Refusing to Work Because Conditions are Dangerous
When you believe working conditions are unsafe or
unhealthful, you should call your employer's attention to the problem.
If your employer does not correct the hazard or disagrees with you about
the extent of the hazard, you also may file a complaint with OSHA.
Refusing to do a job because of potentially unsafe workplace conditions is not ordinarily an employee right under the OSH Act.
(Your union contract or state law may, however, give you this right,
but OSHA cannot enforce it.) Refusing to work may result in disciplinary
action by the employer. However, employees do have the right to refuse
to do a job if they believe in good faith that they are exposed to an imminent danger.
"Good faith" means that even if an imminent danger is not found to
exist, the worker had reasonable grounds to believe that it did exist.
But, as a general rule, you do not have the right to walk off the job
because of unsafe conditions. If you do and your employer fires or
disciplines you, OSHA may not be able to protect you. So, stay on the
job until the problem can be resolved.
Your right to refuse to do a task is protected if all of the following conditions are met:
- Where possible, you have asked the employer to eliminate the danger, and the employer failed to do so; and
- You refused to work in "good faith." This means that you must
genuinely believe that an imminent danger exists. Your refusal cannot
be a disguised attempt to harass your employer or disrupt business; and
- A reasonable person would agree that there is a real danger of death or serious injury; and
- There isn't enough time, due to the urgency of the hazard, to get it corrected through regular enforcement channels, such as requesting an OSHA inspection.
When all of these conditions are met, you take the following steps:
- Ask your employer to correct the hazard;
- Ask your employer for other work;
- Tell your employer that you won't perform the work unless and until the hazard is corrected; and
- Remain at the worksite until ordered to leave by your employer.
If your employer discriminates against you for refusing to perform the dangerous work, contact OSHA immediately.
7 Most Important Things the New Health Care Bill Will Affect!
1) You Must Have Medical Insurance
Under the new law you will have to purchase health insurance or risk being fined. If your employer does not offer health insurance or if you do not earn enough to purchase, you may get assistance from the government. Find if you qualify for discounted health insurance. Additional 33 Million will be insured under this bill.Find Low Cost Medical Insurance
2) More Health Care Jobs
Looking for a job? This is your chance. With new Bill, there will be additional 33 Million insured. There is going to be huge demand for medical professional across the nation. You can get a degree in few months. So you be ready soon if you are thinking of changing your career. Colleges offer consultation for students who are interested at no cost. Find Your Local College
3) Kids can stay on your policy until 26 years
Currently, many insurance companies do not allow adult children to remain on their parents' plan once they reach 19. Companies cannot do that any more.
4) Insurance cannot drop you
Your health insurance company will no longer be allowed to cancel your policy if you get sick.
5) You Can't be Denied Insurance
Starting this year your child (or children) cannot be denied coverage simply because they have a pre-existing health condition. If you don't have insurance, find one today.
6) No maximum limit on coverage
Companies will be barred from instituting caps on coverage when your costs for treatments goes up due to sickness.
7) No waiting time
If you currently have pre-existing conditions that have prevented you from being able to qualify for health insurance for at least six months you will have coverage options. Check Here If you Qualify
FOCUS on Health Reform
THE HENRY J. KAISER FAMILY FOUNDATION www.kff.org
Headquarters: 2400 Sand Hill Road Menlo Park, CA 94025 650.854.9400 Fax: 650.854.4800
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW Washington, DC 20005 202.347.5270 Fax: 202.347.5274
The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible information, research and analysis on health issues.
The Patient Protection and Affordable Care Act signed into law in March 2010 requires private insurers that offer dependent coverage to children to allow young adults up to age 26 to remain on their parent’s insurance plan.
Extending dependent coverage has received a great deal of attention because it is one of the first provisions that goes into effect and because it increases the availability of health insurance to a population that currently
has a high uninsured rate. This summary provides responses to basic questions about the dependent coverage expansion and explains how the new law will interact with current state laws.
Who is eligible for the extension of dependent coverage?
