Can PRN's refuse insurance???

mirandaaa · Apr 23, 2015

I always thought PRNs weren't given health/dental insurance benefits because their hours were never guaranteed.

The way it was explained to me is if you only work a 5 hour shift and your insurance costs at least a 10 hour shift worth of pay, the facility would be out money since they can't take it out of your paycheck since you didn't make enough that week to cover your portion.

Every place I've been, PRNs didn't get benefits but they were given a higher hourly rate.

I'm curious what others say about this now!

ashemson · Apr 23, 2015

No you are correct. But with the new Affordable Care Act, if you work more than 30 hours per week, your employer HAS to offer you insurance. So the PRN's that are working more than 30 are getting their hours cut. I was just wondering how other medical facilities were handling this.

caliotter3 · Apr 23, 2015

They are cutting the hours of their employees too.

mirandaaa · Apr 23, 2015

No you are correct. But with the new Affordable Care Act, if you work more than 30 hours per week, your employer HAS to offer you insurance. So the PRN's that are working more than 30 are getting their hours cut. I was just wondering how other medical facilities were handling this.

Ahhh you are absolutely right, I didn't even think of that. When I was a PRN it was before the ACA became effective.

MunoRN, RN · Apr 23, 2015

If you are working full time as a PRN then your employer has to offer insurance, but the employee is not required to use it, in which case the employer is free to give the employee the employers contribution to buy insurance on their own. This does require the employee to sign a form stating they were offered insurance in order to keep the employer from getting fined.

Home Health Columnist / Guide · Apr 25, 2015

All our PRNS working over 30 hours were changed to benefited positions or told they could only work 20hrs or less. Health system does provide full benefits for those working more than 24hrs in budgeted position with slightly higher cost to add family members compared to FT employees.

Does an employee have to take an employer's insurance if offered?

No. Employees can join their spouse's coverage or purchase coverage through the exchange or the individual market. However, when individual responsibility requirements take effect in 2014, an employee will be subject to a penalty if the employee refuses employer coverage and doesn't obtain coverage on his or her own.
If an employee waives coverage for any reason other than it doesn't meet the affordability test, the employee can still purchase coverage through the exchange, but will not be eligible for the refundable tax credit.
If an employee's share of the premium for employer-sponsored coverage meets the law's definition of unaffordable (i.e., it exceeds 9.5% of the employee's adjusted gross income), the employee can purchase coverage through the exchange. The employee can't receive a tax credit unless the employer plan is deemed unaffordable or is inadequate, meaning it does not have an actuarial value of at least 60 percent (as defined by HHS's essential benefits package).
Whether coverage is adequate and affordable will be determined by the employee's cost for self-only coverage.
Adequacy will be determined with a minimum value calculator to be provided by the IRS and HHS. Employers can input information about the plan, such as deductibles and co-pays, and find out if coverage is adequate.
Affordability will be determined by whether the coverage offered costs an employee more than 9.5% of their annual household income. Because employers may not know employees' household incomes, three affordability safe harbors are proposed:
Form W-2: An employee's monthly contribution for self-only coverage is affordable if it does not exceed 9.5% of their W-2 wages for that calendar year.
Rate of pay: An employee's monthly contribution for self-only coverage is affordable if it is no more than 9.5% of their monthly wages (hourly rate of pay Ã— 130 hours, or, for salaried employees, their monthly salary figure).
Federal Poverty Line (FPL): An employee's monthly contribution for self-only coverage is affordable if it does not exceed 9.5% of the FPL for a single individual.
Employee Rules and Rights | Affordable Care Act Health Coverage Guide

MatrixRn · May 13, 2015

I am a PRN nurse in a hospital and of course we are cutting hours below 30/week. Just wondering if PRN staff signed something that says we refuse benefits if we would be allowed to work more than 30? I can't find any law that addresses that?

This was purely an HR decision.

By the gov standards if you average more than 30 hours per week more than a few weeks the hospital is mandated to offer you insurance.

The hospitals pay for insurance by bulk. This means, for example, the hospital has 100 PRNs and 350 FT staffers they would need to assume that all 450 would take the insurance and add them to the overall package and pay the premium for for a range of 400-450 people. Without the PRNs they could pay for 325-375. Paying for 350 is cheaper than paying for 450.

Now mind you, probably very few of the PRNs would take the medical insurance, but the hospital would have to pay for the plan just the same.

This is also why many hospitals do not offer a kick back of money when a staffer does not take the insurance......because the money is already baked in the cake so to speak.

Signing a document stating you do not want insurance does not free the hospital from its obligation to offer it to you if you worked above 30 hours. Not accepting the insurance is your choice and if you do not have SOME insurance the person would pay a fine the next year in their taxes.

MatrixRn · May 13, 2015

To add on to the above if we consider that the hospitals cost pay is 80% of the total cost of the premium, we can see an average of $1,000 per month per person per year. And with a difference of 100 people that is $1.2 million dollars per year!!

mmc51264, BSN, MSN, RN · May 27, 2015

I work FT and I do not use organization's health insurance. It is cheaper and better for me to be on hubby's policy. We have the choice of purchasing it or not. Maybe if you work over 30 they have to offer it and they are afraid that you would take it

MatrixRn · Jun 5, 2015

Hmm FT staff position that offers benefits? The ACA has rules around using the insurance at your work, if you qualify for it..and FT perm would qualify.

allnurses Guide · Jun 5, 2015

I am a PRN nurse in a hospital and of course we are cutting hours below 30/week. Just wondering if PRN staff signed something that says we refuse benefits if we would be allowed to work more than 30? I can't find any law that addresses that?

AS of January 2015 All adults in the United States must carry health Insurance. The ACA says you may purchase that insurance anywhere but you must have it or face criminal and civil penalties for non-compliance. The federal Government and some states have set up so called affordable exchanges in the private sector but I have yet to find one that is truely affordable. Your employer weather you are full or part time must under the new law off you insurance which you pay for. If you do not buy that insurance you must provide the name of you insurance carrier as proof of compliance with the new law. Employers and employees must report to the IRS how much money they are paying for it. Last year the penalty for not having health insurance was $95.00 per person per household this more that doubles this tax year to $250.00 per person per houshold. As far as there being a law saying if hospitals can cut your hours? Of course they can especially in "At Will" states where you work at the will of the employer.

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