Look who's redefining marriage now
March 8, 2020 12:32 AM Subscribe
Magic Valley NAPA franchise changes health plan to prevent same-sex spouses from receiving insurance (wayback link)
Jacinda Teeter received a letter saying she couldn't add her wife to her insurance policy because
Jacinda Teeter received a letter saying she couldn't add her wife to her insurance policy because
We recently discovered an error in the definition of a “Spouse” covered under Dyson’s 2020 Plan, as well as a need to clarify exclusions for elective abortions under the Plan. ... Dyson's Plan is self-insured, meaning benefits are paid from the Company's general assets and not from an insurance company, which allows flexibility in how coverage sand benefits are established.
Effective May 1, 2020, the Plan will define a “Spouse” entitled to coverage as a person of the opposite sex who is married to a Participant according to the law of the jurisdiction where the marriage occurred.
Also effective May 1, 2020, the Plan will exclude all elective abortions.
The article states that this doesn't apply to corporate stores, but franchises can set their own policies.
Ugh, fuck these franchise owners. If NAPA is smart, they'll find an excuse (like these franchise asshole did) and just drop them from the brand.
So disgusted.
posted by Fizz at 5:50 AM on March 8, 2020 [16 favorites]
Ugh, fuck these franchise owners. If NAPA is smart, they'll find an excuse (like these franchise asshole did) and just drop them from the brand.
So disgusted.
posted by Fizz at 5:50 AM on March 8, 2020 [16 favorites]
That's a pretty direct way for that NAPA franchise to say, "We hope your wife dies."
posted by kyrademon at 5:52 AM on March 8, 2020 [32 favorites]
posted by kyrademon at 5:52 AM on March 8, 2020 [32 favorites]
Cool. Cool cool cool. That deffo makes me feel safe when my spouse's health insurance depends on mine.
America!
posted by sciatrix at 6:36 AM on March 8, 2020 [17 favorites]
America!
posted by sciatrix at 6:36 AM on March 8, 2020 [17 favorites]
So glad private insurance exists so that *checks notes* bigoted employers can have the flexibility and ~freedom~ to uhhhh violate people's basic human rights.
posted by Ouverture at 6:50 AM on March 8, 2020 [48 favorites]
posted by Ouverture at 6:50 AM on March 8, 2020 [48 favorites]
That's a pretty direct way for that NAPA franchise to say, "We hope your wife dies."
The cruelty and the inhumanity is the point. You have to go out of your way to write the policy the way these fuckers have. And the fucked up part is that so much of this is bound in so called "religious freedom". If this is your religion, thanks but no thanks. Pretty certain Jesus would not approve of this kind of cruelty, but you do you assholes.
posted by Fizz at 7:54 AM on March 8, 2020 [22 favorites]
The cruelty and the inhumanity is the point. You have to go out of your way to write the policy the way these fuckers have. And the fucked up part is that so much of this is bound in so called "religious freedom". If this is your religion, thanks but no thanks. Pretty certain Jesus would not approve of this kind of cruelty, but you do you assholes.
posted by Fizz at 7:54 AM on March 8, 2020 [22 favorites]
This person posted to Reddit's r/legaladvice subreddit, asking for guidance.
posted by nathan_teske at 8:24 AM on March 8, 2020 [5 favorites]
posted by nathan_teske at 8:24 AM on March 8, 2020 [5 favorites]
I was going to snark a "can't wait for the 5-4 SCOTUS decision on this" but then remembered we've already been there with Hobby Lobby
posted by Heywood Mogroot III at 8:53 AM on March 8, 2020 [10 favorites]
posted by Heywood Mogroot III at 8:53 AM on March 8, 2020 [10 favorites]
Health care and health insurance in the U.S. are so screwed up. Before a small business I owned closed, and before I had to drop the group health plan because we could not afford it anymore, I remember working late one night, going over competing health insurance plans that became more expensive every year and covered less every year, and just breaking down into tears. I remember thinking, "Why am I having to make decisions that directly affect the kind of healthcare my employees will have?" You want to pick a good plan, but you also have to pick a plan your business can afford, which sometimes means you have to pick the cheapest/worst plan. When I saw the episode of The Office where Michael passes off choosing a group healthcare plan to Dwight to avoid the stress, I literally had a panic attack, reliving that moment, and had to turn it off.