The health reform law will allow qualifying young adults whose parents have private group and non-group health coverage to remain on their parent’s insurance policy up to age 26. Both married and unmarried young adults can qualify for the dependent coverage extension. The law also specifies that young adults can only qualify for dependent coverage through group health plans that were in place prior to the dependent coverage provision
taking effect if they are not eligible for another employer-sponsored insurance plan. The Secretary of Health and Human Services will issue regulations that will further define who will be considered a dependent eligible to remain on a parent’s health insurance policy and will answer the following questions:
• Can working young adults qualify?
• Do qualifying young adults have to live in the same state as the parent whose insurer will be providing the
coverage?
• Are young adults required to be students in order to qualify?
• Can married young adults qualify for the extension of dependent coverage through their spouse’s parent’s
plan?
When will young adults be able to take advantage of this coverage and what should they do if
they want to sign up?
The dependent coverage extension takes effect on September 23, 2010, six months after the health reform law was enacted. At that time, when insurance plans start a new plan year, they will have to abide by the new dependent coverage rules. The law stipulates that the dependent coverage extension is effective for new plan years beginning on or after September 23, 2010. However, some insurers have said that they will begin to make the extension of dependent coverage available prior to September 2010 for individuals who would otherwise lose
coverage.
Regulations that will be issued before the provision takes effect in September 2010 will provide further clarification regarding enrolling in extended dependent coverage. Parents can also talk to their human resources department or to their insurer for information about how to sign their child up for their insurance plan. Young adults who are looking for coverage before the dependent coverage provision takes effect may be able to remain on a parent’s plan through COBRA if they aged off a parent’s coverage within the last 60 days. Otherwise, they
may be able to buy coverage in the non-group market or may qualify for the new temporary high-risk pool created
by the health reform law if they have a pre-existing condition and have been uninsured for six months or more.
FOCUS on Health Reform FOCUS on Health Reform
THE HENRY J. KAISER FAMILY FOUNDATION www.kff.org
Headquarters: 2400 Sand Hill Road Menlo Park, CA 94025 650.854.9400 Fax: 650.854.4800
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW Washington, DC 20005 202.347.5270 Fax: 202.347.5274
The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing
and communicating the best possible information, research and analysis on health issues.
This publication (#8065) is available on the Kaiser Family Foundation’s website at www.kff.org.
How much will it cost for young adults to remain on a parent’s insurance?
The health reform law does not specify how a parent’s premium costs will be affected by having a young adult remain on the parent’s policy. Currently, employers that provide health coverage to employees determine the share of the premium paid by employees. Premium costs vary based on who is covered by the plan and an employee’s share of the premium may increase when additional individuals are added to a family policy.
Employers can vary the amount they contribute to dependent coverage, and it is unclear how employers will respond to this extension of coverage for dependents. Most young adults are relatively healthy, which may cause
the additional premiums for covering a young adult dependent to be lower than adding a spouse or another older adult to an employee’s health plan.
Do states currently allow young adults to remain on their parent’s health insurance plan?
Approximately 25 states have extended the age that young adults can remain on their parent’s health insurance plan, but policies regarding who is eligible for this coverage vary widely. Most of the states that have these policies in place extend coverage to young adults up to age 25, but some states extend dependent coverage to age 24 or 26 and New Jersey extends the dependent age to 30. Some states mandate that eligible young adults be
unmarried, be students, or be living in the same state as their parent with private coverage. State requirements to extend coverage to dependents do not apply to insurance plans that are self-funded. The federal requirements in the health reform law are designed to apply to these self-funded plans, along with other private insurance plans.
The new federal health reform law will be applied to all states, including those who have already expanded dependent coverage to some young adults. Young adults in states with narrower eligibility criteria than the federal law will now be able to take advantage of the federal law. States that have broader eligibility for dependent coverage will be able to continue their current state policies, which will enable more young adults to qualify for
dependent coverage in those states than would qualify under the federal law.
What happens to young adults with a pre-existing condition who rejoin a parent’s
insurance plan?
The health reform legislation does not provide specific information about how pre-existing conditions will be treated by insurers when a young adult rejoins a parent’s plan as a dependent prior to 2014. Before health reform passed, when individuals joined an employer-sponsored insurance plan and had been uninsured for 63 days or
more, they could be subject to a temporary pre-existing condition exclusion.
