The Employee Retirement Income Security Act (ERISA) was brought into law in 1974. Its primary function is to offer guidelines for insurance companies, pension companies and private employers on how they should offer benefit plans to workers. Over the years, numerous amendments have been added to ERISA to help employees get the most out of their plans. Make sure to familiarize yourself with all of them so that all of your workers get the benefits they deserve.
- Question: What Is the Consolidated Omnibus Budget Reconciliation Act?
- Question: Who Qualifies for COBRA?
- Question: What Is the Women’s Health and Cancer Rights Act?
- Question: What Is the Health Insurance Portability and Accountability Act?
- Question: What Is the Mental Health Parity and Addiction Equity Act?
- Question: What Is the Newborns’ and Mothers’ Health Protection Act?
This law, also referred to as COBRA, was brought into law in 1985. In the event that employees receive healthcare coverage for themselves and/or their families through their work, they will continue to receive it for a certain amount of time in the event that they are let go. COBRA must be purchased by the employee and the employee’s family. It will not apply to individuals who voluntarily left their position or had their employment terminated for severe misconduct.
First, a person can only receive COBRA benefits if he or she had coverage prior to losing it. Additionally, there needs to be a viable qualifying event that would allow the person to continue receiving it. For example, someone who purchases COBRA coverage through a spouse’s work would still receive it following a divorce when ordinarily he or she would lose any health benefits.
Enacted in 1998, the Women’s Health and Cancer Rights Act (WHRCA) protects women who undergo mastectomies to treat breast cancer. Under this amendment, employers who offer health coverage for a mastectomy must also offer coverage in the event that a woman also decides to undergo breast reconstruction surgery.
Another ERISA amendment is the Health Insurance Portability and Accountability Act (HIPAA). Since 1996, this amendment has made it easier for employees and any dependents to receive health coverage through employers. One advantage this amendment provided was limiting preexisting conditions. Before HIPAA, an employer’s health plan could not exclude individuals based on a preexisting condition from over 12 months ago. That time frame was reduced to six months. However, under the Affordable Care Act, group health plans beginning on or after January 1, 2014, cannot have any exclusions on preexisting conditions.
While society still contains some stigmas surrounding mental illnesses, the Mental Health Parity and Addiction Equity Act was signed into law in 2008 to help those suffering from mental diseases. This law only applies to business owners who employ 50 or more workers, and it states that any restrictions placed on mental health services through a company’s health plan can be no more exclusive than restrictions placed on other health services. Mental health needs to be treated the same as other medical problems, so if your health plan includes provisions going toward mental health, then you need to be certain that it is compliant with the amendment.
Sometimes referred to as simply the Newborns’ Act, this law offers protections for mothers who have recently given birth. This amendment states that maternity coverage must be offered for hospital stays up to 96 hours for births involving a caesarian section and 48 hours for vaginal births. It is crucial to keep in mind that many states have their own variations of the Newborns’ Act. You should check with your local and state laws to see if there is anything you need to do differently.
In order to avoid any complaints or lawsuits, you want to be sure that you are obeying every aspect of ERISA. Your employees are owed their benefits, so you should examine these amendments more in depth to see what you should do.
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