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Health Benefits Advisor for Employers

Plan Coverage Results

Based on your responses, the following health laws under Title I of ERISA appear to apply to your employer sponsored group health plan.

To find out the requirements of that law, please select it:

Based on your responses, the following health laws under Title I of ERISA do not appear to apply to your employer sponsored group health plan for the listed reason(s).

  • You indicated that you did not employ 20 or more employees in the previous calendar year.

COBRA applies to single-employer group health plans maintained by employers with at least 20 employees on more that 50 percent of its typical business days in the previous calendar year. Both full and part-time employees are counted to determine whether a plan is subject to COBRA. Each part-time employee counts as a fraction of a full-time employee, with the fraction equal to the numbers of hours that the part-time employee worked divided by the hours an employee must work to be considered full-time.

Your State may elect to regulate small groups or individual health arrangements. For more information visit the National Association of Insurance Commissioners (NAIC) website.

  • You indicated that you do not employ more than 50 employees.

MHPA requires that an employer have more than 50 employees on business days during the preceding calendar year and employ at least 2 employees on the first day of the plan year. However, your state (NAIC) may elect to regulate small groups or individual health arrangements

  • You indicated that your plan does not offer benefits with respect to a mastectomy.


Note: If you would like to review the information provided within this Advisor, you may select that issue above and it will take you back to that section in the Health Benefits Advisor where you can reread the description and answer the question again. This Advisor provides general guidance and users are encouraged to review their specific health plan or health plan options in conjunction with the general information provided. In addition, the Advisor does not address health benefits offered through Federal, state, or local government plans or church plans.

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