In the non-group market, the rules for uninsured individuals joining policies vary by state and in many states it is easier for insurers to classify a condition as pre-existing in the non-group market. It is unclear if these rules will apply to young adults rejoining a parent’s plan or if new regulations will be issued.
For more information about the Patient Protection and Affordable Care Act, see the summary of the new health
reform law at http://www.kff.org/healthreform/8061.cfm.
Last modified: April 20, 2010
April 2010
EXPLAINING HEALTH CARE REFORM:
Questions About the Extension of Dependent Coverage to Age 26
FOCUS on Health Reform
The Patient Protection and Affordable Care Act, signed by President Obama on March 23, 2010, creates a temporary national high-risk pool to provide health coverage to people with pre-existing medical conditions who have been uninsured for six months. This high-risk pool will be implemented quickly and will provide temporary coverage until the broader coverage provisions take effect in January 2014. The health reform law establishes basic requirements for the high-risk pool program that will be implemented ninety days after enactment, on
June 21, 2010 (Table 1). On April 2, 2010, U.S. Department of Health and Human Services Secretary Kathleen Sebelius wrote to states to explain the basic requirements of the temporary high-risk pool and to solicit their interest in operating the coverage program. This summary provides responses to basic questions regarding the
temporary high-risk pool.
Table 1. High-Risk Pool Provisions under the Health Reform Law
BASIC QUESTIONS
Who is eligible for coverage through the temporary high-risk pool?
U.S. citizens and legal residents who have a pre-existing medical condition and have not had creditable health coverage for the previous six months are eligible for coverage.
What benefits will high-risk pool enrollees receive?
The Secretary of the U.S. Department of Health and Human Services (HHS) is considering establishing a minimum set of benefits that must be included in the health plans. The health plans will be required to cover pre-existing medical conditions upon enrollment. The high-risk pool programs must cover at least 65% of the health care costs for a standard population.
How much will high-risk pool health coverage cost?
The premium cost for high-risk pool coverage will be established for a standard population in the non-group market and will not be based on the health status of enrollees. Premiums will be allowed to vary by age (by a 4 to 1 ratio), geographic area, family composition, and tobacco use. Health plans must cover 65% of health care costs for a standard population and yearly out-of-pocket costs will be limited to $5,950 for individuals and $11,900 for
families, excluding premiums.
How will the high-risk pool be funded and administered?
The health reform law allocates $5 billion to administer the national high-risk pool. This funding will go toward health care claims and administrative costs that exceed the premiums collected for the high-risk pool.
April 2010
EXPLAINING HEALTH CARE REFORM:
Questions About the Temporary High-Risk Pool
Health Reform Law
Eligibility
Individuals who have a pre-existing medical condition and have not had creditable coverage for the previous six months.
Benefits
The Secretary of HHS will determine the minimum benefits that must be included and plans must cover at least 65% of health care costs.
Premiums and Cost-Sharing
Set premiums as if for a standard population and not for a population with a higher health risk.
Allow premiums to vary by age (4:1), geographic area, family composition, and tobacco use. Limit
out-of-pocket spending to $5,950 for individuals and $11,900 for families, excluding premiums. Funding $5 billion
Timeline
Effective 90 days after the bill is enacted (June 21, 2010). Terminates on January 1, 2014 when the American Health Benefit Exchanges are established.
On April 2, 2010, U.S. Department of Health and Human Services Secretary Kathleen Sebelius issued a letter that gives states the following options for operating the temporary high-risk pool:
(1) Operate a new high-risk pool
alongside an existing state high-risk pool;
(2) Establish a new high-risk pool if the state does not currently have
(3) Build upon other existing coverage programs designed to cover high-risk individuals;
(4) Contract with current HIPAA insurance carriers or insurers of last resort to provide subsidized coverage; or
(5) Do nothing, in which case the U.S. Department of Health and Human Services would carry out the coverage program in the state.
The Secretary’s letter asked states to submit a letter of intent regarding which option they will pursue by April 30,2010.
When does the high-risk pool go into effect?
The temporary national high-risk pool goes into effect in June 2010, ninety days following enactment of the health reform law. The high-risk pool will terminate on January 1, 2014 when the state-based American Health Benefit
Exchanges are established and other insurance market reforms go into effect, providing new coverage options for people with pre-existing health conditions.
