Employer Background
This Health Benefits Advisor
provides employers with 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:
The Advisor offers employers who sponsor group
health plans an understanding of their responsibilities under ERISA. The
Advisor is designed to provide explanations of legislation, statutes, and
regulations. It is intended to provide general guidance 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) web site. 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.
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