Healthcare Reform Update Effective January 1, 2014
New Healthcare Benefits Waiting Period Rules as of January 1st, 2014!
Starting January 1, 2014, for new group plans and at the first
renewal for those group plans renewing after January 1, 2014,
the waiting period may be no longer than 60 calendar days.
A waiting period is the amount of time an eligible employee has
to wait before coverage starts. This is for new or newly eligible
employees and applies to all fully insured medical plans regardless of employer size.
The mandate also includes a special rule about individuals in a
waiting period greater than 60 days and prior to the renewal date.
If the employee is subject to a waiting period that exceeds 60 days
and is within 60 days of the customer’s renewal date, it will no longer be valid.
The employee must then be given the opportunity to elect coverage no later than the customer’s renewal date.
This mandate is extraterritorial, which means it applies to all insurance
policies issued in the state of California and to all California residents
regardless of the state in which their insurance contract is issued.
San Francisco Adopts Family Friendly Workplace Ordinance, Increasing Cost of Employing Workers in the City by the Bay
Approximately two weeks ago, San Francisco’s Board of Supervisors unanimously adopted the Family Friendly Workplace Ordinance, giving employees the right to request flexible work schedules or other accommodations to help the employee with childcare obligations and other similar household obligations. The ordinance of course provides legal remedies to an employee whose rights under the ordinance are violated. San Francisco Mayor Ed Lee has stated that he will sign the ordinance into law, but has not yet done so. If signed into law as expected, the ordinance will take effect January 1, 2014. Thus, employers with employees in San Francisco should familiarize themselves with the newly passed ordinance.
The ordinance applies to employers who regularly employ 20 or more employees, including part-time employees, within the City of San Francisco. The ordinance grants employees with 6 or more months of service and who work at least 8 hours per week the right to request a flexible work arrangement to accommodate the employee’s caregiving responsibilities for (1) a child; (2) a parent age 65 or older; or (3) a spouse, domestic partner, parent, child, sibling, grandparent or grandchild with a serious health condition. An eligible employee may make up to two requests for accommodation per year, but may make additional requests following the birth or adoption of a child and/or an increase in the employee’s caregiving responsibilities for a family member with a serious health condition. An employee may request accommodation in the form of an alternative work schedule, telecommuting, job sharing, part-time work, or any other type of flexible work arrangement. An employee’s request must be made in writing, and must detail the accommodation requested and how that accommodation relates to the employee’s caregiving responsibilities. The request must also state the proposed commencement and duration for the requested accommodation.
An employer who receives a written request must respond both verbally and in writing. The employer must meet with the employee about the request within 21 days of receiving the request. The employer thereafter must respond to the request in writing within 21 days, explaining whether the employer will grant or deny the request. An employer who denies the request must explain, in writing, “bona fide business reasons” for the denial, such as identifiable cost of granting the request (lost productivity, rehiring or retraining costs), negative effect on ability to meet customer demands, inability to meet work demands or transfer work among employees, etc.If an employee’s request is denied, the employee then has 30 days to seek reconsideration, which requires the employer to again meet with the employee within 21 days and respond in writing thereafter within 21 days.
The new ordinance states that it shall be unlawful for a San Francisco employer to interfere with, restrain, deny the exercise of any rights granted by the ordinance. It also makes it unlawful to discharge, threaten to discharge, demote, or otherwise take adverse employment action against an employee for exercising rights under the ordinance. The ordinance grants enforcement authority to San Francisco’s Office of Labor Standards Enforcement, which can investigate alleged violations and take administrative and legal action to enforce the ordinance and remedy certain violations. The ordinance does not provide for a private right of action.
Employers will be required to post mandatory posters (not yet published) concerning the new ordinance and will also be required to maintain records of employee requests for 3 years.
Note: This may be in San Francisco but Governor Brown and the California Legislators may not be very far behind in adopting legislation for the entire state.