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November 4, 2008    DOL Home > Compliance Assistance > By Topic > Benefits > Health Benefits   

Benefits:

Health Benefits


 Frequently Asked Questions

OVERVIEW

A group health plan is an employee welfare benefit plan established or maintained by an employer or by an employee organization (such as a union), or both, that provides medical care for participants or their dependents directly or through insurance, reimbursement, or other means.

Most private sector health plans are covered by the Employee Retirement Income Security Act (ERISA). Among other things, ERISA provides protections for participants and beneficiaries in employee benefit plans (participant rights), including providing access to plan information. Also, those individuals who manage plans (as well as other fiduciaries) must meet certain standards of conduct under the fiduciary responsibilities specified in the Act.

The U.S. Department of Labor's Employee Benefits Security Administration (EBSA) is responsible for administering and enforcing these provisions of ERISA.

COMPLIANCE ASSISTANCE MATERIALS

BASIC INFORMATION

General:

Participants and Beneficiaries:

  • 1996 Changes in Health Care Law - Provides an overview of recent changes in federal law that can affect the health benefits of workers and their families. (PDF)

E-TOOLS

  • elaws Health Benefits Advisor - Helps workers and their families better understand employer and employee organization (such as a union) provided group health benefits and the laws that govern them, especially when they experience changes in their life and work situations such as marriage, childbirth, job loss or retirement; also assists employers in understanding their responsibilities under the applicable laws.

RECORDKEEPING

  • Form M-1 Online Filing System - An electronic filing system for the Form M-1 annual report for multiple employer welfare arrangements that allows filers to complete the form and submit it at no cost.

APPLICABLE LAWS AND REGULATIONS

  • Employee Retirement Income Security Act of 1974 (ERISA) - Sets uniform minimum standards to ensure that employee benefit plans are established and maintained in a fair and financially sound manner. In addition, employers have an obligation to provide promised benefits and satisfy ERISA's requirements for managing and administering private pension and welfare plans.
  • 29 CFR Parts 2509 to 2590 - EBSA (formerly known as the Pension and Welfare Benefits Administration) regulations, including interpretive bulletins related to ERISA (29 CFR Part 2509).

RELATED TOPICS AND LINKS

DOL CONTACTS*

  • Employee Benefits Security Administration (EBSA)
    200 Constitution Avenue, NW
    Room N-5623
    Washington, DC 20210
    Contact EBSA
    Tel: 1-866-444-EBSA (3272)
    TTY: 1-877-889-5627
    Regional Offices

  • For questions on other DOL laws,
    please call DOL's Toll-Free Help Line at 1-866-4-USA-DOL. Live assistance is available in English and Spanish, Monday through Friday from 8:00 a.m. to 8:00 p.m. Eastern Time. Additional service is available in more than 140 languages through a translation service.
    Tel: 1-866-4-USA-DOL
    TTY: 1-877-889-5627

*Pursuant to the U.S. Department of Labor's Confidentiality Protocol for Compliance Assistance Inquiries, information provided by a telephone caller will be kept confidential within the bounds of the law. Compliance assistance inquiries will not trigger an inspection, audit, investigation, etc.



Phone Numbers