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  • About
    • Membership
    • News
    • Boards and Committees
    • Alice Dittman Trailblazer Award
    • NBA Foundation
    • Leadership Program
    • Staff Directory >
      • Contact Us
  • Workforce
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    • Legislative Update
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    • Young Bankers (YBON)
  • Insurance
    • Agency Services >
      • Commercial Insurance
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    • Bank Property & Liability
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HEALTHCARE REFORM LAW - EMPLOYEE RETALIATION PROTECTIONS

I.         INTRODUCTION

Among the new requirements for employers under the Patient Protection and Affordable Care Act of 2010 (PPACA) is a new “whistleblower” protection amendment to the Fair Labor Standards Act (FLSA). 

The U.S. Department of Labor issued interim final regulations governing the employee whistleblower protection of section 1558 of the PPACA, which added section 18C to the FLSA. The interim final regulations establish procedures and timeframes for the handling of retaliation complaints under section 18C, including procedures and timeframes for submitting employee complaints to the Occupational Safety and Health Administration (OSHA), investigation of complaints, and appeals. 

Under section 18C, an employer may not retaliate against an employee for receiving subsidized coverage under a qualified health plan through an insurance exchange. Certain “large” employers who fail to offer affordable coverage that provides “minimum value” may be assessed a tax penalty if any of their full-time employees receive a subsidy for coverage obtained through the exchange. This creates an incentive for an employer to retaliate against an employee, and Section 18C is designed to protect employees against such retaliation.

II.        EMPLOYEE RETALIATION PROTECTIONS

Section 18C protects an employee from retaliation for providing information or participating in proceedings regarding any conduct the employee reasonably believes violates Title I of the PPACA. Specifically, retaliation is prohibited for: 

(i) providing information to their employer, the federal government, or the attorney general of a State relating to any violation of, or any act or omission the employee reasonably believes to be a violation of, title I of the PPACA (such as prohibitions on annual and lifetime limitations and coverage of preventive services);

(ii) testifying or being about to testify in a proceeding concerning such violation;

(iii) assisting or participating, or being about to assist or participate, in such a proceeding; or

(iv) objecting to, or refusing to participate in, any activity, policy, practice, or assigned task that the employee reasonably believes to be in violation of any provision of title I of the Act, including any of its implementing rules or guidance.

The procedures under the Consumer Product Safety Improvement Act of 2008 (CPSIA) apply to address complaints by employees about retaliation under section 18C. Key procedural requirements include:

  • Employees need to file complaints with the Secretary of Labor within 180 days of the alleged retaliation.
     
  • Within 60 days of receiving the complaint, the Secretary must give the complaining employee and the employer/issuer an opportunity to submit a response and meet with the investigator to present statements from witnesses, and conduct an investigation.
     
  • The Secretary may conduct an investigation only if the employee has made a prima facie showing that the protected activity was a contributing factor in the adverse action alleged and the employer/issuer has not demonstrated, through clear and convincing evidence, that it would have taken the same adverse action in the absence of that activity.
     
  • If the Secretary finds there is reasonable cause to believe that retaliation has occurred, the Secretary may issue a preliminary order that requires the employer/issuer, where appropriate to: (i) take affirmative action to abate the violation; (ii) reinstate the employee to his or her former position together with the compensation of that position (including back pay) and restore the terms, conditions, and privileges associated with his or her employment; and (iii) provide compensatory damages to the complainant, as well as all costs and expenses (including attorney fees and expert witness fees) reasonably incurred by the complainant for, or in connection with, the bringing of the complaint upon which the order was issued.
     
  • If neither of the parties requests a hearing before an Administrative Law Judge within 30 days of the Secretary’s award, the preliminary order becomes final and not subject to judicial review.
     
  • Before the Secretary’s order becomes final, the parties may enter into a settlement agreement that terminates the proceedings.
     
  • If the Secretary finds that the employee’s complaint is frivolous or that it was brought in bad faith, the Secretary may award the employer a reasonable attorney’s fee not exceeding $1,000.
     
  • Within 60 days of the issuance of a final order by the Secretary, any person adversely affected or aggrieved may file an appeal with the appropriate United States Court of Appeals.  

Nothing in section 18C shall be deemed to diminish the rights, privileges, or remedies of any employee under any federal or state law or under any collective bargaining agreement, and the rights and remedies in section 18C may not be waived by any agreement, policy, form, or condition of employment. As a result, an employee may still bring claims under other laws and regulations protecting the employee from retaliation, including for example, section 510 of ERISA. 

III.       CONCLUSION

Employers need to be prepared to respond to employees’ section 18C complaints and should be in a position to demonstrate through “clear and convincing” evidence that they would have taken the same adverse action in the absence of the employee’s asserted PPACA protected activity.

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