Outten & Golden: Empowering Employees in the Workplace

Posts Tagged ‘COBRA’

Retired Medical Technologist Gets a $600/Month Subsidy Thanks to New Healthcare Law

Sunday, January 26th, 2014

seiu-org-logoLarry Daniels, a 62-year-old medical technologist from Paintsville, Ky., was a few years away from qualifying for Medicare, so each month he paid $732 to keep his health insurance from his past employer through COBRA.

Read the previous blog post on Daniels from October HERE

It was hard coming up with that money every month, so Daniels was thrilled when he found out that he might be eligible for subsidies that would reduce the amount he paid for his plan from Kentucky’s health insurance exchange. “It’s nice not to worry about pinching pennies in order to be able to afford that monthly premium,” he said.

He ended up qualifying for a $600/month subsidy, which covers the cost of his platinum plan entirely. “And its better insurance than I had before,” said Daniels. “My deductible used to be $1,500, and now it’s only $500.”

Last fall, Daniels helped set up an information booth on the new healthcare law at the well-attended Kentucky Apple Festival. “It make me feel proud that I might have helped hundreds or even thousands of people at the festival sign up for health insurance,” he said.

For millions of American’s, the day has finally arrived when they can visit a doctor without worrying about the costs. And for many others like Daniels, their quality of life will be vastly improved by not having to pay outrageous premiums for the plans they desperately need.

“When I got that card in the mail, it was the greatest thing I’ve felt in a long time,” Daniels said. “I’ve always said that from the moment we get out of bed in the morning, our lives are deeply affected by politics. And this is one of the instances where I feel proud of both the state of Kentucky and the lawmakers who passed the healthcare law.”

This article was originally printed on SEIU on January 17, 2014.  Reprinted with permission.

Author: SEIU Communications

How Does the Fall of DOMA Impact the FMLA and Other Employee Benefits?

Friday, June 28th, 2013

Jeff NowakUnless you’ve been securely wedged under a rock over the past 24 hours, you know that the U.S. Supreme Court has declared unconstitutional the Defense of Marriage Act (DOMA), which had established a federal definition of marriage as a legal union only between one man and one woman.

Yesterday, as Justice Anthony Kennedy read the opinion of the Court in U.S. v. Windsor, I can only imagine that his thoughts were consumed completely by the manner in which the extinction of DOMA would impact the future of the Family and Medical Leave Act. Right?

But let’s not leave this to chance.  In the unlikely event that Justice Kennedy (and the rest of the Court’s majority) didn’t fully appreciate how the FMLA might be impacted, we’ve got the Court’s back, as we discuss the issue more fully below:

How FMLA is Impacted after the Fall of DOMA

As we know, the FMLA allows otherwise eligible employees to take leave to care for a family member with a serious health condition.  “Family member” includes the employee’s spouse which, under the FMLA regulations, is defined as:

a husband or wife as defined or recognized under State law for purposes of marriage in the State where the employee resides, including common law marriage in States where it is recognized.  29 C.F.R. 825.102

Initially, this seems to suggest that the DOL would look to state law to define “spouse.”  Not so fast. According to a 1998 Department of Labor opinion letter, the DOL acknowledged that the FMLA was bound by DOMA’s definition that “spouse” could only be a person of the opposite sex who is a husband or wife.  Thus, the DOL has taken the position that only DOMA’s definitions could be recognized for FMLA leave purposes.  As result, FMLA leave has not been made available to same-sex spouses.

That changed yesterday, at least in part.

What’s Clear about FMLA After the Court’s Ruling

In striking down a significant part of DOMA, the Supreme Court cleared the way for each state to decide its own definition of “spouse.”  Thus, if an employee is married to a same-sex partner and also lives in a state that recognizes same-sex marriage, the employee will be entitled to take FMLA leave to care for his/her spouse who is suffering from a serious health condition, for military caregiver leave, or to take leave for a qualifying exigency when a same-sex spouse called to active duty in a foreign country in the military.

What’s Unclear about FMLA After the Court’s Ruling

But what about employees who live in a state that does not recognize same-sex marriage?  Are they entitled to FMLA leave to care for their spouse?

As an initial matter, the regulations look to the employee’s “place of domicile” (state of primary residence) to determine whether a person is a spouse for purposes of FMLA.  Therefore, even if the employee formerly lived or was married in a state that recognized the same-sex marriage, he/she is unlikely to be considered a spouse in the “new” state for purposes of FMLA if the state does not recognize the marriage.  This is no small issue, since 30+ states currently do not recognize same-sex marriage and some don’t go all the way (e.g., Illinois, which recognizes same-sex unions, not marriages).

