How should I handle this work situation? Long, insurance-related.

Background: I work in a small office with three doctors, an office manager, a billing person, and myself.
I have worked in this office for nearly three years without insurance. Everyone else in the office does have insurance. Originally, I did not qualify for insurance since I worked part time, that has since changed, and I now work full time. Because of this, the office manager gave me some forms to fill out to get on the company’s insurance. I opted for the family plan since I have a husband and a daughter.

The doctors started dragging their feet about signing the paperwork, and then asking the office manager to show figures comparing single coverage to family coverage. They balked at the cost of adding me, my husband, and our daughter onto the plan. One of the doctors even laughed at the office manager and said, “I can’t afford that!” They asked the insurance person if her husband was covered on her insurance. She said he was and had been for twenty years. The doctors asked the office manager if they could offer me the single insurance, but have me pay the difference myself if I wanted family coverage. The office manager informed them that it was not legal to offer family coverage to one employee, but not the other. The doctors told her they would have to talk about this further.

That was over a week ago, and still, nothing. Is this even worth it? Is there any action I can take? This seems really underhanded, and although I know it’s not personal, it’s offending me more than I’m comfortable with. It’s hard not to take it personally.

I’m appalled that this conversation took place either in front of you or in a way that you heard all about it. That should have been a private conversation between the financial decision makers and no one else.

You should be offended.

Do they have any kind of office policies in writing, like an employee manual? Probably not required in a workplace that’s so small. The only fair thing would be to go ahead with the family coverage for you, or revoke it for everyone. You only have a legal leg to stand on, I think, if they don’t offer you the same coverage that someone else has.

Myself, I would wait a little longer if I thought they were seriously thinking things over and weighing all considerations. If I thought they were just dicking around at this point, I’d push for a decision.

It’s a very small office, and it’s hard for anything to be kept a secret for long. Like it or not, everything comes through the grapevine eventually. It sucks. At this point, I really think they’re dicking around.

If you are eligible now and they aren’t submitting the paperwork then you may be out of luck for another year. If something doesn’t start moving I would be in touch with the department of labor.

What state are you in? Are these pre-tax plans?

I’m in Michigan.
By pre-tax plans, do you mean that the cost is taken out before my paycheck is taxed? If so, then yes. Why?

You might want to start looking for another job. If you file a complaint with the labor board you may need it.

Most people only look at the wage when taking a job. Me I want to know the pay and what the benifits are.

Am I the only one somewhere between amused and appalled that it’s doctors who don’t want to pay the cost of medical insurance (and are shocked by the cost)?

IMO, a week isn’t too long for the partners to digest and get used to the surprisingly high expense they’ve got now, so without other evidence I wouldn’t assume deliberate dicking around yet (it’s human nature to delay facing an unpleasant bill for a week). But you could still gently inquire and help them get to the acceptance stage of grief.

You might want to check the unemployment rate in Michigan…

Insurance plans that are pre-tax are governed by Section 125 of the Internal Revenue Code. These regulations provide strict guidelines about when employees can join or cancel their insurance, how they are offered, etc. All of this information is required to be outlined in the Summary Plan Description.

It sounds like your office manager may know about these regulations, so I would suggest talking to her. If your plan violates these regulations, they could become taxable or even be cancelled by the insurance company.

The doctors called a meeting today with everyone. I thought they were going to tell us that they were rethinking the policies, and making some changes. I’m so naive! Instead, they called us in to tell ME that they were NOT going to give me any health insurance at all.
I reminded them that I work the same amount of hours as the insurance biller and was informed that she was “grandfathered in” under the old policy from when the office was part of a bigger clinic. I told them that I didn’t think this was fair, but they apologized and said they’d revisit the decision in 6 months.
Is this legal? I only ask because the “old policy” has never been mentioned, and I doubt it’s even been changed in the employee manual. Is there any action I can take besides looking for a new job? I just want the basic legal stuff. All I can find is stuff on race, religion, gender, and age discrimination.

No, this is not legal if it is a Section 125 Cafeteria Plan. The Department of Labor has some resources on its website:

They also have a toll-free hotline for questions about obtaining benefits: 1.866.444.EBSA (3272).

I would also ask your company for a copy of it’s Summary Plan Description, which they are legally required to provide. This will explain all of the regulations of your plan.

Thank you. I really appreciate your input. I’d REALLY like to just find a new job, but the job market is horrific here in Michigan, and I don’t want to leave unless I have something else lined up.

I would call the Department of Insurance and ask them. Their phone # is 877-999-6442. This doesn’t sound legal to me, but I’m not licensed to sell insurance in MI and am not up on their laws. As I previously mentioned, the Department of Labor may be a resource also.

How many employees are there total? Could they fall under different rules because they are a small enough business?
This really sucks…I would be shocked if they were this clueless and doing something illegal so blatantly, I would think their HR person would know if this was illegal, but maybe it is. ( usually a business will get around it by keeping an employee just under full time hours)
unfortunately if you need this job I would be hesitant to fight too much until you get something else lined up…in this economy they can always come up with another reason to fire you.

There are six employees total.

  1. Office Manager, who, I suppose, would also be considered our HR person.
  2. Biller
  3. Me (Medical Records/Grunt)
  4. Dr. Gladiator
  5. Dr. Hippie
  6. Dr. Trustfund

Doctors Gladiator and Hippie are both on their wives’ insurances, while Dr. Trustfund is single and has single insurance, Office Manager is single and on single insurance, and Biller is married on family insurance.
Can the size of an office determine how they handle benefits?

I am not sure of the legality as small business (I believe under 25 employees) do indeed have different laws they work under, but regardless it is 100% time for you to start looking for a new job. They have showed you how much you are worth to them (and apparently it is not much), and it is time to bail on them as soon as you can line something else up. Even if it is something illegal, calling them on it will not lead to a pleasant work place environment and you will be fired for it once they can create a long enough document trail for them not to get in trouble over unlawful termination. Quite frankly if it was me I probably would of been furious enough with them to quit on the spot.

TRUST ME, I wanted to quit right then and there, but this is Michigan after all, and the unemployment rates are terrifying. I am looking for a new job, but I’m going to have to stick it out for awhile until I get one.
Thanks, everyone, for your input, ideas, and suggestions. I’ll update if anything new or exciting happens.


Can you ask for company coverage for yourself and you will pay the difference to put your family on the plan?

“The office manager informed them that it was not legal to offer family coverage to one employee, but not the other.”

Sure, they have to offer it, but they don’t have to pay for it. You can pay the difference yourself.

But if they’re paying for the one employees family they must pay for hers as well.