Topic:

Coordination of large employer health benefits with Medicare.

Source:

Sec. 1862, Social Security Act; 42 U.S.C.A. 1395y.

Features:

Requires employers with 20 or more employees to provide primary coverage for certain otherwise eligible Medicare beneficiaries (e.g., workers aged 65 to 69 and those with end-stage renal disease). Individuals and government may enforce this by lawsuit and obtain double damages.

Effect:

Subordinates Medicare payment to employers' plans and reduces outlays by Medicare.

Comment:

Subject of current nationwide recoupment effort; topic of past investigations. ¹³⁵

Topic:

Discrimination in employment practices.

Source:

Civil Rights Act of 1964, Title VII; 42 U.S.C.A. 2000e-2.

Features:

Employment practices include health benefits. Protected classes for race, color, sex, religion, and national origin.

Effect:

Bans discrimination in health benefits based on a suspect classification.

Comment:

Few cases have been reported based on race discrimination; more cases arise under the Pregnancy Discrimination Act of 1978, an amendment. ¹³⁶

Topic:

Discrimination in employment practices.

Source:

29 U.S.C.A. 621 et seq.

Features:

Employment practices include health benefits. Protects workers who are at least 40 years of age. Age-based distinctions are allowed pursuant to a "bona fide" benefits plan, provided that the distinctions are not a "subterfuge."

Effect:

Provides equal access to health benefits for older workers.

Comment:

Older Workers Benefit Protection Act¹³⁷ codified the "equal benefits/equal cost" rule from EEOC regulations,¹³⁸ which allows employers to either provide the same amount of benefits or to spend an equal amount to provide reduced coverage to older workers

Topic:

Discrimination in employment practices.

Source:

42 U.S.C.A. 12101.