Some of ERISA’s health-based amendments

On Behalf of | Feb 1, 2019 | Uncategorized |

The Employee Retirement Income Security Act (ERISA) offers guidance on how private employers should administer employee benefit plans. Since the law was signed in 1974, there have been several amendments that address health care.

Here are some of them.

Consolidated Omnibus Budget Reconciliation Act (COBRA)

COBRA was enacted in 1985 and allowed employees who lost their jobs to retain healthcare coverage. The coverage would be paid by the former employee and wouldn’t be available to an employee who was fired for “gross misconduct” or resigned.

The coverage is available to the employee for 18 months after termination and up to 36 months for the employee’s spouse and child.

Health Insurance Portability and Accountability Act (HIPAA)

HIPAA was enacted in 1996 and aimed to make healthcare coverage more secure, especially for pre-existing conditions.

The law requires employers to cover pre-existing conditions if they were treated six months prior to enrolling in the new plan. Before HIPAA, the time frame was 12 months. Since 2014, Obamacare (the Affordable Care Act) eliminated pre-existing conditions.

Newborns and Mothers Health Protection Act

Also enacted in 1996, the Newborns’ and Mothers’ Health Protection Act was aimed at negating the “drive-through birth” practice and changed the amount of time a mother and newborn are allowed to stay in the hospital.

The law requires insurance companies to pay for at least a 48-hour hospital stay after a vaginal birth and 96 hours after a caesarean section.

Mental Health Parity and Addiction Equity Act

Signed into law in 2008, the law requires insurance plans treat mental illness and addiction as they treat other medical issues.

The law applies to companies that employ 50 or more workers and does not require medical plans to offer mental illness benefits, but if they do, they have to be in parity with the other offered plans.

Womens Health and Cancer Rights Act

The law, enacted in 1998, requires health plans that offer coverage for mastectomies to also offer breast reconstructive surgery


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