Q & A – What laws govern benefit plans?

Q: What laws govern benefit plans?

A: All qualified private retirement and health and welfare plans are subject to the Employee Retirement Income Security Act (ERISA). Provisions of ERISA include notice and disclosure requirements, fiduciary requirements, claims and appeals, and retirement plan specifics. Public employers and church plans are not subject to ERISA.

If an employer offers a health plan (no mater how small the employer is) they are subject to the Affordable Care Act (ACA). Common requirements include the employer mandate, reporting, coverage for dependents up to age 26, no pre-existing condition exclusions allowed, no annual or lifetime limits and no excessive waiting periods.

Other laws employers need to be aware of when offering benefits include the Genetic Information Nondiscrimination Act (GINA), Americans with Disabilities Act (ADA), Health Insurance Portability and Accountability Act (HIPAA), Mental Health Parity Act, Title VII, and various state laws (this list is not all inclusive).