It is horrible that this NAPA franchise owner is *allowed* to weaponize healthcare coverage. But even when you're trying to do the right thing for everyone, you can end up making decisions you're not proud of because of the system we have.
posted by jabah at 8:58 AM on March 8, 2020 [36 favorites]
It is horrible that this NAPA franchise owner is *allowed* to weaponize healthcare coverage. But even when you're trying to do the right thing for everyone, you can end up making decisions you're not proud of because of the system we have.
posted by jabah at 8:58 AM on March 8, 2020 [36 favorites]
I was going to reflexively say "of course this is illegal" but I'm not so sure it is clear. We have marriage equality nationally and broad protections for that, but we don't have non-discrimination in place for LGBT people nationally. Particularly not for employment. Dunno where this falls. And of course with the Republican-fucked courts every case is a roll of the political dice now, now necessarily about judicial fairness.
posted by Nelson at 8:59 AM on March 8, 2020 [3 favorites]
posted by Nelson at 8:59 AM on March 8, 2020 [3 favorites]
We needed ENDA in 2004, and we need it now.
posted by nikaspark at 9:53 AM on March 8, 2020 [9 favorites]
posted by nikaspark at 9:53 AM on March 8, 2020 [9 favorites]
I worked at a NAPA auto warehouse in 2001. 10 hours a day of unloading transmissions and 50 pound tubs of hand cleaner from palettes and then stocking them on shelves with narrow aisles.
While dodging forklifts.
And security would search us on the way out of the warehouse. Sometimes it would be 30 minutes, sometimes it would be a hour. We were not paid while we waited in line. I was taking the bus to and from work. So I would miss buses if the line was long.
So I am not entirely shocked to learn that they are not good people.
posted by johnpowell at 10:16 AM on March 8, 2020 [22 favorites]
While dodging forklifts.
And security would search us on the way out of the warehouse. Sometimes it would be 30 minutes, sometimes it would be a hour. We were not paid while we waited in line. I was taking the bus to and from work. So I would miss buses if the line was long.
So I am not entirely shocked to learn that they are not good people.
posted by johnpowell at 10:16 AM on March 8, 2020 [22 favorites]
They have legal consultants who say this is legal because discrimination by orientation is not forbidden. I'm not so sure - the letter doesn't say they refuse coverage for LGBT people; it says they refuse coverage based on the sex of the spouse. That sounds unconstitutional - nothing prevents two straight women from marrying, and they're not allowed to have different policies based on the sex of the people involved.
posted by ErisLordFreedom at 10:20 AM on March 8, 2020 [15 favorites]
posted by ErisLordFreedom at 10:20 AM on March 8, 2020 [15 favorites]
That sounds unconstitutional - nothing prevents two straight women from marrying, and they're not allowed to have different policies based on the sex of the people involved.
If it were well-understood that anti-LGBT discrimination is necessarily sex-discrimination, we'd be much further ahead on the whole thing.
posted by bile and syntax at 10:27 AM on March 8, 2020 [13 favorites]
If it were well-understood that anti-LGBT discrimination is necessarily sex-discrimination, we'd be much further ahead on the whole thing.
posted by bile and syntax at 10:27 AM on March 8, 2020 [13 favorites]
Folks here seem to assume that the NAPA franchise believes their actions are legal, but I'm not sure about that. I think it's likely that they're intentionally provoking a legal challenge. A lawsuit would let them ride the persecution circuit, right-wing religious orgs would line up to pay their legal bills, and if they win they get to expand the Hobby Lobby precedent so that "religious freedom" doesn't just apply to what is covered by employer insurance but who is covered.
