Are your competitors spending less on their employee medical claims?

Many American workers rely on their benefits as valuable protective services. Health and life insurance, workers’ compensation and investment plans can all help workers protect their assets.

Nonetheless, each worker is different. They may be full-time employees, part-time workers or contractors. An employee’s status with the company may determine their eligibility for benefits.

Benefits Eligibility Overview

At times, the law may require employers to offer benefits to certain employees. For example, the Affordable Care Act (ACA) says that certain companies must offer health insurance to most of their full-time employees. If they fail to do so, the company might face penalties. In other cases, employers may have full discretion whether to offer certain benefits. Employers often follow specific practices to determine which employees qualify for required benefits.

Once an employee becomes eligible for required benefits, the company should give the employee the chance to enroll. The employer may not be able to force the employee to take the coverage. However, they may have to at least offer the worker the opportunity to enroll.

Determining Eligibility for Benefits

Employers usually determine employee eligibility for benefits based on the worker's employment status. Employees may work full-time, part-time or on a contracted basis.

  • Full-time employees usually qualify for most or all benefits offered by the company. The Fair Labor Standards Act (FLSA) does not define full-time employment. However, other laws may define which employees classify as full-time. For example, the ACA defines full-time employees as those who work over 30 hours per week. Therefore, employers may have to offer these employees health insurance. If not required to offer certain benefits, employers may have discretion about whether to cover full-time employees.
  • Part-time workers may or may not qualify for all of the benefits offered by employers. Depending on the number of hours the employee works, even if part time, they may be eligible for benefits. If part-time workers don’t qualify for required benefits, employers may still choose to offer them.
  • Contractors usually are not employees of the company for which they contract. They may work for a contracting company, or are self-employed. Often, contractors do not receive benefits from their clients. They may receive them from their own employer or self-fund their own benefits.

Other classifications of employment exist as well. In each situation, an employer should carefully review their local insurance law. This can help them determine when to offer benefits.

Do you need Pennsylvania employee benefits? Come to Stalwart Insurance Agency today! We can help you get the coverage you need. Call us at (412) 677-2312 for more information.

Posted 11:42 AM  View Comments

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