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Louisiana - Compensation & Benefit Legislation

LOUISIANA - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

LOUISIANA - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children, unmarried grandchildren in the legal custody of a grandparent, and transportation of newborn to hospital or neonatal unit must also be covered.

 

Preventive care for children: Yes, for immunizations to age 6.

 

(Louisiana Rev. Stat. Ann. Sections 220215.1, 22-215.2, 22-215.4, 22-215.14, 22-227)

 

LOUISIANA - ALCOHOLISM & DRUG ABUSE

Employer option.

 

Minimum yearly inpatient coverage: no statutory requirements.

 

Minimum yearly outpatient coverage: no statutory requirements.

 

Minimum lifetime coverage: no statutory requirements.

 

(Louisiana Rev. Stat. Ann. Section 22-215.5)

 

LOUISIANA - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: No. Follows FUTA.

 

LOUISIANA - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

LOUISIANA - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (Louisiana Rev. Stat. Ann. Section 22:315.)

 

LOUISIANA - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

LOUISIANA - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

Who is Covered by Statute: Employers who are not subject to a federally mandated drug testing program.

 

Applicant Testing: There are no restrictions to testing.

 

Employee Testing: There are no restrictions to testing; rehabilitation (EAP) is permitted but not required.

 

How Test Results are Used: State has no statutory requirements.

 

Enforcement of Statutes: State has no statutory requirements.

Employee Remedies: State has no statutory requirements.

 

Employer Penalties: State has no statutory requirements.

 

Who Pays for Testing: State has no statutory requirements.

 

Employee Assistance Benefits: State has no statutory requirements.

 

Other Requirements: Testing law is subject to state unemployment compensation law and sets forth employee testing requirements in order to support a misconduct discharge and, thus, deny benefits.

 

(Louisiana Rev. Stat. Ann. Sections 23:1601, 49:1001 et seq.)

 

LOUISIANA - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Policies providing family coverage must cover adopted children as of the date of placement. (Louisiana Rev. Stat. Ann. Section 22:227.)

 

Alcoholism and Drug Abuse: Insurers must make available group coverage for alcohol and drug abuse treatment. (Louisiana Rev. Stat. Ann. Section 22.215.5.)

 

Cleft Lip and Palate: Policies covering primary medical conditions associated with a cleft lip and palate must cover secondary conditions such as surgery, orthodontics, speech therapy. (Louisiana Rev. Stat. Ann. Section 22:215.8.)

 

Coverage Continuation and Conversion: Group policies must provide continuation rights to surviving spouses age 55 or over (Louisiana Rev. Stat. Ann. Section 215.7.) Group policies canceled by insurers must offer conversion rights to members of that group previously diagnosed as terminally ill. (Louisiana Rev. Stat. Ann. Section 22.228.) Group health insurers must notify policyholders in writing at least 45 days before an increase of 20 percent of more in policy rate. An insurer must give policy holders at least 60 days written notice before canceling or failing to renew a group health policy. Insurers and policyholders may agree to amend or cancel a group health policy and it shall be binding upon the insured, but the amendment or cancellation may not affect a claim for any prior accrued benefit. (Louisiana Rev. Stat. Ann. Sections 215, 215.9.) Insurance policies including HMOs must be portable; insured individuals, having had previous coverage that was continuous to a date not more than 60 days prior to the effective date of the current insurance plan, must be covered for pre-existing conditions, and credit must be given for a lifetime benefits paid by a prior insurer against a latter health insurance coverage. (H920, 1995) (Louisiana Rev. Stat. Ann. Section 22:215.16.)

 

Dependents: In child support cases, a court may order one of the parties involved to enroll or maintain a dependent child in a health plan. Costs of maintaining a child in a plan must be added to the basic child support obligation (H1000, 1995) (Louisiana Stat. Ann. Section 9:315.4.) Insurers including HMOs must allow a parent (ordered by a court to provide dependent child care coverage) who participates in or is eligible to participate in a plan to enroll and maintain coverage for a dependent child. (H1713, 1995) (Louisiana Rev. Stat. 46:236.8(G), Section 236.8.)

 

Handicapped Dependents. Coverage for dependent children cannot be terminated while a person is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Louisiana Rev. Stat. Ann. Section 22:215.2.)

 

Health Maintenance Organizations: Non-participating health care providers (including anesthesiologists, pathologists, or radiologists who provide patient services at facilities that contract with HMOs) may collect from an HMO for services rendered to a patient, provided these health care providers have no direct knowledge that a particular patient is enrolled in an HMO. (H1676, 1995) (Louisiana Rev. Stat. Ann. Section 22:2018(D).)