posted by skymt at 10:51 AM on March 8, 2020 [10 favorites]
posted by skymt at 10:51 AM on March 8, 2020 [10 favorites]
Was this what Mayor Pete was talking about when he said people loved their healthcare, then?
posted by fifteen schnitzengruben is my limit at 11:46 AM on March 8, 2020 [13 favorites]
posted by fifteen schnitzengruben is my limit at 11:46 AM on March 8, 2020 [13 favorites]
I think it's fair to note that this situation has nothing at all to do with insurance companies. This particular chain of Napa stores is self-insured, with employees paying into a fund maintained by the chain itself, and medical expenses paid out of that pool of money.
I'm not entirely sure how that all works, and it seems a bit scammy to me (what is the company doing with that money it's holding?), but this isn't about insurance companies and the plans they offer at all. This is a private company with a private self-insurance program.
posted by hippybear at 11:50 AM on March 8, 2020 [5 favorites]
I'm not entirely sure how that all works, and it seems a bit scammy to me (what is the company doing with that money it's holding?), but this isn't about insurance companies and the plans they offer at all. This is a private company with a private self-insurance program.
posted by hippybear at 11:50 AM on March 8, 2020 [5 favorites]
Mod note: Few comments removed. Don't turn this into a general Supreme Court misery thread please,and be decent to your fellow MeFites.
posted by jessamyn (staff) at 1:12 PM on March 8, 2020
posted by jessamyn (staff) at 1:12 PM on March 8, 2020
I'm intrigued by the self-insurance aspect of this and the claim that "benefits are paid from the Company's general assets" which is not the way that self-insurance works. There is supposed to be a set-aside fund for self-insurance.
I agree that the policy is terrible. But underneath that terrible is a health-care scheme that isn't "insurance" in any meaningful way, and the coverage must surely have high deductibles and low caps because otherwise it's an unacceptable risk to the company.
This also shows how healthcare in the US is at the whim of your employer. That's just not an acceptable situation.
So, yeah, this is terrible on its own merits but is also a condemnation of the whole system.
posted by sjswitzer at 1:15 PM on March 8, 2020 [7 favorites]
I agree that the policy is terrible. But underneath that terrible is a health-care scheme that isn't "insurance" in any meaningful way, and the coverage must surely have high deductibles and low caps because otherwise it's an unacceptable risk to the company.
This also shows how healthcare in the US is at the whim of your employer. That's just not an acceptable situation.
So, yeah, this is terrible on its own merits but is also a condemnation of the whole system.
posted by sjswitzer at 1:15 PM on March 8, 2020 [7 favorites]
There is supposed to be a set-aside fund for self-insurance.
(I don't actually think this is topical, but it has come up twice in this thread)
Self-insurance plans do require a set-aside fund for plan assets, but that doesn't really mean much in practice. ERISA allows self-insurance plans to be entirely unfunded if employees do not contribute at all (ie, employer covers 100% of cost of insurance). In that case, the general assets of the employer pay all claims. Correspondingly, if an employer covers less than 100%, the employee contributions must be set aside, but can also immediately be used to pay claims, with the employer covering the overage. In other words, the employer is obligated to keep contributions separate, but can also itself pay no money into the plan until necessary. In practice, most companies aim to pay claims from available cash flow or general assets. Yes, this is a risk to the company, but it's also a fairly well-characterized risk if you have enough employees. Although individual employees vary drastically in their health care needs, large pools of employees (n>200-500) don't and can be predicted with good precision. This is the case at most large companies, including ones that have particularly good health care plans.
