“Understood. It’s like a deductible.” Mary knew the basics of employment benefits.
“Exactly.” Simon nodded. “But Rachel’s bills alone are so high that the insurance company was going to raise the premiums.”
“I see, and are the premiums going up?”
“I don’t know, but I’m getting ahead of myself. After Rachel’s first round of chemo, my boss, Todd, kept asking me how Rachel was. I thought he was interested, like, being nice. He has a ten-year-old daughter. But then he made comments about the bills when I submitted them. And then when the first bills for chemo came in, for seven grand, he reduced my territory from three states—Jersey, Pennsylvania, and Delaware—to just Delaware.”
Mary didn’t understand something. “What does it matter that your territory was reduced?”
“A reduction in my territory means I can’t make my sales quotas. Not only that, but the territory he gave me was more residential and had less businesses, so there was no way I could ever make quota.” Simon flushed. “I tried, but no matter what I did, I was only selling a fraction of the units. For the first time in twelve years, I didn’t make quota.”
Mary put it together. “So your sales go down and your performance suffers.”
“Right.” Simon nodded. “Todd was trying to force me out, hoping that I would quit, but I didn’t. I love my accounts, my reps, and my job, and I need the job.”
“Of course.”
“So when Rachel’s pediatric oncologist told me she needed the transplant and referred me to CHOP, I told Todd and he asked how much it was going to cost. At the time, I didn’t know the costs of the transplant, but the donor search alone cost like $60,000 to $100,000, and I told him that.”
“To search for a match? Why does that cost so much? It didn’t cost that much when we tried before, did it?” Mary was referring to a previous time, when Rachel had been considered for a bone marrow transplant and they had all registered as donors, by giving cheek swabs to collect DNA. None of them had been matches.
“It’s not the costs of donating, it’s the costs of finding a donor. The hospital has to contact the Bone Marrow Donor Registry to get a list of potential matches, but they have to test at least six potential donors to get one that’s a perfect match. Each test costs six to nine grand. It adds up fast.”
“Oh, man.” Mary hadn’t realized.
“Luckily, CHOP found us a match, changed Rachel’s chemo protocol, and got her into remission. You have to be in remission to do the transplant.”
“That’s sounds like a Catch-22.”
“I know, but it isn’t. I’ll fill you in another time. Anyway, when I told Todd that Rachel needed the transplant, he fired me the next week, supposedly because I didn’t make quota—for one month. The first time in twelve years.”
“So it was a pretext because they didn’t want to pay for Rachel’s expenses? And they didn’t want their premiums to go up?”
“I think so.”
“That’s heartless.” Mary felt a surge of anger, the kind she always felt when somebody had been wronged. But here, it had happened to someone she knew and loved. Simon. And Rachel.
Feet shook his head. “They’re bastards!”
“WHAT KINDA PEOPLE FIRE YOU BECAUSE YOU GOT A SICK KID? THEY SHOULD BURN IN HELL!”
“Disgrazia!”
Simon shook his head. “The irony is that OpenSpace wouldn’t have had to pay another penny. CHOP worked with me and Aetna, and since I’m a Pennsylvania resident and the illness is life-threatening, I can use secondary insurance like the CAT fund and Medicaid. They cover the costs of the transplant, which is astronomical.”
“How much does a bone marrow transplant cost?”
“A million bucks.”
“Whoa, are you kidding?” Mary said, shocked.
“No, start to finish, it’s almost a year-long process, and you can’t imagine the expertise and care it takes.”
“I bet.” Mary got back on track. “Do you remember the comment your boss, Todd, made to you, about how much it was costing?”
“Yes, and I even have proof. I wrote down every time Todd said something to me about her bills. I didn’t want to write it on my phone because it’s company-issued.” Simon reached into his sport jacket, pulled out a Moleskine notebook, and set it down. “I can show you right here, when and where.”
“Great.” Mary picked up the notebook, opened it, and glanced at Simon’s characteristically neat writing, with dates and times noted. “Simon, what’s your boss’s full name?”
“Todd Eddington.”
Mary made a note. “How long has he been your boss and what’s his job title?”
“He’s sales manager. I’ve reported to him for twelve years.” Simon swallowed hard. “I thought we were friends. I know his ex-wife, Cheryl. They were both good to Ellen.” Simon’s voice trailed off, but Mary wanted to keep him on the case.
“So did Todd make the decision or did somebody else?”
“He does. He makes a recommendation upstairs, to hire or fire, and it gets rubber-stamped by the president, Mike Bashir.”
Mary made a note of the name.
“So is it legal, what they did?” Simon leaned over. “It seems so wrong to me. I understand that a transplant costs a lot, but they’re going gangbusters and I worked for them for twelve years. Can they get away with this?”
“Not in my book. We can sue them for this, and we should, right away.” Mary knew disability law as a result of her growing special-education practice and she was already drafting a complaint in her mind. She loved it when the law actually did justice, which happened less frequently than God intended.
“So it’s illegal?” Simon leaned forward, newly urgent.
“Yes. There’s a federal law, the Americans with Disabilities Act, and it prevents discrimination in employment based on disability or illness. So for example, you can’t fire somebody because they have cancer—”
“But how does that apply to me? I’m not the one with cancer, Rachel is.”
“I know, but the law has a special provision that applies here, though it’s not well-known. In fact, there’s very little case law on it, but it applies to us.” Mary started searching online for the statute. “It’s called the ‘association provision’ and it forbids employment discrimination on the basis of an illness contracted by people who are associated with the insured employee, like their family.”
“Really?” Simon’s eyes widened with hope.
“Yes, under the ADA, an employer is prohibited from”— Mary found the statute and started reading aloud—“‘excluding or otherwise denying equal jobs or benefits to a qualified individual because of the known disability of an individual with whom the qualified individual is known to have a relationship or association.’”
“MARE, WE DON’T GET THE LEGALESE!”
Mary explained, “It means Simon is a qualified individual under the law and he is associated with Rachel. In other words, Simon’s company can’t fire him because she got sick and her medical expenses are going to cost them. I have to research the cases and get more facts from you, but I think we have an excellent case here.”