New COVID-19 rules may mean higher premiums and even pink slips for the unvaccinated

Millions of workers are facing new federal vaccine rules in the wake of President Joe Biden's order on Thursday that large employers require their staffs to be vaccinated, or implement weekly COVID-19 testing for workers who are not.

The new requirement applies to employers with at least 100 workers, potentially affecting more than 80 million people. Another 20 million who work with or for the federal government will have to be vaccinated.

Vaccine mandates are legal as long as employees can seek accommodations for legitimate medical or religious reasons, most experts say. And a survey released last month by business management platform Qualtrics found that six in 10 workers support vaccine requirements, though 23% of workers said they'd strongly think about quitting if their employer imposed such a rule.  

“The president’s order means employers can stop discussing whether to impose a vaccination requirement, and begin the next important step of communicating with their employees about how they will act on it,'' Sydney Heimbrock, Qualtrics' chief industry advisor for government, said in a statement. 

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Here is how the new federal rules may play out in the workplace.

How soon do the new rules kick in?

Some companies, such as United Airlines and Tyson Foods, have already mandated that their workers get the shot. But it may take a little time for the new, broader federal rules to kick in, with the White House saying the formal guidelines should be issued "in the coming weeks.''

Will I lose pay if I take off to get the vaccine?

No. Under the rule, which will be spelled out by the Department of Labor's Occupational Safety and Health Administration (OSHA), employers must provide paid time off to allow workers to get the shot and also recover if they suffer some side effects.

Employees may pay more for insurance

Employers are starting to impose insurance surcharges on workers who refuse to get vaccinated, similar to how many charge employees who smoke a higher premium to cover the higher medical costs they may incur. 

"Employers are saying, just like with tobacco surcharges, 'If you take the risk of becoming seriously ill which is going to cost us hundreds of thousands of dollars...you're going to share in some of that'' cost, says Johnny C. Taylor Jr, president and CEO of the Society for Human Resource Management. 

Delta Air Lines announced such a step weeks before the new federal mandate.

The airline says that starting Nov. 1, it will charge employees who refuse to get vaccinated an additional $200 per month for their health insurance coverage.

Ed Bastian, the airline's CEO, said in an earlier memo to employees that the average Delta employee hospitalized for COVID-19 cost the company $50,000. 

"This surcharge will be necessary to address the financial risk the decision to not vaccinate is creating for our company," Bastian wrote.

Take a weekly test? It may cost you

Some colleges and universities are saying they will charge unvaccinated students hundreds of dollars for the COVID-19 tests they are required to take if they're enrolled. And some workplaces, faced with the prospect of constantly testing unvaccinated employees, are choosing to do the same, Taylor says.

“Employers are saying ... we're going to require testing on your dime,'' he says, adding that some businesses are even making unvaccinated employees pay for the masks they're required to wear in the workplace.

Making workers pay may push some to go ahead and get the shot, says Laura Boudreau, a professor of economics at Columbia Business School who focuses on occupational health and safety as well as relations between workers and employers. 

"If they require employees to bear that cost,'' she says, "That's yet another nudge for those employees to get vaccinated.'' 

Will my employer offer perks for getting the vaccine?

Some already have and more could in the near future.

In a statement issued Friday, American Airlines CEO Doug Parker and President Robert Isom reminded employees of incentives being offered to most U.S.-based staffers who haven't gotten vaccinated. 

Those that decide to get the shot can receive an additional day of vacation pay this year, and $50 in Nonstop Thanks points.

They have until Oct. 1 to submit proof that they've been vaccinated to qualify for those perks. 

"We put our incentive program in place because the science supports vaccination and has shown it’s the only way to fully end this pandemic,'' Parker and Isom wrote.

Other businesses may also continue to offer such bonuses.

“I think many of us will continue to do some combination of the carrot and the stick,'' Taylor says. 

But some companies may feel less pressure to entice employees to do what they feel is necessary for the safety of the entire workplace.  

"In the past month there’s been a dramatic increase in the number of companies that are implementing more stringent COVID policies,'' says Boudreau, and in the wake of Biden's federal mandate "I think that companies are (feeling) more comfortable ...starting to use more sticks.''

Can I be fired if I don't get the vaccine?

It's possible.

Generally, companies have the right to dismiss employees as long as the action isn't deemed in violation of a worker's civil rights, Taylor says. And some businesses have already fired employees who refused to be vaccinated, he and Boudreau say.

"I do think this policy will push more employers towards mandates,'' Boudreau says, "And I think ultimately we’ll see more employers who are firing employees who are unwilling to comply.’’ 

Can I refuse to be vaccinated for religious or health reasons? 

Employers must consider making reasonable accommodations for workers who have medical or religious reasons for refusing to be vaccinated, says Taylor.

But "it's not an exemption under the law,'' he says.

If such an accommodation can't be made, because for instance the employee needs to be onsite, or there isn't a way to isolate them in the office, the business may decide the employee can't continue to work for them.  

If I'm in a union, can my employer make me get the vaccine?

When a collective bargaining agreement is in place, conditions of employment must be negotiated. But under the emergency provisions that OSHA will be putting in place, vaccine requirements likely can't be challenged, Taylor says.

"On the whole, there seems to be a general understanding that the employer's legal footing for mandating vaccines is strong and unions have acknowledged that,'' says Boudreau.

But she says, unions will likely "be very active around implementation of the policies themselves,'' such as establishing a reasonable timeline for getting the shots.

Contributing: Nathan Bomey

Follow Charisse Jones on Twitter @charissejones