Healthcare Continuation

In Minnesota, police officers and firefighters who are duty disabled are eligible for continued healthcare benefits under Minnesota Statutes section 299A.465. This statute is designed to provide healthcare continuation for first responders who are unable to continue working in their profession due to an on-duty injury.

If you are a duty disabled police officer or firefighter covered under the PERA Police and Fire Plan, it’s important to understand how healthcare continuation works, the process your employer must follow if they challenge your entitlement to healthcare continuation benefits, and the legal steps you may need to take if your benefits are contested.

This article explains Minnesota Statutes Section 299A.465, how employers can challenge healthcare continuation, and how working with an experienced attorney can help protect your rights.

Eligibility for Healthcare Continuation Benefits under Section 299A.465

Under Minnesota Statutes section 299A.465, healthcare continuation benefits are available only to duty-disabled police officers and firefighters who are enrolled in the PERA Police and Fire Plan. Duty disability benefits are granted when a police officer or firefighter sustains an on-duty injury that makes them incapable of continuing their duties. If you are determined to be duty disabled under the PERA Police and Fire Plan, you may be entitled to continued health insurance coverage through your employer under this statute.

However, not all public safety employees are eligible. The statute specifically targets duty disabled individuals enrolled in the PERA Police and Fire Plan, meaning you must be officially recognized by the Public Employees Retirement Association (PERA) as having suffered an injury that meets the requirements for duty disability.

Employer’s Right to Contest Healthcare Continuation Benefits

Once a duty disabled police officer or firefighter is determined eligible for healthcare continuation, the employer has 60 days to contest the entitlement. It’s crucial to note that the employer is the party that can contest the benefits — not the employee. If the employer does not contest the eligibility within the required timeframe, they are barred from challenging the police officer or firefighter’s entitlement to healthcare continuation under Minnesota Statutes Section 299A.465.

If the employer wishes to contest the healthcare continuation benefits, they must follow a strict legal process. Here’s how the process works:

Petition for Review: The employer must petition PERA or the Minnesota State Retirement System (MSRS) to initiate a contested case at the Office of Administrative Hearings (OAH).
Contested Case Hearing: Once the petition is filed, the OAH assigns the contested case to an Administrative Law Judge (ALJ). This ALJ is responsible for overseeing the legal proceedings and determining whether the police officer or firefighter is entitled to continued healthcare benefits.

Burden of Proof: The employer bears the burden of proof in the contested case hearing. They must demonstrate that PERA or MSRS was “more wrong than right” in determining that the officer or firefighter is duty disabled and thus entitled to healthcare continuation

Impact of Contested Case Hearing

The contested case hearing focuses solely on whether the officer or firefighter is entitled to healthcare continuation under Minnesota Statutes Section 299A.465. The contested case will not revisit or affect the employee’s entitlement to PERA or MSRS duty disability benefits. The issue under review is limited to whether the employer is obligated to continue healthcare coverage.

If the employer loses the case and is determined to be responsible for healthcare continuation, they must enroll the duty disabled employee in the same health insurance plan (either single or family coverage) that the employee had at the time of their disabling injury.

What Happens If the Employer Doesn’t Petition for Review in Time?

If the employer does not file a petition to review the employee’s healthcare continuation benefits within the 60-day timeframe, they are barred from contesting the entitlement. This means that the duty disabled police officer or firefighter will be entitled to continued health insurance coverage as specified in Minnesota Statutes Section 299A.465.

Unfortunately, some employers may ignore their responsibilities or delay the process. In these cases, the duty disabled employee may face unnecessary hurdles in obtaining the healthcare benefits they are entitled to. If this happens, it may be necessary to retain an experienced attorney who understands how to navigate these situations and ensure that the employee receives their entitled health insurance benefits.

Enrolling in Healthcare Coverage

Once a duty disabled police officer or firefighter is enrolled in healthcare continuation under Section 299A.465, they will have access to the same health insurance plan they had at the time of their disabling injury. The coverage will include the same single or family coverage options they were previously enrolled in.

There are some nuances in cases where the employee waived coverage or received a stipend in lieu of coverage at the time of the injury. In these cases, the specific terms for enrollment might vary, and it’s important to work with an attorney to ensure the correct benefits are received.

Once enrolled, the employee is responsible for paying their portion of the premium, and the employer will pay their portion of the premium. The employee can add or drop coverage as their circumstances change. For example, if a duty disabled police officer or firefighter gets a new job that offers health insurance and opts into that plan, they can re-enroll in 299A coverage if they later leave that job.

What to Do If the Employer Refuses to Provide Healthcare Continuation

Despite the law, some employers may refuse to enroll a duty disabled police officer or firefighter in their healthcare insurance plan, even though Minnesota Statutes Section 299A.465 requires it. In these situations, the duty disabled employee may have to take action to ensure they receive their entitled healthcare coverage.

If the employer refuses, it is essential to contact an attorney experienced in handling healthcare continuation claims. The attorney can help you understand your rights and take the necessary steps to ensure your coverage under the statute.

The process for securing healthcare continuation benefits under Minnesota Statutes Section 299A.465 can be complex, particularly if the employer contests the entitlement. If you are a duty disabled police officer or firefighter facing challenges with your healthcare continuation benefits, working with an attorney with experience securing PERA and MSRS disability benefits for their clients is crucial. An experienced attorney can help you navigate the legal process, protect your rights, and ensure you receive the healthcare coverage you are entitled to under the law.

At Meuser, Yackley & Rowland, we have extensive experience helping Minnesota first responders defend their right to healthcare continuation benefits. If you need assistance with healthcare continuation or any other duty disability related issue, contact us today for a consultation. Our team is dedicated to securing the benefits you deserve.

Request a free Case Evaluation

Learn More About Our Other Practice Areas

Read Related Articles