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Benefit regulations

wendyawendya 2 Posts
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If your parent company is located in one state and your company doing business in another, which state governs benefits provided to you? The parent company state or the state that you work in? Also, are there any regulations regarding the type of insurance you offer, and if you are required to offer more than one choice, such as a PPO and a HMO?

Thank you for any response!
Wendy


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Comments

  • 5 Comments sorted by Votes Date Added
  • Scott RuthScott Ruth 65 Posts
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    Generally speaking, most of your welfare benefits (health, life, etc.) and your
    retirement benefits offered by your employer are governed by federal law (ERISA
    and the Tax Code) which supercede most state laws. However, there are many
    state laws which regulate the insurance contracts, if any, that actually provide
    the benefits. They may also regulate HMOs. With respect to those laws, the law
    of the state where the coverage is provided will generally govern.

    The employer generally has wide latitude in deciding the type of benefits it
    will offer, or even to offer any at all, and I am not aware of any law that
    would require an employer to offer more than one choice. However, if a company
    does offer health insurance it must meet limitations on preexisting conditions,
    nondiscrimination requirements and the like under HIPAA and to offer
    continuation of of coverage under COBRA when coverage is lost because of certain
    events, such as termination of employment, divorce, loss of dependent status,
    etc., assuming the employer has over 20 employees.

    I hope this helps.
    Scott Ruth

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  • wendyawendya 2 Posts
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    Scott,
    Thank you so much for your quick reply! Now I can stop banging my head against the wall!
    Wendy


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  • jndrsnjndrsn 4 Posts
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    I noticed in your reply that your company has one medical plan for your national company. We also have a national company, although we only have about 95 employees. I'm looking for a good medical plan that will work for all. Can you provide me with your plan provider and your experience with them? My phone number is 503-659-1708 and email is [email]janelle.anderson@achemists.com[/email]. Thanks.


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  • MichelleMichelle 7 Posts
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    I know of at least one carrier that can provide national plans. We had one plan with BCBS of GA. Everything was handled right here in GA and worked smoothly - the only thing is that they had to get their network directories from the different states since all of the Blues are independent. I think that United Healthcare also has this capability. Kaiser permanente is now in about 7 states across the country as well.


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  • jndrsnjndrsn 4 Posts
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    Michelle, thanks for the info. Unfortunately,none of those options will work for us. We have BCBS of South Carolina for our southern group now, but haven't had very good luck with them. We were going to switch to United Health this year, but only for the southern group. They aren't currently in Oregon. They blew their chance with us,however, by quoting us one rate to get our business, then billing us at a much higher rate after we had signed on. Left a rather bad taste. We offer Kaiser in Oregon, but it's not far reaching enough for all our states. So, my search will continue. Thanks again.
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