Our New Jersey disability lawyers help many people with their ERISA cases, including some involving issues with the amendments to the law. Both the original law and the amendments that have come since its passage in 1974 give you numerous important rights. When you understand the law and its amendments, you can better assess whether you have been denied coverage that you should have received. The following is a brief outline of the amendments to ERISA that are important to you, as noted by your disability lawyers NJ residents trust.
COBRA and Your Rights
One issue that people used to have was that when they lost their jobs, they also immediately lost their health insurance coverage. The Consolidated Omnibus Reconciliation Budget Act of 1985 sought to rectify that problem. It provides that you are able to continue your medical insurance that you had through your job after you have been terminated. There are exceptions allowed if the reason for your termination was your own gross misconduct or if you resigned voluntarily. COBRA coverage is also available to spouses and dependent children who had insurance through the employees’ plans as well. In order to qualify for COBRA coverage, you must have experienced an event such as a divorce from your spouse that had insurance covering you or a job termination. If you qualify as an employee, you can extend your coverage for up to 18 months after your job ends. If you are a spouse or a dependent child, then your coverage can be extended for up to 36 months, allowing you time to secure alternate medical insurance coverage.
Before the Health Insurance Portability and Accountability Act was passed in 1996, your new insurance company after you switched companies could deny coverage for any condition for which you had received treatment in the six months prior to the start of your policy. That exclusion could last up to a year. This meant that many people went without coverage for their medical conditions for lengthy periods of time. With HIPAA, insurance companies must give you credit for coverage you held at your last job. Your former employer should have provided you with a certificate of creditable coverage that you can provide to your new employer when you sign up for insurance there.
Coverage Under the Newborns’ Act
An important act that protects the rights of both infants and their mothers is the Newborns’ and Mothers’ Health Protection Act. Passed in 1996, this amendment mandates that, as long as you have maternity coverage, your provider must pay for you to stay for 48 hours following a vaginal delivery or 96 hours following a cesarean section. While a physician can discharge you sooner than that, they cannot do so because of pressure from your insurance company.
Your Rights Under the Women’s Health and Cancer Rights Act
Many women end up needing a mastectomy due to breast cancer. A lot of them want to get reconstructive surgery following their mastectomies, and the Women’s Health and Cancer Rights Act, passed in 1998, allows you to not only do so, but it mandates that your insurance provider pay for the reconstruction if they also covered your mastectomy. The cost for both may be applied towards your annual deductible limits, per the U.S. Department of Labor.
Mental Health Parity and Addiction Equity Act
Society now recognizes that mental illness and addition deserve to be treated the same as other medical conditions. If your insurance plan offers coverage for mental health and addiction treatment, the plan is not allowed to limit the coverage any more than they do for other conditions or illnesses under the Mental Health Parity and Addiction Equity Act. While the law does not mandate that this type of coverage be offered to you, if it is offered, then your insurance provider must follow the law as outlined by this important act. If you believe that your rights under ERISA or any of its amendments have been violated, you probably need to get the help of an attorney. Our New Jersey disability lawyers will explain to you exactly what type of coverage you should have been provided. They can then contact the insurance company on your behalf to negotiate your receiving the coverage you should have been provided by your company.
Contact Disability Lawyers NJ Residents Trust
If you have questions about ERISA or any of its amendments, call the New Jersey disability lawyers of Uscher, Quiat, Uscher & Russo, P.C. at 800-797-5575.