Surely, some might argue that the United States Constitution requires other states to recognize the marriage; however, this issue is far from settled.  My friend and Indiana University Maurer School of Law professor Steve Sanders writes a compelling article for SCOTUSblog contending that an individual married in one state maintains a “significant liberty interest” under the 14th Amendment’s Due Process Clause as to the ongoing existence of the marriage.

Here, employers clearly need some help from the DOL.  Might the DOL draft regulations on how employers administer the FMLA in situations where the employee’s spouse is not recognized under state law?  If so, we could see the DOL give life to concepts such as a “State of Celebration” rule, in which a spousal status is determined based on the law of the State where the employee got married.

Without more guidance, it still is too early to tell where this question is heading.  Nevertheless, the employer community looks forward to helping shape these rules.

Other Key Benefits Affected by the DOMA Decision

FMLA is not the only federal law impacted by the fall of DOMA.  If federal regulations follow through, some of the notable federal laws and benefits impacted may include:

  • Taxes: Same-sex spouses likely will share many federal benefits and be able to manage tax liability in a way that opposite sex spouses typically do.  For instance, an inheritance, which was taxed under DOMA, will no longer be taxed for a same sex spouse (this was the factual scenario at issue in the decision). Income taxes, payroll taxes, health insurance benefits, and tax reporting may also be impacted.
  • Affordable Care Act and COBRANPR reports that the Court’s decision will impact how the Affordable Care Act (affectionately referred to as Obamacare) is carried out, though many details remain unclear. Moreover, same-sex spouses may be eligible for continuation of health insurance benefits (COBRA) even though the spouse may lose his/her job.
  • Employee benefits: Same-sex spouses likely will be treated equally when it comes to employee benefits, including a 401(k) plan.
  • Social security benefits: The Court’s decision also paves the way for social security survivor benefits to continue onto a legally married same-sex partner.
  • Citizenship:  According to NBC News, some 28,000 same-sex spouses who are American citizens will now be able to sponsor their non-citizen spouses for U.S. visas and can qualify for immigration measures toward citizenship.

For future updates on the impact of DOMA on FMLA and employee benefits generally, feel free to follow me on Twitter or Linkedin.  I’ll be posting more there.  You also can subscribe to this FMLA Insights blog on the right hand side of this page.  Just enter your address and I’ll email you my updates directly.

This article was originally printed on FMLA Insights on June 27, 2013.  Reprinted with permission.

About the Author:  Jeff Nowak is a management side attorney at Franczek Radelet P.C. and author of the FMLA Insights blog.

On Being Unemployed

Monday, June 7th, 2010

Image: Mitchell HirschI am unemployed, and have been now for a little more than three months. People like me often say “I lost my job” — as if their situation were the result of some personal failing or act of stupidity. Like “I lost my car keys” or “I lost my wallet.” No. Let me say, instead: My job was taken from me.

For nearly a year, roughly 15 million Americans have been officially unemployed, according to the monthly reports. So I know I am not alone. But there are many times when it doesn’t feel that way.

On a freezing night with a biting wind, around the holidays this past winter, I went to see the film Up in the Air with my wife, her sisters and my two teenage kids. Laura mentioned the film in a great post last January. The film’s protagonist, played by George Clooney, works for a firm that gets hired by other companies to fly him around and fire people from their jobs. In addition, he has the temerity to promote a kind of sidecar career for himself, lecturing people looking for work about how they need to clean out their backpacks, or whatever.

I sat there trying to contain my anger, while part of me felt a deepening sadness — not just for the people being thrown out of work, but for the spreading epidemic of corporate callousness and for the needless devastation wrought by this monster recession. On the way out of the theater my kids asked me what I’d thought of the film, and all I could say was “this all just makes me so angry,” adding I was glad that I still had my job.

Two months later, I did not.

For nearly twenty years I had managed a successful, multi-million-dollar retail store, part of a specialty chain. In a move to further reduce store payrolls, which along with overall benefits had already been reduced several times in recent years, it was determined that my modest salary — which was below the median household income in my state — no longer fit the new payroll scheme. The day I was informed of this I was also told it was my last day.