The only real guarantee the government makes is that employee contributions don't benefit the company and that employee claims past the contribution asset pool are not the responsibility of the employee. How the rest of the payment of claims happens past that is not really under the purview of the law.
posted by saeculorum at 2:05 PM on March 8, 2020 [8 favorites]
(I don't actually think this is topical, but it has come up twice in this thread)
Self-insurance plans do require a set-aside fund for plan assets, but that doesn't really mean much in practice. ERISA allows self-insurance plans to be entirely unfunded if employees do not contribute at all (ie, employer covers 100% of cost of insurance). In that case, the general assets of the employer pay all claims. Correspondingly, if an employer covers less than 100%, the employee contributions must be set aside, but can also immediately be used to pay claims, with the employer covering the overage. In other words, the employer is obligated to keep contributions separate, but can also itself pay no money into the plan until necessary. In practice, most companies aim to pay claims from available cash flow or general assets. Yes, this is a risk to the company, but it's also a fairly well-characterized risk if you have enough employees. Although individual employees vary drastically in their health care needs, large pools of employees (n>200-500) don't and can be predicted with good precision. This is the case at most large companies, including ones that have particularly good health care plans.
The only real guarantee the government makes is that employee contributions don't benefit the company and that employee claims past the contribution asset pool are not the responsibility of the employee. How the rest of the payment of claims happens past that is not really under the purview of the law.
posted by saeculorum at 2:05 PM on March 8, 2020 [8 favorites]
I am dubious that the company can define the term "spouse" however they want. It seems like, by their logic, they could say "we have defined Spouse as 'a virginal person married to the participant'" and try to dodge out of providing health care for spouses at all.
I also wonder what options a spouse denied coverage has through the ACA. I expect it quickly starts running into weird tax situations, though.
I very much want the legal challenge to point out that the policy does not discriminate by orientation; it discriminates only by sex. A bisexual man married to a bisexual woman is covered; two bisexual men are not.
posted by ErisLordFreedom at 2:46 PM on March 8, 2020 [12 favorites]
I also wonder what options a spouse denied coverage has through the ACA. I expect it quickly starts running into weird tax situations, though.
I very much want the legal challenge to point out that the policy does not discriminate by orientation; it discriminates only by sex. A bisexual man married to a bisexual woman is covered; two bisexual men are not.
posted by ErisLordFreedom at 2:46 PM on March 8, 2020 [12 favorites]
Really, shouldn't it be you can deny it or allow it for all married couples? If your spouse is a different race can you deny coverage? What if your spouse was previously divorced? What if your spouse is an atheist? Can you deny a couple if they had a civil ceremony instead of a religious one? This is asinine. I'll be glad when current millenials are my age and run everything. I think I'd like to live in that world.
posted by Grumpy old geek at 3:03 PM on March 8, 2020 [4 favorites]
posted by Grumpy old geek at 3:03 PM on March 8, 2020 [4 favorites]
Ouverture: So glad private insurance exists so that *checks notes* bigoted employers can have the flexibility and ~freedom~ to uhhhh violate people's basic human rights.
So gladprivate insurance privately owned companies, especially with a reach of a regional or national chain exists so that *checks notes* bigoted employers can have the flexibility and ~freedom~ to uhhhh violate people's basic human rights. FIFY!
Remember, Hobby Lobby used such a "freedom of a privately held company" excuse, even though they employ on the scale of the Best Buy next door, to go after the ACA to force their religion on the rest of us.
I can see a mom and pop getting some of these small business exemptions. But most folks think of the diner in Seinfeld, where sexism turned out to be DNA.
posted by MrGuilt at 3:52 PM on March 8, 2020
So glad
Remember, Hobby Lobby used such a "freedom of a privately held company" excuse, even though they employ on the scale of the Best Buy next door, to go after the ACA to force their religion on the rest of us.
I can see a mom and pop getting some of these small business exemptions. But most folks think of the diner in Seinfeld, where sexism turned out to be DNA.
posted by MrGuilt at 3:52 PM on March 8, 2020
This "self-insured" thing bit us in the keester while the wife was working for an Ivy League university. It is true that they don't have to follow state laws, only federal regulations which are much more basic.
