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elaws - employment laws assistance for workers and small businesses


- Health Benefits Advisor for Employers

The Health Benefits Advisor for Employers provides an overview of certain Federal laws that can affect health benefit coverage provided by group health plans. The requirements described in this Advisor generally apply to group health plans and group health insurance issuers (i.e., insurance companies and health maintenance organizations (HMOs)). However, for convenience, references here are generally limited to "group health plans" or "plans."

The laws discussed in this Advisor are included in Parts 6 and 7 of Title I of the Employee Retirement Income Security Act of 1974 (ERISA). These laws include:

  • Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Mental Health Parity and Addiction Equity Act (MHPAEA) and Mental Health Parity Act (MHPA)
  • Newborns' and Mothers' Health Protection Act (Newborns' Act)
  • Women's Health and Cancer Rights Act (WHCRA)
  • Genetic Information Nondiscrimination Act (GINA)
  • Michelle's Law

This Advisor was developed by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA) and is designed to provide explanations of legislation, statutes and regulations. It provides general guidance only and should not be considered legal advice. If you have further questions not specifically addressed in the Advisor, please contact the Employee Benefits Security Administration regional office nearest you or call toll free 1-866-444-3272.

If you are an employer whose plan provides benefits through an insurance policy or HMO, you may also contact your state insurance department. For more information visit the National Association of Insurance Commissioners (NAIC) website. As discussed in the Advisor, state law regulating insurance companies and HMOs can change some of these Federal rules if the state law is more protective of individuals.

The specific laws included in Parts 6 and 7 of ERISA are applicable to group health plans, and may or may not apply to your plan depending upon a number of factors, including the employees in your organization and the type of benefits offered under your health plan.

The Advisor contains sections on each law, provides a description of the employer obligations contained in the law and regulations, and links you to other materials to assist you in complying with that law.

Please note: The Patient Protection and Affordable Care Act (ACA) provides additional health protections. This website does not reflect the passage of the ACA. For an overview of the Affordable Care Act, please visit the ACA Summary. For regulations, guidance and additional information, please visit the Department of Labor's ACA webpage.

The Health Benefits Advisor for Employers is one of a series of elaws (Employment Laws Assistance for Workers and Small Businesses) Advisors developed by the U.S. Department of Labor (DOL) to help employers and employees understand their rights and responsibilities under Federal employment laws. To view the entire list of elaws Advisors please visit the elaws website. To learn more about DOL's efforts to ensure the security of the retirement, health and other workplace-related benefits of America's workers and their families, visit the Employee Benefits Security Administration (EBSA) website.