Skip to content Skip to footer

Table of contents

Regulation of group health plans — Benefits

Most group health plans sponsored by employers in the private sector - other than certain health savings accounts (HSAs) - are considered employee welfare benefit plans under the Employee Retirement Income Security Act (ERISA). If a group health plan (or any other welfare benefit plan) is governed by ERISA, a number of ERISA’s provisions relating to plan adoption and other procedural requirements apply. Some of the more significant of these requirements are discussed in the first section of this chapter, as well as in Chapter 12: Employee communications and Chapter 13: Fiduciary duties.

When originally adopted, ERISA did not contain many requirements as to specific benefits that group health plans would be required to provide, nor did it contain prohibitions against particular terms and conditions that might be included in such plans. State laws regulating the business of insurance were immunized from ERISA preemption, and Congress evidently believed that the vast majority of employees would have ample protection as the result of state insurance law and the dynamics of the market for insured indemnity plans. However, beginning in 1985 with the adoption of continuation coverage requirements under the Consolidated Omnibus Budget Reconciliation Act (COBRA), Congress has amended ERISA many times to add substantive...


Please call us at (312) 960-9400 if this is an error or if you have any questions.