Given that this is a temporary form of coverage, what happens to people when the high-risk
pool terminates in 2014?
When the temporary national high-risk pool terminates on January 1, 2014, high-risk pool enrollees will transition into receiving health coverage through the state-based American Health Benefit Exchanges. Procedures will be developed to ensure that there are no lapses in coverage. Individuals without employer health coverage and small
businesses with up to 100 employees will be able to purchase coverage through the Exchanges. Premium and cost-sharing subsidies will be available for individuals with incomes between $14,404 - $57,616 and for families
of four with incomes between $29,327 - $88,200. People will also be able to choose to purchase coverage in the individual market. As of 2014, insurers will not be able to deny people coverage or charge higher premiums based on health status.
How many high-risk pools currently exist in the United States and what will happen to
enrollees?
Currently, 34 states operate high-risk pools that provide health coverage to nearly 200,000 individuals. State high-risk pools share a common structure and some similarities but differ by state in many ways including eligibility, benefit design, pre-existing condition exclusions, premium costs and cost-sharing, and administration, among other areas.
People who currently obtain health coverage through a state high-risk pool will maintain their current coverage. In 2014, these individuals will likely transition into the state-based American Health Benefit Exchanges. Given that the Exchanges would prohibit people from being denied coverage or charged more based on health status and would limit cost-sharing, current state high-risk pool enrollees may receive more affordable coverage in the
Exchanges than they currently have in the high-risk pool. For more information about the Patient Protection and Affordable Care Act, see the summary of the new health
reform law at http://www.kff.org/healthreform/8061.cfm. For more information about current state high-risk
pools see “State High-Risk Pools: An Overview” at http://www.kff.org/uninsured/8041.cfm. For more information
about Secretary Sebelius’ April 2nd letter see: http://www.dhhs.gov/news/press/2010pres/04/20100402b.html.
Last modified: April 20, 2010FOCUS on Health Reform FOCUS on Health Reform
STABLE COST • SECURE CHOICES • QUALITY CARE
How Health Insurance Reform Will Help Your Family
Lower Costs for American Families
Preventive Care for Better Health and Lower Costs:
Prevents insurance companies from charging you for preventive care so illness and disease can be prevented instead of just treated when it’s too late and costs more.
Insurance Industry Reforms that Save You Money:
Puts a cap on what insurance companies can force you to pay in out of pocket expenses and
deductibles. Eliminates yearly and life-time limits on how much insurance companies cover if you get sick.
Greater Choices for American Families One-Stop Shopping – Putting Families in Charge:
With the new health insurance exchange you can easily compare insurance plans, prices and
performance so you can decide which quality affordable insurance option is right for you.
Insurance Security:
Health insurance reform will ensure that you and your family always have guaranteed choices of quality, affordable health insurance whether you lose your job, switch jobs, move or get sick. With a competitive public insurance option, you will also benefit from increased competition that holds insurance companies accountable.
Quality, Affordable Health Care for all Americans Ending Insurance Company Discrimination:
Health insurance reform will prevent insurance companies from denying you health insurance
because of a pre-existing health condition and it will prevent them from dropping your coverage if you get sick or charging you more because of your health of gender.
Tax Credits and Premium Assistance for Families and their Employers:
Health insurance reform provides credits and assistance to working families to make sure they can afford quality coverage and to small businesses so they can offer competitive, affordable rates to their employees.
W W W . W H I T E H O U S E . G O V
The Main Street Alliance of Washington – www.mainstreetalliance.org/washington – (206) 805-6674
Small Businesses and the Final Health
Reform Package: 5 Need-to-Know Points
March 23, 2010
Now that the health reform package has passed, it’s time to evaluate what’s in the bill and what it means for the
small business community. Here are 5 need-to-know points:
1. SMALL BUSINESS TAX CREDITS:
The bill includes tax credits that take effect immediately to help 3.6 million small businesses afford health coverage.
