Health Plans

The Department of Labor provides resources for health plan compliance, fiduciary responsibilities, and tools like the Health Benefits Advisor. These tools will help you understand and comply with health plan laws.

Health Benefits Advisor

The health benefits advisor is a tool that helps employers understand their federal rights and responsibilities related to health coverage, particularly during life events such as marriage, childbirth, job loss, or retirement.

I know my plan is covered by one of the specific Federal laws below and want to learn whether I’m in compliance with its provisions:

• Consolidated Omnibus Budget Reconciliation Act (COBRA)

  COBRA sets rules for eligible employees and their families to temporarily continue their group health insurance after losing coverage due to a qualifying event. Learn how and when continuation coverage must be offered and provided.

• Health Insurance Portability and Accountability Act (HIPAA)

  The Privacy Rule establishes standards for how covered entities can use and disclose Protected Health Information. It grants individuals rights regarding their own health information. Determine compliance with special enrollment provisions.

• Mental Health Parity and Addiction Equity Act (MHPAEA) and Mental Health Parity Act (MHPA)

  Ensure compliance with MHPAEA and MHPA provisions under Part 7 of the Employee Retirement Income Security Act (ERISA) for plans offering mental health, substance use, and medical benefits.

• Newborns’ and Mothers’ Health Protection Act (Newborns’ Act)

  Learn how the Newborns’ Act protects hospital stay benefits for mothers and newborns, ensuring compliance with Part 7 of ERISA.

• Women’s Health and Cancer Rights Act (WHCRA)

  Determine WHCRA requirements for health plans offering mastectomy-related benefits under Part 7 of ERISA.

• Genetic Information Nondiscrimination Act (GINA)

  Stay compliant with GINA provisions under Part 7 of ERISA, protecting against premium adjustments based on genetic information.

• Michelle’s Law

  Understand Michelle’s Law and its requirements for maintaining dependent student health coverage during medically necessary leaves of absence.

Claims Procedure

If you believe your employer or plan administrator has violated the law regarding your benefits, you can file a complaint for investigation. If you disagree with a final denial of your claim, the Employee Benefits Security Administration (EBSA) can assist or guide you on how to navigate the appeals process.

Learn more about Claims Procedure

Events

Find EBSA-sponsored seminars, workshops, and webcasts in your area.

Learn more about Events

Multiple Employer Welfare Arrangements

Learn about Multiple Employer Welfare Arrangements (MEWAs), their regulation under the Employee Retirement Income Security Act (ERISA), filing requirements, and available guidance.

Learn more about Multiple Employer Welfare Arrangements

Tools and Resources

Explore our resources for workers, families, employers, plans, service providers, and researchers.

Explore Tools and Resources for Health Plans

Law and Regulations

Discover essential health care laws and regulations, including the Affordable Care Act (ACA), the Consolidated Omnibus Budget Reconciliation Act (COBRA), the Health Insurance Portability and Accountability Act (HIPAA), the Children’s Health Insurance Program (CHIP), the Genetic Information Nondiscrimination Act (GINA), and the Mental Health Parity Act (MHPA), designed to safeguard rights, enhance access to care, and ensure equity in health coverage.

Learn more about Law and Regulations for Health Plans