JOSEPH LEBLANC, APPELLANT,
v.
HARMON CONTRACT GLAZING AND LIBERTY MUTUAL INS. CO., APPELLEES
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Florida appellate court affirmed exclusion of group health insurance premium savings from average weekly wage calculation where employer made no direct or indirect contribution to the insurance cost.
The value of reduced health insurance premiums attributable to group membership is properly excluded from average weekly wage calculation when the employer made no contribution to the group policy.
[1] Employer contributions to group health insurance are includable in average weekly wage calculations, but the mere availability of lower group insurance premiums without e…
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Join FLexlaw to unlock all legal intelligence“the value of the reduced premium cost of health insurance attributable to group membership was properly excluded from claimant's average weekly wage calculation”
Court's statement of the basis for affirmance
A claimant sought review of a workers' compensation order denying a claim for increased wage rate based on group health insurance premium savings.…
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WENTWORTH, Judge.
Claimant seeks review of a workers’ compensation order by which a claim for increased wage rate was denied. Because employer was not shown to have contributed directly or indirectly to the cost of group insurance, we find that the value of the reduced premium cost of health insurance attributable to group membership was properly excluded from claimant’s average weekly wage calculation and accordingly affirm.
The fair market value of an employer contribution for group health insurance has been included in the calculation of an employee’s average weekly wage. See section 440.02(21), Fla.Stat.; Constanzer v. Sta Rite, 432 So. 2d 775 (Fla. 1st DCA 1983). However, the record reflects no contribution by or identifiable benefit to claimant’s employer from the group policy. Although claimant paid a lower premium than required for individual insurance by virtue of his membership in the group covered by the policy, we find no basis in the statute for concluding that availability of that option was a fringe benefit to be valued as a part of wages paid by employer. The deputy commissioner therefore correctly excluded the value of this reduction in premium cost from his determination of claimant’s average weekly wage.
The order is affirmed.
JOANOS and NIMMONS, JJ., concur.
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Pishotta v. Pishotta Tile & Marble, Inc., 613 So. 2d 1373 (Fla. 1st DCA 1993)…However, an exception to this rule exists where the evidence establishes that the business profits are “almost entirely the direct result of personal management and endeavor.” MDM Marble Co., 512 So. 2d at 307. See also Perini Corporation v. Licata, 548 So. 2d 815 (Fla. 1st DCA 1989); Rios v. Fred Tietelbaum Construction. As was true in MDM Marble Co., “the conclusion is inescapable” in the instant case that claimant was not receiving his company’s profits merely because of his status as owner; rather, the p…
Authorities Cited
- Constanzer v. STA Rite & the Travelers Ins. Co., 432 So. 2d 775 (Fla. 1st DCA 1983)