what's the law?
Employers must disclose health plans
Two years ago, when I was hired by my company, I was only offered one medical insurance provider, which was paid 100 percent by the employer - not a local insurance provider. Here on the Big Island there is a doctor shortage, and most doctors are not taking new patients and I've been without a primary provider for more than two years. Recently, the HR representative mentioned that he had Kaiser, so I asked if Kaiser was an option for us. I was told that Kaiser is available but that I would have a co-pay. I have a predisposition for ovarian cancer and am supposed to have tests every six months - no doctor, no tests. I was also unable to get medications for another condition since I didn't have a doctor to prescribe them. What is the law regarding employers not giving employees all their options regarding medical insurance?
Answer: Under the Hawaii Prepaid Healthcare Act, HRS S393-11, every employee who is paid monthly wages in an amount of at least 86.67 times the minimum hourly wage and works at least 20 hours per week for four consecutive weeks is entitled to coverage by a prepaid health care plan.
According to the applicable Hawaii Administrative Rules S12-12-17, the employer is required to post a notice stating what coverage is available and provide employees with the "health care contractor's name, plan number, group number, effective date of coverage, and employee's cost." However, S12-12-12 allows an employer to "provide more than one approved plan from the same or different health care contractor," and the employer must only cover the cost of the least expensive plan when multiple plans are offered. Furthermore, under section S12-12-13, "An employer may provide different plans for different classes of employees." So, employers do not have to provide all "classes" of employees with the same options regarding prepaid health care plans as long as employees are provided with at least one approved plan.
Further questions regarding the Hawaii Prepaid Healthcare Act can be answered by calling the Investigation Section at the Department of Labor and Industrial Relations at 586-9200.
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