An estimated 3.6 million small businesses will qualify in 2010. The credits (for up to 35 percent of an employer’s
contribution to health care in 2010-2013 and up to 50 percent starting in 2014) will provide an estimated $40 billion
in assistance to small businesses over 10 years to make coverage affordable. The credits are offered on a sliding
scale to businesses with 25 or fewer employees and average wages under $50,000 (the maximum credit goes to
businesses with 10 or fewer employees and average wages under $25,000).
2. EMPLOYER CONTRIBUTIONS:
Businesses with fewer than 50 full-time employees (or full-time equivalents) will be exempt from any requirements
to contribute toward employees’ health coverage. An estimated 96 percent of all firms in America have fewer than
50 employees and would be exempt. Of those businesses with more than 50 employees, another 96 percent
already offer health coverage. So, provisions to establish a level playing field starting in 2014 by requiring larger
employers (more than 50 full-time employees) who do not offer coverage and whose workers receive tax credits in
the exchanges to pay a fee will impact only a tiny fraction of employers.
3. ENDING INSURANCE DISCRIMINATION:
The final package prohibits insurance companies from denying coverage for pre-existing conditions, ends premium
discrimination based on gender and health status, and eliminates lifetime and annual limits on coverage that
threaten to bankrupt small business owners and employees. It also strengthens oversight of insurance premium
increases, protecting small businesses from arbitrary and unreasonable rate hikes.
4. HEALTH INSURANCE EXCHANGES:
The bill will give small businesses better choices by setting up new, simplified marketplaces called insurance exchanges. Small businesses with up to 100 employees will be able to participate in the exchanges and pool together for coverage. Once operational in 2014, the exchanges will maximize small business bargaining power to
negotiate better coverage, promote transparency and informed choice, and increase competition to lower rates.
5. BENEFITS FOR SELF-EMPLOYED BUSINESS OWNERS:
An estimated 21 million Americans are self-employed. The self-employed will be able to shop for health coverage in the insurance exchanges and benefit from the increased transparency and competition there. Experts have projected a savings of close to 20 percent for self-employed people in the exchange. Sliding scale premium affordability credits and caps on out-of-pocket costs will provide additional assistance and security for self employed
people and their families.
Health Reform for American Families
The Affordable Care Act Gives
American Families Greater Control Over Their Own Health Care.
Lower Costs for American Families
Insurance Industry Reforms that Save Families Money
o This year, eliminates all lifetime limits on how much insurance companies cover if beneficiaries get sick and bans insurance companies from dropping people from coverage when they get sick. The Act also restricts the use of annual limits in all new plans and existing employer plans this year, until 2014 when all annual limits for these plans are prohibited.
o Going forward, plans in the new Health Insurance Exchanges and all new plans will have a cap on what insurance companies can require beneficiaries to pay in out-of-pocket expenses, such as copays and deductibles.
Financial Relief for Working Families
o Provides tax credits to working families to make sure they can afford quality coverage.
o This year, provides tax credits to small businesses so they can offer competitive, affordable health care to their employees.
o Supports States starting in plan year 2011 in requiring health insurance companies to submit justification for requested premium increases, and insurance companies with excessive or unjustified premium exchanges may not be able to participate in the new Exchanges.
o Cracks down on excessive insurance overhead starting in 2011 by applying standards to how much insurance companies can spend on non-medical costs, such as bureaucracy, executive salaries, and marketing, and provides consumers a rebate if non-medical costs are too high.
Ending the “Hidden” Tax on American Families
o Covers more Americans to reduce cost-shifting that increases premiums for insured Americans. To pay for the medical costs of the uninsured, medical providers pass these costs on to private insurers, which pass them on to families, increasing family premiums by, on average, about $1,000 a year. Greater Choices for American Families
More Affordable Choices and Competition
o Creates state-based health insurance Exchanges to provide families with the same private insurance choices that the President and Members of Congress will have, including multi-state plans to foster competition and increase consumer choice.
One-Stop Shopping to Put Families in Charge
o Provides standardized, easy-to-understand information through the Exchange on different health insurance plans offered in a geographic region so families can easily compare prices, benefits, and performance of health plans to decide which quality affordable option is right for them.
