could I be expected to time the delivery of my baby according to the payment schedule for our health insurance?

Am I to assume that if my baby decided to arrive between payments, I wouldn't be covered? Can't I techhnically take my unused vacation time after the 5th, thus making me eligible for one more month of health insurance coverage?

Thanks for the responses.

 

[cbg]

Whether or not you would be able to take vacation during that time, and if you did whether or not that would extend your health insurance, is dependent on your employer's policy and the eligiblity requirements stated in your health insurance policy. It's not a right granted by law; it's policy-driven.

I ask again, have other employees who took extended leave for reasons other than maternity been allowed to continue their coverage? There's a reason I'm asking.

As I said, you will not be left without coverage. Under CA law, they are required to allow you to continue the coverage at your own expense, just like COBRA.

 

[lintycat]

Sorry, didn't mean to be evasive. We've never had another employee take extended leave for maternity or any other reason.

When you say CA law...are you saying California? Excuse my ignorance. I reside in Pennsylvania, so just want to make sure I am getting information that applies to me.

Thanks!

 

[cbg]

Sorry, for some reason I thought you were in California. Must have confused you with someone else.

PA does not have the same law, although many employers will allow it. Have you asked them if they will?

Since no other employee has ever taken extended leave, they are essentially setting policy with you. As long as all subsequent employees are treated similarly in future, they are legal. If, however, some similarly situated employee is allowed to retain their job and/or their benefits after taking a similar leave for a non-maternity condition and you were not, there might be a cause of legal action then.

 

[lintycat]

Yes, I have asked them if I could extend my healthcare by paying out of pocket. I let them know that I wasn't asking them to continue to pay their portion (it was originally 50/50), but rather that I was more interested in making sure I had insurance for the birth of my baby and my hospital stay, so was willing to do what I had to do.

I'm positive I can get insurance for myself AFTER the birth of my baby who will then subsequently be covered by my boyfriend's insurance.

I was told I would get an answer on Monday or Tuesday. I just wanted to get my ducks in a row before then and go armed with some information.

So, my last part of the question is....do they not have to offer me my job back? And do they have to pay me for the unused vacation time?

 

[cbg]

No, they do not have to offer you your job back. They are too small to be subject to FMLA or the Pregnancy Discrimination Act so you have no protections under Federal law. You have some protections under PA law but they only relate to your not being treated differently because of your pregnancy and do not require that you be brought back to work. Since you cannot point to another employee and say, see, this person was out with a broken leg, or pneumonia, or back surgery, and they got their job back and they got their health insurance continued, you're not being treated differently. You are setting the standard. If at some point in future they have an employee go out for some non-maternity reason and they get treated differently, you can then go to the state and say hey, when I was pregnant I didn't get this treatment, but as long as they treat you the same as they treat others, they are legal. Very small employers are exempted from some laws since having even a single employee out can create a hardship on the employer, while a larger employer can weather having someone out with less difficulty.

PA law does not require that you have your unused vacation paid out unless there is a company policy that says they will. This does not mean that they won't; just that the law does not say they have to.

 

[lintycat]

Thank you so much for all of your help. I guess in my case I have to hope that morality wins out...since legality can't really help here.

Thank you!!!

 

[lintycat]

Now that Monday has rolled aorund and I've been able to call my healthcare provider, I've found out that there is no way to extend my coverage with my current provider (on my own) or acquire a new policy from many other insurance providers, because a baby is considered a pre-existing condition. So basically, I have to hope that my current employer accepts my offer of me paying out of pocket for the additional month of coverage.

This brings me to my next question. When I was given my first raise with this company, I was told that vacation pay and sick days are figured in as part of my salary and therefore, just becasue I didn't see a huge jump in my actual paycheck, didn't mean I wasn't actually being compensated in other ways. I have this in writing.

Doesn't this mean I have to paid for those vaction days and sick days? If we are told that vaction days can be accrued and then used within the next calendar year...do I forfeit the money if I don't take the vacation days or is it mine because it is considered part of my "salary".

Thanks!

 

[cbg]

While there are a few states where earned time off is considered wages, PA is not one of them.

I have had employees in PA on a couple of different occasions and I have been told directly from the PA Department of Labor and Industry that unused vacation is due to the employee ONLY when there is a company policy saying that it will. No state requires the payout of unused sick time unless a binding contract, policy or CBA says otherwise.

The fact that the days accrue for your use during your employment does not automatically, at least in your state, make them payable.

I have one possible solution for you on your health insurance issue. Are you married? Is your husband employed? Does his employer offer health insurance? Does that insurance also cover dependents?

If the answer to all four questions is yes, and if his employer's health insurance is under a Section 125 plan (and possibly even if it isn't), they MUST allow you to join his plan as long as you apply for coverage within 30 days of the date you lose yours. And in that case, the pregnancy and birth WOULD be covered because federal law prohibits employer-sponsored group plans from considering pregnancy a pre-existing condition.