I was stunned. To say that I had been the face and the name, the personification of the store and the company in a highly coveted market would be an understatement. Yet, no new role was offered, no severance, nothing. Less than a year earlier, after a significant restructuring in which a number of long-time employees had been let go, particularly at the firm’s headquarters, the company’s president had indicated to me that my job was safe. So much for that.

I came home to find my wife having lunch in the kitchen. When I told her what had happened, she cried. I held her and told her we’d be alright. But part of me didn’t really believe it. That I haven’t cried yet probably isn’t a healthy thing.

Within a couple of weeks, my long-time assistant manager was also let go. We happen to both be 59 years old. It had been determined that the new payroll scheme would not support having two assistants. Apparently, the private equity group that had financed the company’s buyout several years earlier now wanted to see more of the ‘R’ part of their ‘ROI’. Think back to my post titled “Sharks”.

I applied for unemployment insurance for the first time in my life. I began submitting claims online, but was told on the phone that I would not see any payments for a while, because my eligibility had to first be determined in a telephone hearing — and, because of the high volume of first time claims (this was, by the way, late February 2010) that hearing wouldn’t be scheduled for a month. Fortunately, I had filed my 2009 tax returns early and we’d already received our refunds.

I filed to continue our family’s health insurance with the COBRA administrator, and for the federal COBRA subsidy — the one that, while you’re unemployed, temporarily reduces monthly premiums by 65 percent, but that got stripped out of the jobless aid bill in the House last week. So, unless the continuation of that program is restored, newly unemployed people will no longer be eligible for the reduced premiums.

Despite the lightning fast online application process, COBRA insurance approvals appear to take weeks. So prescription medications, of which there are several for my son and myself, were paid for in full until the COBRA insurance was confirmed. I postponed an annual physical checkup.

Meanwhile, of course, the networking, resume writing, posting, emailing and door-knocking began and has continued unabated. Unlike many folks I’ve heard about, I’ve actually had several responses and even some interviews. But, as yet, no actual offers. Have I mentioned that I’m 59 years old?

The stories of these mundane details may vary from person to person. Mine are certainly not unique. What are far more significant are the stories of how being unemployed affects your life, your thoughts, your emotions, your self-esteem and your sense of social worth.

On these matters, I can only speak for myself. What struck me most immediately was that, without my job, I had no place to go to. Not just the routine of going to work, but having a sense of ‘place’ and belonging in and to a place, was suddenly taken from me. The psychologist James Hillman has written extensively on the subject of the soul being nourished by its sense of place, and that our workplaces are, or should be, vital places that help instill a sense of shared purpose, of mutual encouragement, so that they themselves have a sense of soul.

But increasingly our workplaces are being robbed of their soulfulness, replaced by the cold domination of callous cost-cutting and disregard for people. The layoffs don’t just harm those laid off. It is as if the lost souls of those laid off linger in the workplace, haunting those who remain on the job.

While it is difficult to admit, for me the sense of rejection has been palpable. Several decades of experience and prior accomplishments at times feel all but negated, as if they not only mattered little but may as well not have happened at all. I find myself struggling, at times to fight off a sense that society has deemed me expendable.

And a fear of the future, which while I was working had receded largely to lurk only in a far-off corner somewhere, is now back with a vengeance. What will happen if I need surgery? What if my old car dies on me? Will we ever be able to have a real vacation or travel anywhere again? Will I be able to help my kids go to college in a couple of years? Will I ever be able to afford not to work? Will I ever be able to work?

The staggeringly huge number of unemployed Americans has been fading from the headlines. In a series of diaries posted on Daily Kos in the spring and late winter of 2009, I noted to the astonishment of some that with nearly 15 million unemployed, the number of unemployed Americans was more than it was in 1933 at the depths of the Great Depression. I made note of that fact again in my very first post here on Main Street last September. And it’s as true now as it was then.

Now, however, there appears to be a growing sense that mass unemployment is something that must be accepted, as if it’s somehow unavoidable. Moves are already underway by some in Congress to chip away at and begin to dismantle the jobless aid programs for the unemployed. Two months ago, when I wrote “Wall Street Declares War on the Unemployed” some readers probably thought I was exaggerating in order to make a point.

Where is the outrage? Where the fierce urgency to find and implement effective solutions to this, our most pressing national economic emergency? My sense of being socially expendable is increasing. When a society begins trashing its human capital on a mass scale, it is headed down a very ominous road. How can this be happening?

