Hi, Bleeb -
I'm an HR professional with 20+ years of experience, so I think I can answer your questions.
With regard to your employer not having an employee manual because it's "easier" for them legally not to have one, I can tell you that the exact opposite is probably true! They probably lose every Unemployment case they have, and they would certainly lose any
discrimination or harassment case if they don't have even the most basic of procedures laid out for employees to follow to report something. They're running around naked and it's not very smart! Not having a defined dress code is the LEAST of their worries! I wouldn't bother too much about the fashion police. What I'd do is send an email to the boss, asking for clarification. Say something like "So-and-so informs me that blank, blank and blank aren't acceptable within the guidelines of COMPANY's dress code. However, because COMPANY has no published dress code guidelines, employees are understandably put in the uncomfortable position of being judged on an individual basis. I have observed that female employees are more often judged as "not conforming" to the unwritten dress code. I respectfully request that COMPANY's dress code be defined and distributed to all employees so that it may be consistently applied going forward.
Sincerely,
You"
Regarding the health insurance benefits: the DOL is correct (no surprise!) that your employer is required by law to have and provide to each employee an SPD (Summary Plan Description). Here's a link to the DOL's handy Fact Sheet on SPDs. Perhaps your HR person would react more favorably if you said, "Listen, I really hate to have to get the Department of Labor involved, because I understand there are some HEFTY FINES for companies that don't follow the law by providing the SPDs to their employees as required. So I'm sure you know who to contact to get the SPDs for us and make sure that all of our employees - including me - receive one within the next 10 days so that a call to the DOL isn't necessary." Even the GREENEST HR person won't ignore a veiled threat to bring the federal government down on their head! heeheehee Watch 'em run!!!
http://www.dol.gov/ebsa/newsroom/fserisa.html
Here's the text of the DOL's Fact Sheet on SPDs:
Fact Sheet: Workers’ Right To Health Plan Information
The Employee Retirement Income Security Act (ERISA) governs approximately 2.5 million health benefit plans sponsored by private sector employers nationwide. These plans provide a wide range of medical, surgical, hospital and other health care benefits to some 137 million Americans.
Under ERISA, workers and their families are entitled to receive a summary plan description (SPD). The SPD is the primary document that gives information about the plan, what benefits are available under the plan, the rights of participant and beneficiaries under the plan, and how the plan works.
Among other information, the SPD of health plans must describe:
Cost-sharing provisions, including premiums, deductibles, coinsurance and copayment amounts for which the participant or beneficiary will be responsible
Annual or lifetime caps or other limits on benefits under the plan
The extent to which preventive services are covered under the plan
Whether, and under what circumstances, existing and new drugs are covered under the plan
Whether, and under what circumstances, coverage is provided for medical tests, devices and procedures
Provisions governing the use of network providers, the composition of provider networks and whether, and under what circumstances, coverage is provided for out-of-network services
Conditions or limits on the selection of primary care providers or providers of specialty medical care
Conditions or limits applicable to obtaining emergency medical care
Provisions requiring preauthorizations or utilization review as a condition to obtaining a benefit or service under the plan
The SPD must also explain how plan benefits may be obtained and the process for appealing denied benefits.
ERISA also requires that SPDs be updated periodically. Furthermore, ERISA requires disclosure of any material reduction in covered services or benefits to participants and beneficiaries generally within 60 days of the adoption of the change through either a revised SPD or a summary of material modification (SMM). Material changes that do not result in a reduction in covered services or benefits must be disclosed through an SMM or revised SPD not later than 210 days after the end of the plan year in which the change was adopted.
The Department’s claims procedure regulation describes your right to get an answer from your health plan regarding your health benefit claim. The regulation protects you – providing for a timely response by describing the timeframes for a decision, providing for a fair process by describing the standards for a decision, and providing for meaningful disclosure by describing the notice and disclosure that you are entitled to receive from your plan. Look to the SPD for information on your health plan’s claims procedure.
This fact sheet has been developed by the U.S. Department of Labor, Employee Benefits Security Administration, Washington, DC 20210. It will be made available in alternate formats upon request: Voice phone: 202.693.8664; TTY: 1.202.501.3911. In addition, the information in this fact sheet constitutes a small entity compliance guide for purposes of the Small Business Regulatory Enforcement Fairness Act of 1996.
