Is there a money owed here?
June 20, 2014 12:57 PM   Subscribe

How to get those health care dollars?

My brother worked in a pharmacy retail chain in San Francisco a few years back. He no longer works there, but he's recently found out about the SF HCSO, which essentially states that an employer must contribute a certain dollar amount to their employee's health care plan for every hour worked. He isn't exempt from the program, and he's never signed the numerous waiver forms they mailed him. However, he never received contributions to a health care plan or anything of the sort. Is there a way to find out if he's owed anything? If he is, how can he get these funds from his employer?
posted by Qberting to Law & Government (4 answers total)
I apologize if this is obvious.

The HCSO doesn't require that the employer give money to the employee, it requires the employer to contribute to all employees health care in some way or another - either through direct employee reimbursement (to an HSA or equivalent) or through purchase of health care insurance. So, if the employer offers a health care plan, the employer has to pay for part of the health care plan.

For instance, if a health care plan offered to employees costs the employer $480/month ($3.00/hour worked), the employer needs to pay for at least $2.44/hour of that (for an employer in 2014 with >100 employees). The employer can either give the employee $2.44/hour for health care (and not provide the health care plan), or provide the health care plan costing the employee anywhere from free to $0.56/hour.

In other words, the answer here is dependent on:
  1. Whether or not the employer is actually covered under HCSO (not all are).
  2. Whether or not your brother is covered under HCSO (certain management employees aren't).
  3. What health care plans the employer offered, if any.
  4. The cost of those health care plans to the employee and the employer.
  5. Whether your brother accepted those health care plans. If your brother's employer offered health care that is sufficient to meet HCSO requirements, but your brother declined them, your brother is not due the amount your brother's employer paid for health care (instead, it just goes to pay for other employee's health care).

posted by saeculorum at 1:08 PM on June 20, 2014 [1 favorite]

Right, sorry, I didn't mean to imply that he was getting dollars directly from the company, but in the form of some health care coverage. I'm not positive on the exact details, but I believe my brother should be covered under the HCSO, because I also worked in the same company at a different position (both non management) and I was eligible for a medical reimbursement account. We're both covered under my dad's insurance plan, which I believe exempted him from having to accept a health care plan from his employer. The employer is Walgreens if it makes a difference.
posted by Qberting at 2:07 PM on June 20, 2014

If the medical reimbursement account was an HRA (healthcare reimbursement account), then it's legal for the company to contribute the HCSO-mandated amount every year to comply with HCSO. However, HCSO-compliant HRAs only need to roll over funds year to year for 24 months. In other words, it's legal for the company to contribute money and then have the money revert back to the company after 24 months.

I don't know what plans Walgreens offers, but if they offered a health insurance plan that was also HCSO-compliant and your brother declined that plan, it may be the case that Walgreens fulfilled their HCSO requirements without needing to also offer your brother an HRA.
posted by saeculorum at 3:45 PM on June 20, 2014

Well, the MRA I received wasn't through Walgreens - Walgreens contributed to the city option, which is run by SF and rolls over year to year. I was under the impression that my brother would also be eligible for this plan, because he already receives health care under my father. I believe Walgreens contributes to the city option if you have insurance coverage under a spouse or family member, because that's how it worked for me. The difference is, I received monthly contributions into the city option and for some reason my brother didn't.
posted by Qberting at 4:06 PM on June 20, 2014

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