One reason, I think, is the sheer invisibility of much of our current-day unemployment. Gone are the Depression-era breadlines and the mass street demonstrations of the 1930s by unionists and the unemployed. There’s no longer a need to stand in line at the unemployment office to file your claims — it’s all done so privately and invisibly online. And the sense of isolation, which Susan wrote about here, is reinforced by the media’s disregard and the implicit message that if you’re unemployed it’s your own fault.

But it’s the silence and the impersonal invisibility of our nation’s unemployment nightmare that must be countered creatively. Perhaps this blog post will help.

*This post originally appeared in Working America’s Main Street blog on June 3, 2010. Reprinted with permission from the author.

About the Author: Mitchell Hirsch is a featured blogger for Working America’s ‘Main Street’ blog.  He writes frequently on the economy, jobs policy, unemployment, politics and legislative issues.

Unemployment Q & A's

Wednesday, December 16th, 2009

Image: Brett BrownellI’m thankful for the opportunity to be part of a great organization like Workplace Fairness. We’re using online tools to educate workers about their rights and job-seekers about their search. But I’m no stranger to unemployment.

In the not-too-distant past my resources became limited and I hit a wall in my job search. So I made the tough decision millions of Americans have had to make: I decided to file for unemployment… But making the decision was just the beginning.

What I remember most vividly about the time that followed were two things:

1) The confusion, hassle, and frustration of the application process

2) My relief when I received the first ameliorating check

So, when I came across the The New York Times’ money blog “Bucks” and their series “Answers About Unemployment Benefits” I wanted to share it and hopefully save some frustrated job-seekers a few minutes, or hours, or dead-end research.

The answers are provided by Andrew Stettner, deputy director of the National Employment Law Project. All four parts in the series can be found here:

Answers About Unemployment Benefits: Part 1

Answers About Unemployment Benefits: Part 2

Answers About Unemployment Benefits: Part 3

Answers About Unemployment Benefits: Part 4

Among the topics the series covers are:

• COBRA health care
• Tip earners
• Temp workers
• How to determine eligibility?
• How to determine amount?
• New 2009 Recovery Act extensions
• Students
• Self-employment
• Independent contractors

I hope you find it helpful.

*For more information on unemployment insurance visit the Workplace Fairness Unemployment Insurance Information page and 2009 Economic Stimulus Package and its Effect on Unemployment Insurance page.

About the Author: Brett Brownell is a new media fellow at the New Organizing Institute where he manages the Today’s Workplace blog and new media for Workplace Fairness. Brett served as deputy director of new media & videographer for the Obama campaign in Pennsylvania. He is also the founder of Worldwide Moment (an international photography project for peace) and the son of a 40-year veteran of the Association of Professional Flight Attendants union.

Senator Kennedy - A Health Care Champion

Thursday, August 27th, 2009

Senator Kennedy’s legacy cannot be defined within one issue, no matter how important. But it would not be an understatement to say that his life’s work revolved around health care for all. He said so himself, calling it “the cause of [his] life” in a passionate Newsweek op-ed published just last month.

True to form, Kennedy turned his passion into real results. The list of health care legislative accomplishments he was part of is stunning. From the website set up by his family dedicated in his honor:

  • In 1966, Kennedy helped establish the community health center model in the United States. Community health centers are now serving 20 million low-income Americans around the country.
  • In 1985, Kennedy led the fight to enact COBRA, giving workers the ability to purchase health care through their employer after they have been let go from their job.
  • In 1996, Kennedy co-sponsored HIPPAA, which now ensures access to health care coverage for an estimated 25 million Americans who move from one job to another, are self-employed or have pre-existing medical conditions.
  • In 1997, Kennedy was instrumental in passing the CHIP program that gives health care to millions of children.
  • In 2006, Kennedy passed the Family Opportunity Act, which provides states with the opportunity to expand Medicaid coverage to children with special needs, giving low- and middle-income families with disabled children the opportunity to purchase health coverage under Medicaid.
  • From 1997-2008, Kennedy helped grant Massachusetts the Medicaid waivers it needed to pass its state health care reform plan.
  • In 2008, Kennedy enacted legislation to reform the inequities in the way mental health and substance use disorders are treated by the insurance industry, a 10 year battle.
  • And finally, in 2009 under his leadership and the leadership of his close friend, Senator Chris Dodd, Kennedy passed the Affordable Health Choices Act – which would give everyone in America a guarantee of quality, affordable health care – through the Senate committee he chaired, the Health, Education, Labor and Pensions (HELP) Committee. The bill awaits a vote by the Senate as the health reform process moves forward.