Extends Dependent Coverage
o This year, allows young adults to stay on their parents’ health care plan until age 26. (This applies to all plans in the individual market, all new employer plans, and existing employer plans if the young adult is not eligible for employer coverage on his or her own. Beginning in 2014, children up to age 26 can stay on their parent’s employer plan even if they have an offer of coverage through their employer.) This will help cover the one in three young adults who are uninsured
Ends Insurance Company Discrimination
o This year, prohibits insurance companies from denying children coverage based on pre-existing conditions. Going forward, the Act will prohibit insurance companies from denying coverage to all individuals. The Act will also end discrimination that charges beneficiaries more if they are sick and limit the amount an insurance company can increase an individual’s premium simply due totheir age.
o This year, provides access to affordable insurance for uninsured Americans with pre-existing
conditions through a temporary subsidized high-risk pool, which will help protect them from
medical bankruptcy. This high risk pool is a stop-gap measure that will serve as a bridge to a
reformed health insurance marketplace.
Insurance Security
o Ensures that families always have guaranteed choices of quality, affordable health insurance whether they lose their job, switch jobs, move or get sick, through the creation of Exchanges.
Independent Appeals Process
o This year, ensures consumers in new plans have access to a straightforward and independent appeals process to appeal decisions by their health insurance plan.
Quality, Affordable Health Care for all Americans
Preventive Care for Better Health
o This year, requires new plans to cover prevention and wellness benefits at no charge to American families by exempting these benefits from deductibles and other cost-sharing requirements.
o Invests in prevention and public health to encourage innovations in health care that prevent illness and disease before they require more costly treatment.
Increases the Number of Primary Care Practitioners
o Provides new investments to increase the number of primary care practitioners, including doctors, nurses, nurse practitioners, and physician assistants.
How Seniors Benefit from the New Health Care Law
Reduces drug costs by phasing out doughnut hole – Provides a $250 rebate in 2010 for seniors who fall in the doughnut hole. Beginning in 2011 seniors will receive a 50% percent discount on their prescription drugs when they fall in the doughnut hole and by 2020 the doughnut hole will be completely eliminated.
Covers Preventive Services – In 2011, seniors in Medicare will receive free annual check-ups. In addition, the law eliminates co-payments or cost-sharing for mammograms, colonoscopies and other preventive screenings.
Supports Early Retiree Coverage – Provides financial assistance to employer health plans that cover early retirees, bringing down health costs and premiums by as much as $1,200 per family, per year for some plans.
Encourages Doctors to coordinate care and improve quality – Creates incentives for providers to work together to better serve patients and reduce wasteful care like repeated tests.
Removes Obstacles to Changing Part D Plan – Allows Part D enrollees to make a mid-year change in their enrollment if their current plan unexpectedly makes a change that result in higher cost for a drug they take.
Significantly Lowers Cost for Struggling Seniors –Expands the Medicare Part D low-income subsidy, which will dramatically help struggling seniors afford their health care costs.
Enacts CLASS Act creating a new option for long-term assistance for seniors and the disabled – Creates a new, voluntary, self-insured insurance program to help families pay for the costs of long-term supports and services if a loved one develops a disability. Also, creates new options for states to provide home and community based services in Medicaid, enabling more people with disabilities to access long-term services in the setting they choose.
Enacts the Elder Justice Act – Authorizes new criminal background checks on long-term care workers who have access to residents or patients and requires greater transparency of nursing homes, including public disclosure of the entities that own, govern, operate and profit from nursing homes. The law also requires better information about the quality of nursing care and improves complaint process.
Brings Savings to Medicare - By eliminating wasteful overpayments to Medicare Advantage plans and by creating new incentives for coordinated, high quality care across the health care spectrum, the law extends the solvency of the Medicare Trust Fund by 9 years and improves Medicare for generations to come.
[March 2010]
Provisions Effective Date
$250 Medicare Rebate for
Individuals in Doughnut Hole 2010
Subsidies to Employers who
Provide Coverage to Early
Retirees (55 to 64) 2010
50 % Part D Drug Discount
for those in Doughnut Hole 2011
Annual Free Checkups 2011
No Co-payments for
Preventive Screenings 2011
Increases Medicaid Payments
for Primary Care Physicians 2013
Doughnut Hole Eliminated 2020