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3 Reasons Why Employers Have to Offer Health Insurance and Work Comp

The Affordable Care Act raises new questions and challenges for employers in many areaswork comp of benefits, with some re-examining whether they should make health insurance available to all their employees. Recently, one employer asked HNI the following question:

“If I have to offer all of my employees a health plan, why do I have to pay for workers' compensation insurance, too?”

There are three big reasons why employers should offer work comp alongside health insurance.

1.) Work Comp is the Law

Most states require employers to have workers' compensation insurance. In some states, whether work comp is required depends on the number of employees. The U.S. Department of Labor provides a listing of links to states' work comp divisionsTo avoid legal action, employers must obey work comp regs.

Affordable health insurance is also required by the Affordable Care Act for businesses with over 50 full time employees. You may otherwise get penalized for not providing insurance if you meet that requirement. You are not required by law, however, to provide health insurance to under 50 full time employees, but it is still recommended.

2.) Work Comp and Health Insurance Protects Employers From Being Sued

Here's an [abbreviated] history of workers' compensation:

About 100 years ago, the first law was put into place to protect injured employees. Today it is commonly referred to as workers' compensation. Before this law, employees who were hurt on the job needed to file tort actions against (in other words, sue) their employers. It was the employee’s responsibility to prove the employer’s negligence or liability. Damages were not statutory and punitive damages could be awarded.

The modern system of workers' compensation is no-fault and provides injured workers with medical treatment to regain pre-injury condition and indemnity benefits to cover both lost wages and permanent impairment. Work comp is the sole remedy for employees and limits them to statutory benefits and does not provide for punitive damages. In other words, because of work comp, employees can't sue employers for workplace injuries.

If you also are providing health insurance as a business with over 50 full time employees, then you are avoiding potential financial penalties.

3.) Work Comp Covers More than Medical Expenses

Workers' compensation is designed to cover costs associated with workplace injuries, including medical expenses and lost wages. Health insurance covers more medical expenses, including those that don't have anything to do with employment, but it does not cover lost wages due to mishaps.

From a health insurance perspective, an employer's policy includes the right to subrogate. When a work-related injury occurs, the health insurer subrogates a third party (workers' compensation insurance) for the medical expense paid out on the employer's behalf. The employer is not held liable or negligent because workers' compensation is no-fault. (Remember the No. 2 reason above?)

Because workers' compensation exists, the employer's personal health insurance is not responsible for paying for work-related injuries. Subrogation allows this system to work.

Bottom line, workers' compensation never will be abolished. This being the case, employers need both health insurance and workers' compensation.


Related Posts:

How Workers' Compensation Subrogation Works

Reporting Workers Compensation Claims: 5 Reasons to File 'Em Fast!

Workers Compensation Trends: Where We’ve Been and Where We’re Headed

Top 10 Worker's Compensation Claim Handling Mistakes

Photo by Shermeee via Flickr

Topics: HR / Employee Benefits