 

Hearing Impaired Interpreter Expenses: Health insurance policies require payment for expenses incurred by the insured for services performed by an interpreter -- other than a family member -- when services are used in connection with medical treatment. (Louisiana Rev. Stat. Ann. Section 22:215.10.)

 

Mental Health: Insurers must make available group coverage for mental and nervous disorders on the same basis as other illnesses. (Louisiana Rev. Stat. Ann. Section 22:669.) Seclusion or Restraints: Use of seclusion or restraints for patients suffering from mental illness or substance abuse must be allowed only in emergency situations in which patients are thought to be capable of physically injuring themselves or others. Generally, written orders from a physician or psychologist are required prior to the use of these measures. Staff members must evaluate patients who are restrained or secluded every 15 minutes; such patients must be released as soon as precipitating behaviors improve. (S704, 1995) (Louisiana Rev. Stat. Ann. Section 171(D),(E).)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness, including treatment of medically diagnosed congenital defects, birth abnormalities, and prematurity and transportation to the nearest available hospital or neonatal unit. (Louisiana Rev. Stat. Ann. Section 22:215.1.)

 

Pap Testing and Mammography Screening: Any health and accident insurance policy shall include benefits payable for an annual Pap test and minimum mammography examination. Minimum mammography examination means one baseline mammogram for any woman 35 through 39 years of age; one mammogram every 24 months for any woman who is 40 through 49 years of age, or more frequently if recommended by her physician; one mammogram every 12 months for any woman who is 50 years of age or older. (Louisiana Rev. Stat. Ann. Section 22:215.11.)

 

Providers: Dentist and ambulatory surgical centers: Costs for services must be covered if the provider is licensed, the services is within the provider's scope of services, and the service is covered by the policy. (Louisiana Rev. Stat. Ann. Sections 22:231.1, 22:223.) Obstetricians or gynecologists: Insurers including HMOs and PPOs must allow enrollees direct access to obstetricians or gynecologists for routine gynecological care with consists of 2 annual visits; the second visit shall be based upon medical need. (H318, 1995) (Louisiana Rev. Stat. Ann. Section 215.17, 2027(D), 40:2206.) Speech, Physical and Occupational Therapy: Insurers must make available coverage for speech, physical, and occupational therapy. (Louisiana Rev. Stat. Ann. Section 230.1.)

 

Student Dependents: Policies must covered unmarried student dependents up to age 24. (Louisiana Rev. Stat. Ann. Section 22:215.4.)

 

Optional Benefits: Policies (except short term policies with a duration of 6 months or less) must cover pre-existing conditions incurred more than twelve months following the effective dates of an insured person's coverages under a plan. (H920, 1995) (Louisiana Rev. Stat. Ann. Section 22:215.12.)

 

LOUISIANA - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

Eligibility Criteria: 2 - 35 employees.

Restrictions on premiums: Yes.

Restrictions on cancellation: Yes.

Pre-existing Conditions: No specific provision to small employers. (Louisiana Rev. Stat. Ann. Section 22:228.1, 22:250.7)

 

LOUISIANA - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): 75%.

 

Percent of employees who must be covered if employer pays all of premium: 100%.

 

Minimum number of employees in group plan: 1 at date of issue; for some plans, at least 10 new insured must be added each plan year.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 30.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Louisiana Rev. Stat. Ann. Sections 22:175, 22:176)

 

LOUISIANA - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Columbus Day (or 2nd Monday in October), Thanksgiving, Sunday. Other: If holiday falls on Sunday, following Monday is a holiday; if holiday falls on Saturday, preceding Friday is a holiday. (Louisiana Rev. Stat. Ann. Sections 1:55-1:58)

 

LOUISIANA - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

LOUISIANA - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Employer must reinstate employee in same position with same wages and benefits, and will be fined $100 - $1,000.

 

Other Requirements: Employer must pay employee for jury service up to 1 day. If employer does not pay, employer may also be fined from $100 - $500. (Louisiana Rev. Stat. Ann. Section 23:965.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: State reports no statutory requirements.

 

Other Requirements: None reported.

 

LOUISIANA - LEAVES OF ABSENCE

Employers Subject to Leave Laws: Employers with more than 25 employees.

 

Criteria for Eligibility: State reports no statutory requirements.

 

Maximum length of leave: Reasonable period during disability; 6 weeks for disability from pregnancy or childbirth; pregnancy leave not to exceed 4 months.

 

Paid Leave: State does not require paid leave.

 

Acceptable Reasons for Leave: Birth of child or pregnancy and/or disability due to pregnancy, birth of child, or related medical condition.

 

Employment Guarantees After Leave: Entitled to the same benefits and privileges of other employees who are similarly situated in employment.

