What You Need to Know About Health Care Rights for Georgia Employees

The law requires employers to provide their employees with medical benefits and a safe work environment. Here’s everything you need to know about health care rights for employees in Georgia.

Georgia employees have limited rights regarding health insurance provided by employers. Federal and state laws allow employees to take medical leave under specific circumstances but do not provide any other type of leave. Georgia employees have a right to safe working conditions, which entitles them to claim worker’s compensation in case of a workplace accident.

Health Insurance for Georgia Employees

Large Employers vs. Small Employers

No federal or Georgia law formally requires employers to provide their employees with health insurance benefits. The law only provides incentives that apply differently to large and small employers. Federal and Georgia laws identify a large employer as a company that employs at least 50 full-time workers, whereas small employers have less than 50 full-time employees.

The federal Affordable Care Act (ACA), known as Obamacare, incentivizes large employers to provide insurance coverage. They must either offer health insurance to their employees or pay a heavy fine to the IRS. However, employees cannot claim health insurance from their employer under the ACA, as employers may simply choose to pay the fine to avoid the obligation to provide insurance.

Related: Georgia Minimum Wage FAQs

Small employers are not subject to ACA restrictions. Like large employers, they don’t have to provide health insurance to their employees, but they often do in practice.

Mandated Benefits

Employers who provide group health insurance via contract with insurance providers must comply with federal and state insurance laws. In Georgia, insurance policies must cover state-required benefits, which the law terms “mandated benefits.”

These benefits include, among others:
· maternity care (prenatal and postnatal);
· primary care doctor visits;
· hospital services;
· urgent care and emergency room services;
· prescription drugs;
· cancer chemotherapy treatment and clinical trials;
· diabetes treatment; etc.

Coverage Continuation

The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) grants employees who lose their health benefits an extension of their health insurance coverage for 18 to 38 months. Employees are eligible for coverage continuation under specific circumstances such as job loss, reduced working hours, death, divorce, or transition between jobs. This law prevents employees from instantly losing their company-provided health benefits if their employment situation changes.

While the federal COBRA only applies to companies with at least 20 employees, Georgia law provides a mini-COBRA covering employers with two to 19 employees. Under the Official Code of Georgia Annotated (O.C.G.A.) §33-24-21.1, employees may qualify for coverage extension if they had at least six months of continuous coverage before termination of health benefits. Coverage will continue through the end of the remaining month on the policy, plus three additional months.

Exception for Self-Insured Employers

Mandated benefits and coverage continuation laws don’t apply to self-insured employers. Self-insured employers directly provide health care benefits to their employees without contracting with an insurance provider. In this case, employers don’t have to provide state-required benefits or coverage continuation.

Medical Leave and Other Leaves for Georgia Employees

1. Medical Leave

Georgia law doesn’t require employers to provide unpaid or paid sick leave. However, certain employers must comply with the federal Family and Medical Leave Act (FMLA), which allows eligible employees to take up to 12 weeks of unpaid leave per year with a right to reinstatement.

Related: Tipped Employee Rights in Georgia

FMLA only applies to companies with at least 50 employees in the previous or current year. Under the FMLA, employees are eligible for family and medical leave if they meet the following conditions:
a. they have worked for the company for at least a year;
b. they worked at least 1,250 hours during the previous year;
c. they need family or medical leave for:
i. recovery from a serious health condition;
ii. care for a family member suffering from a serious health condition;
iii. bonding with a new child;
iv. managing exigencies due to a family member’s military service;
v. care for a family member with an injury incurred during active duty in the military.

Georgia law establishes certain requirements for companies who choose to provide sick leave. The Georgia Family Care Act allows employees to use five days of sick leave per year to take care of an ill family member if they meet the following conditions:
a. their company has at least 25 employees;
b. their company provides sick leave.

However, the Georgia Family Care Act doesn’t impose any penalty for companies that fail to comply with its provisions.

2. Other Leaves

Georgia law doesn’t require employers to provide their employees with paid or unpaid vacation leave. However, employers who choose to include vacation leave in contracts must comply with contractual terms and effectively provide vacation leave to employees.

In Georgia, private employers do not have to provide their employees with holiday leave for official state holidays.

Georgia law doesn’t provide paid jury duty leave. However, an employer may not penalize an employee for taking leave to attend jury duty.

Employee Safety in Georgia

Right to a Safe Work Environment

Under federal and state law, employees have a right to work in a safe environment. The federal Occupational Safety and Health Act (OSH Act) regulates safe working conditions in the private sector. The Occupational Safety and Health Administration (OSHA) enforces its provisions.

The OSH Act requires employers to:
· make sure the workplace is compliant with OSH Act standards;
· warn employees of potential hazards in the workplace;
· post all posters required by the OSHA, including a poster informing employees about their rights;
· inform employees about the company’s health and safety rules;
· report serious work-related injuries; etc.

In Georgia, the Public Employee Hazardous Chemical Protection and Right-to-Know Act (PEHCPA) protects the right to safe working conditions in the public sector.

What To Do in Case of Unsafe Working Conditions

Employees working under unsafe conditions may file a confidential complaint with the OSHA via two methods:
· online by filling out the OSHA Online Complaint Form;
· via fax, email, or mail by filling out the OSHA Complaint Form and sending it to a local OSHA office.

Employees may also obtain worker’s compensation if they suffer from a workplace incident. They must:
a. report the injury to their employer as soon as possible;
b. file a claim with the Georgia State Board of Workers’ Compensation by filling out Form WC-14.

Injured workers will receive full compensation for their injuries and losses, including missing pay and medical expenses such as:
· emergency room costs;
· prescriptions;
· diagnostic tests;
· travel expenses to medical visits.

Suing Employers for Workplace Accidents in Georgia

Employees cannot sue their employer for a workplace accident, as worker’s compensation already provides monetary relief to victims.

Georgia law establishes an exception to this rule. Employees may sue their employer despite worker’s compensation only if they show gross negligence and disregard for employee safety. In that case, plaintiffs may recover compensatory and punitive damages.

FAQs About Health Care Rights for Georgia Employees

When can I demand that my employer provides health insurance in Georgia?

Generally, you cannot demand company-provided health insurance because no federal or Georgia law forces employers to provide it. However, federal law establishes some exceptions.

Under the federal Health Insurance Portability & Accountability Act (HIPAA), employers providing health insurance must offer coverage to similarly situated employees. This provision means that an employer cannot offer insurance to Employee A but deny insurance to Employee B if they are similarly situated.

Under Title VII of the Civil Rights Act, employers cannot discriminate in employment based on race, color, gender, national origin, age, disability, pregnancy, religion, or genetic information. This provision includes benefits, meaning an employer cannot offer health insurance only to white employees.

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If you or a loved one would like to learn more about Health Care Rights for Georgia Employees, get your free consultation with one of our Employment Attorneys in Georgia today!