Health Acts Passed to Assist Individuals in Obtaining Health Insurance

Health Acts Passed to Assist Individuals in Obtaining Health Insurance

Health Acts Passed to Assist Individuals in Obtaining Health Insurance

A group health plan is a type of employee welfare benefit plan that an employer gives to their employees. The plan is maintained by the business or the employee organization (union), and it provides medical care to employees and their families. This can happen in a number of ways, including direct payment, reimbursement, and insurance.

The Employee Retirement Income Security Act (ERISA) is a federal law that protects employees' retirement income

The bulk of private-sector health plans are covered by the Employee Retirement Income Security Act. The Act's goal is to ensure that participants in employee benefit plans and their beneficiaries are protected and have access to plan information. The entities in charge of these programs are required by law to follow a set of conduct guidelines.

The Employee Benefits Security Administration (EBSA) provides a variety of compliance services, including publications, voluntary compliance programs, and advisory opinions, among others. On the EBSA's website, you may find a wealth of information about compliance assistance. Its purpose is to assist businesses and employee benefit plan practitioners in understanding the ERISA obligations.

This federal law establishes minimal standards for the majority of voluntarily established private sector health and retirement plans in order to ensure that persons who participate in the plans are protected.

The ERISA ensures that members have access to the plan information they need to make educated health-care decisions. This information can include plan funding and features, fiduciary obligations for those administering the plan's funds, a grievance and appeals mechanism in place to ensure participants receive their benefits, and so on.

Several revisions to the ERISA have been made, enhancing safeguards for health plan participants and beneficiaries. COBRA is a good example of extra security.

Health Acts Passed to Assist Individuals in Obtaining Health Insurance

What Is COBRA and How Does It Work?

The United States Department of Labor aided in the passage of the Consolidated Omnibus Budget Reconciliation Act (or COBRA), which allows workers and their families to keep their health insurance coverage after they lose it due to a voluntary or involuntary loss of employment, a reduction in working hours, a job transition, divorce, death, or other major life events. Those who qualify for COBRA will be responsible for the entire payment, up to 102 percent of the plan's cost.

Employers with 20 or more employees often provide group health plans that prolong this temporary extension of health care (known as continuation coverage) when plan coverage would otherwise terminate. COBRA explains how an employee and their family can keep their health insurance while also forcing companies to provide notice to their employees.

The Health Insurance Portability and Accountability Act is another ERISA amendment that protects working Americans and their dependents from discrimination in health coverage based on their health.

  • Other significant changes include:
  • Mental Health Parity Act
  • Mental Health Parity and Addiction Equity Act
  • Newborns’ and Mothers’ Health Protection Act
  • Affordable Care Act
  • Women’s Health and Cancer Rights Act

The US Department of Labor's Employee Benefits Security Administration is responsible for ensuring that ERISA is properly handled and enforced. Its responsibilities include informing consumers about various health plans and assisting with the compliance of employers, plan service providers, and other entities. Due to the highly technical nature of the material, it is recommended that entities consult other sources of information to learn how to stay compliant.

Learn more about health plan tax provisions by visiting the Internal Revenue Service's website. To learn more about the provisions of the Public Health Service Act, contact the Center for Medicare and Medicaid Services at the US Department of Health and Human Services.