So, the plan (which was administered by a major insurer) decided that we were on the hook for a $24K procedure that state law says must be covered. (They also allegedly told our doc it was covered.) We had to fight this prestigious university for a good year or two before they finally decided that they had "gotten it wrong." I was still a grad student, $24K in debt would have been absolutely crippling.
posted by anhedonic at 4:27 PM on March 8, 2020 [9 favorites]
So, the plan (which was administered by a major insurer) decided that we were on the hook for a $24K procedure that state law says must be covered. (They also allegedly told our doc it was covered.) We had to fight this prestigious university for a good year or two before they finally decided that they had "gotten it wrong." I was still a grad student, $24K in debt would have been absolutely crippling.
posted by anhedonic at 4:27 PM on March 8, 2020 [9 favorites]
So, can someone explain to me: if an employee (or spouse) gets sick in a way that costs, say, $100k per year, is there anything preventing the company from firing that employee? It seems that they would have a big incentive to do so. Especially when the company is directly covering the cost of medical care.
Doing some googling, the answer seems to be "not much".
posted by alexei at 11:32 PM on March 8, 2020 [1 favorite]
Doing some googling, the answer seems to be "not much".
posted by alexei at 11:32 PM on March 8, 2020 [1 favorite]
I wonder if NAPA Auto Parts has an anti-disparagement clause in their franchise agreement? I can't find a copy online.
posted by mikelieman at 5:16 AM on March 9, 2020
posted by mikelieman at 5:16 AM on March 9, 2020
Pretty certain Jesus would not approve of this kind of cruelty, but you do you assholes.
Health is pretty much the big one on this and honestly I would love to start seeing religious freedom cases doing the thing the Army does for conscientious objectors and start measuring how much you follow the other tenets of your faith other than the convenient one.
If you’re a Christian you are pretty directly called to help the sick regardless of what they are doing that you don’t like. The abortion thing is kind of iffy but there is absolutely nothing prohibiting you from funding people’s healthcare except avarice.
posted by corb at 6:26 AM on March 9, 2020 [1 favorite]
Health is pretty much the big one on this and honestly I would love to start seeing religious freedom cases doing the thing the Army does for conscientious objectors and start measuring how much you follow the other tenets of your faith other than the convenient one.
If you’re a Christian you are pretty directly called to help the sick regardless of what they are doing that you don’t like. The abortion thing is kind of iffy but there is absolutely nothing prohibiting you from funding people’s healthcare except avarice.
posted by corb at 6:26 AM on March 9, 2020 [1 favorite]
Why would a small franchisee go for self-insurance. It’s one cancer claim away from going belly up. Or is he confident that he can fire anyone before they know they have cancer so they cannot make a claim.
I understand self insurance for large companies, but small ones it’s like sitting on gunpowder and playing with matches. It’s fine until it’s not.
posted by jmauro at 8:20 AM on March 9, 2020 [3 favorites]
I understand self insurance for large companies, but small ones it’s like sitting on gunpowder and playing with matches. It’s fine until it’s not.
posted by jmauro at 8:20 AM on March 9, 2020 [3 favorites]
Why would a small franchisee go for self-insurance.
I'm fairly certain this is not just a single franchise. There appears to be 27 locations now. There were 18 locations as of 2013.
(FCC filing linking Bob Dyson with Dyna Auto Parts, so I think I have the right group)
posted by saeculorum at 9:00 AM on March 9, 2020 [1 favorite]
I'm fairly certain this is not just a single franchise. There appears to be 27 locations now. There were 18 locations as of 2013.
(FCC filing linking Bob Dyson with Dyna Auto Parts, so I think I have the right group)
posted by saeculorum at 9:00 AM on March 9, 2020 [1 favorite]
Why would a small franchisee go for self-insurance. It’s one cancer claim away from going belly up.
The company can purchase stop-loss insurance that pays them only if there is a catastrophic loss. The stop-loss insurance protects the company, not the employees.
posted by JackFlash at 9:23 AM on March 9, 2020 [3 favorites]
The company can purchase stop-loss insurance that pays them only if there is a catastrophic loss. The stop-loss insurance protects the company, not the employees.
posted by JackFlash at 9:23 AM on March 9, 2020 [3 favorites]
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