Senator Kennedy’s towering vision for health care was built on his numerous accomplishments. While there is sadness in knowing Senator Kennedy won’t be with us to see his life’s work completed, we will keep him in our thoughts as our fight continues and we finally achieve quality, affordable health care for all this year.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

This article originally appeared on the Health Care for America NOW! Blog on August 27, 2009 and is reprinted here with permission from the author.

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COBRA's High Cost Bites Into Jobless Safety Net

Monday, June 22nd, 2009

As unemployment rises more women are turning to COBRA for health insurance coverage, but discovering it’s either too expensive or not available. Women who shop for individual insurance often face higher rates due to “gender rating,” a recent study found.

COBRA American Recovery and Investment Act

(WOMENSENEWS)–When Jane Schiffler loses her job on July 1, the college administrator will face tough choices.

“To help make ends meet for me and my 7-year-old son, I’ve decided to give up our land line and just use a cell phone; to cancel our cable TV and just get the basic channels; to go to the library instead of buying books; and to cook at home instead of eating out,” says Schiffler, a single mother in New York City. “But I haven’t figured out what to do about our health insurance coverage, which remains my biggest–and most frightening–challenge.”

Schiffler qualifies for COBRA, the Consolidated Omnibus Budget Reconciliation Act.

The 1985 law allows laid-off workers and their dependents to remain on their former employer’s group health plans for 18 months as long as they pay the same amount for coverage as their employer did, and 150 percent of that amount if they extend COBRA coverage beyond 18 months.

“The problem is that COBRA is just too expensive for me to afford,” says Schiffler, who is using a pseudonym in this article because she doesn’t want her concerns about health coverage–and the fact that she may have to do without it at some point–to negatively impact her job search or her chances of getting health coverage in the future.

The average monthly unemployment payment in the United States is $1,278.

COBRA for an individual consumes 30 percent of that. Family coverage devours 84 percent.

Little Left Over

That leaves many laid-off workers with little left for rent, mortgage, utilities, groceries, and other necessities, found a January 2009 report from the Washington-based Families USA.

In February, the federal government moved to help such workers by passing the American Recovery and Reinvestment Act of 2009 (ARRA), which provides $25 billion in temporary subsidies so workers who were involuntarily terminated between Sept. 1, 2008 and Dec. 31, 2009 pay 35 percent of the normal cost of COBRA.

“While this is a significant subsidy, for the average woman, it’s still more than the 16 percent of the cost of individual coverage or the 27 percent of the cost of family coverage that she would have paid as her contribution to health insurance while she was still working,” says Karyn Schwartz, a senior policy analyst for the Kaiser Family Foundation, based in Menlo Park, Calif.

Many unemployed women, meanwhile, don’t qualify for COBRA.

Ineligible are laid-off women with individual incomes of more than $125,000; family incomes of more than $250,000; employers who never offered health insurance in the first place, and employers who went out of business (and therefore had no health plan at the time of job termination).

10 States Lack ‘Mini Cobra’ Laws

“Company size is also barrier to coverage,” says Cheryl Fish-Parcham, deputy director of health policy for Families USA. “COBRA only applies to workers in companies with 20 or more full-time employees. Some states are working to help laid-off people from smaller firms. But in 10 states, there are still no ‘mini COBRA’ laws creating coverage for these laid-off workers, who now have to go without coverage, or pay high premiums for individual plans.”

The average private health insurance plan for an individual costs $4,704, while one for a family costs $12,680, according to a March study in the New England Journal of Medicine. And due to a practice known as “gender rating,” most private insurers charge women more than they charge men, according to a 2008 report by the Washington-based National Women’s Law Center.

“I can only afford COBRA for a few months, and I definitely can’t afford to buy private coverage,” says Schiffler. “If my savings run out, I may have to go without coverage, though my son may qualify for a state program for children. I need a safety net, but if I have to choose between eating and buying health insurance, I am going to eat.”

About the Author: Molly M. Ginty is a freelance reporter based in New York City. A graduate of Columbia University’s Graduate School of Journalism, she has written for Ms., Marie Claire, Good Housekeeping, Redbook, Ladies’ Home Journal, pbs.org and On Earth as well as Women’s eNews.

This article originally appeared in Women’s eNews on June 18, 2009. Re-printed with permission by the author.

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