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November 3, 2008    DOL Home > elaws Advisors > Health Benefits Advisor for Employers
elaws - employment laws assistance for workers and small businesses - Health Benefits Advisor for Employers

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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