Help Wanted: Cheated out of retiree benefits?

When an employee is forced into retirement, what

When an employee is forced into retirement, what health care options are available when the package cuts out or restricts coverage for dependents? (Credit: iStock)

Carrie Mason-Draffen

Newsday columnist Carrie Mason Draffen Carrie Mason-Draffen

Mason-Draffen, a business reporter, writes a column about workplace issues.

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DEAR CARRIE: I worked for a Fortune 500 company for 32 years. When my sales position was cut, I was offered a buyout package, which I reluctantly accepted. It bridged me to retirement age so that I qualified for the company's retirement benefits. Now the time has come for me to make my elections, and in the package I just received the benefits are dramatically different from what an active employee is entitled to. They include no well-care or preventive-care coverage; most importantly, no dependents over the age of 23 are covered. Doesn't the Obama health care law require insurers to cover dependent children up to age 26? Can you explain? Also, what options does an unemployed, graduate student then have? I looked into Healthy NY, and you must have worked in the past 12 months. All this seems so unfair to our young people. -- Unsure of Insurance

DEAR UNSURE: The key words in your letter are "retirement benefits," because retirement plans can legally be more restrictive under the president's Patient Protection and Affordable Care Act, a local expert said.

"Generally, retiree-only plans are exempt from many of the benefit mandates under . . . PPACA, including the requirement that group health-plan coverage must be available for adult children up to age 26," said Gregory Feigenbaum, vice president of business development for the Long Island Employee Benefits Group Ltd., a Hauppauge benefits-services provider.

On a more detailed note, that exemption applies to a group health plan and coverage offered in connection with it if at the beginning of each plan year, the program has fewer than two participants who are current employees, Feigenbaum said. In other words, virtually all the people covered under the plan have to be retirees.

Feigenbaum said that retirement plans are also exempt from the New York State insurance law requiring companies that aren't self-insured to cover dependents up to age 29.

As for your unemployed graduate-school dependent, you're right about the Healthy NY requirements of current employment or some work in the past 12 months. But your dependent has other options for more affordable coverage, albeit limited ones. For example, several insurers offer limited health plans to individuals at more affordable premiums, Feigenbaum said. So he or she would have to shop around for the best rate. Other options are the "standardized individual direct-payment policies," which all HMOs in New York State offer, Feigenbaum said.

For more information about these individual plans and others for the unemployed, go to newsday.com/business.

Beginning in 2014, the unemployed will have another benefits option. That's when the new federal health law will require states to implement health insurance exchanges that will provide jobless individuals with subsidized health insurance coverage, Feigenbaum said.

DEAR CARRIE: I work the overnight shift and put sodas in the refrigerator, but someone often steals them. I have asked my boss to put a lock on the refrigerator. He has refused and had told me to keep the sodas in my locker. But if I do that, they won't be cold when I need them. Shouldn't he do something? -- Fizzing Over Soda

DEAR FIZZING: This probably rates as one of the most unusual questions Help Wanted has ever received. Labor laws don't cover this problem, so they won't help. But a thermal bag and cold packs might. I can understand the boss' point of view: Putting a lock on the fridge creates a problem of access.

And who knows? The soda thief could wind up with a key, and then you are back to square one. I think the solution is cold packs and a thermal bag. They will keep your beverages cold for hours in the security of your locker.

For more on exemptions for retiree-only plans under health-care reform go to http://bit.ly/MpQlL6. For more on health-insurance options for the unemployed go to http://bit.ly/Ng24KA.

Call Carrie Mason-Draffen with workplace questions at 631-843-2791, or email her at carrie.mason-draffen@newsday.com. Your name and number won't be published. Not all questions can be answered; some may be edited for length and clarity.