Work: Starting At A New Employer - A Primer

Benefits can be a major reason to join or remain in the workforce. It is likely that qualify for most of the benefits employers offer despite your health history.

The general guideline in deciding which benefits to take as a new employee with a health history is to "take as much as you can get."

• You can always drop a benefit. 
• Because of your health history, it may be more difficult to sign up later or to increase amounts of a benefit. There are usually "Open Enrollment" periods during which you can make changes without health questions or an exam. However, they may not cover all benefits or increases in coverage.

When you review benefits,check: each of the following:

• The definition of the benefit. For example, if it is salary continuation, how much salary will be paid and for how long?
• Does the list of eligible employees include you?
  • Does the list include your type of job? Larger employers in particular may provide different benefits for different classifications of employees. For example, employees who work on the factory floor versus executives.
  • Does the employer distinguish between part time and full time employees?
    • Most employers only offer benefits to employees they consider to be full-time employees. The definition of "full-time" varies from employer to employer. As a general matter, employees who work thirty (30) hours or more per week are full-time.
    • A minority of employers offer benefits to part-time employees. If part-time employees are eligible for benefits, the benefits are generally less than those offered to full-time employees.
• Is there a probation period before are eligible for the benefit? The probation period is the period of time between the date of hire and the date benefits become effective. For example, an employer offers health insurance to new employees, but not until 30, 60 or 90 days after the employee starts work. The 30, 60 or 90 day period is the "probation period." A probation period gives you time to examine the employer's benefits and decide which ones you want to enroll in.
  • If there is a probation period, how long it is?
  • If there is a probation period, you will have to look elsewhere for health insurance. For example, if you have continued health coverage under COBRA from your previous employer, you need to continue it until the new coverage starts at the end of the probation period.
  • A probation period doesn't count with respect to HIPAA, the federal law which limits an employer's right to impose a new pre-existing condition exclusion in a health insurance policy in certain circumstances. The date of hire becomes the enrollment date for purposes of determining whether you have been without creditable health insurance for more than 63 days. This becomes important if you are considering letting your previous health insurance lapse until the new employer's coverage starts -- which we do not recommend. (If money is an issue, see How To Deal With A Financial Crunch). If you nonetheless want to let your previous coverage lapse and are relying on HIPAA to eliminate a new pre-existing condition exclusion, contact the new employer's insurer to confirm that their practice is to consider the date of hire the important date with respect to a pre-existing condition exclusion -- not the end of the probation period.
• Is there a period during which pre-existing health conditions are excluded? If so, does your condition count as one of those which are excluded? For example, some pre-existing condition provisions provide that a condition is pre-existing if a reasonable person would have seen a doctor for the condition in the past 6 months. If there was no reason to see the doctor, your condition may not be considered to be "pre-existing."
• Who pays for what?
  • There is no legal requirement that employers provide benefits or, if they do, the portion the employer pays, if any.
  • Most employers pay at least a portion or many employee benefits. The amount paid by the employer depends on many factors, including management philosophy, insurance company requirements, union contracts, geographical location, type of industry, and size of the pool of potential workers in your geographic area. The question remaining for you is how much you will be expected to pay for each benefit, if anything.

If there is a question concerning whether the employer's health plan legally can exclude coverage for your pre-existing health condition, and if so, for how long, read: HIPAA. 

For a list of benefits offered by employers, and guidelines concerning their value to a person with a history of a serious health condition, click here. 

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