 

Use of Vacation or other Time-off Benefits: Employee may use any accrued vacation leave.

 

Certification Required: State reports no statutory requirements.

 

Effect Of Leave on Other Benefits: State reports no statutory requirements.

Effect of Seniority Accrual During Leave: State has not statutory requirements.

 

Minimum Requirements for Notification to Employer: Reasonable notice may be required by employer.

 

Conditions for Denial of a Request For Leave: State reports no statutory requirements.

 

(Louisiana Rev. Stat. Ann. 23:1008.)

 

See U.S. Federal Family and Medical Leave Act

 

LOUISIANA - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

LOUISIANA - MANDATED PROVIDERS

Optometrists, chiropractors, dentists, psychologists, podiatrists, and social workers. Mandatory coverage for audiologists, speech pathologists, occupational therapists, and physical therapists. Direct access to obstetrician/gynecologist is mandatory. (Louisiana Rev. Stat. Ann. Sections. 22.213.1, 22.215.17, 22.230.1, 22.662, 22.664, 22.665, 22.668, 22.669, 22.1513)

 

LOUISIANA - MENTAL HEALTH CARE

Employer option.

 

Minimum weekly inpatient coverage: Policy must provide coverage that is no less than the coverage it provides for physical illness.

 

Minimum weekly outpatient coverage: Policy must provide coverage that is no less than the coverage it provides for physical illness.

 

Minimum lifetime coverage: No less than lifetime maximum for physical illness.

 

(Louisiana Rev. Stat. Ann. Section 22-669)

 

LOUISIANA - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

State reports no statutory requirements.

 

See U.S. Minimum Wage

 

LOUISIANA - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: New employees and rehires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 or employer’s own form if it contains all required information.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and tax identification number.

 

Employee information to be included: Name, address, and SSN.

 

Penalty for failure to report: $25 for each failure to report; if employer conspired with employee not to report, fines may be up to $500.

 

(Act 97 of the 1997 Louisiana Legislative Session)

 

LOUISIANA - NEWBORN CARE MANDATE

Mandated coverage of birth, transportation of newborn to hospital or neonatal unit must also be covered.

 

Preventive care for children: yes, for immunizations to age 6. (Louisiana Rev. Stat. Ann. Sections 220215.1, 22-215.2, 22-215.4, 22-215.14, 22-227)

 

LOUISIANA - OVERTIME COMPENSATION REQUIREMENTS

State reports no statutory requirements.

 

LOUISIANA - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

LOUISIANA - PRE-EXISTING CONDITIONS

State reports no statutory requirements.

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

LOUISIANA - PROTECTED CLASSIFICATIONS

Age:  Yes, age 40 and over.

Race:  Yes.

Color:  Yes.

National Origin: Yes.

Ancestry:  No specific law. State has expressed policy against discrimination.

Religion: Yes.

Sex:  Yes.

Pregnancy: Yes.

Sexual Harassment: No specific law. State has expressed policy against discrimination.

 

(La. Rev. Stat. Ann. Sections 23:301 et seq.)

 

LOUISIANA - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

LOUISIANA - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

LOUISIANA - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Within 3 days.

 

Date due if employee resigns: Within 3 days.

 

Wages: Yes. (Wages include all fringes payable under a collective bargaining agreement and commissions.)

 

Vacation Pay: Yes. (Case law appears to define wages as including vacation pay.)

 

Holiday: No.

 

Sick leave: No.

 

Severance: No.

 

(Louisiana Rev. Stat. Ann. Section 23-631. See Potvin v. Wright's Sound Gallery In., 568 So. 2d 623 (LA Ct. App. 1990); Brown v. Navarre Chevrolet, Inc., 610 So.2d 165 (App. 3d Cir. 1992); Franklin v. Ram, Inc., 576 So.2d 546 (App. 2d Cir. 1991))

 

LOUISIANA - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes. Within 30 days of mailing of notice or within 25 days of receipt of notice.

 

(Louisiana Rev. Stat. Ann. Sections 23:15434-23:1536, 23:1541, 23:1660.)

 

LOUISIANA - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

LOUISIANA - VOTING TIME OFF

State reports no statutory requirements.

 

LOUISIANA - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments, including corporate executives. Corporate officers who are 10% shareholders and sole proprietors may reject coverage.

 

Public Employers: Mandatory as to all public employments, except sheriffs, deputies, and officials. Sub-divisions may cover elective and appointive officials.

 

Exceptions: Crews of crop spraying aircraft while acting as contractors, or employees or persons principally engaged in agriculture; real estate brokers and salespersons; domestic workers.

 

Special Coverage Provisions: Excludes officers of non-profit charitable, fraternal, cultural, or religious corporations or associations.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)