The ADA covers the benefits an employer offers, and plan design, leave and wellness all matter.
The Americans with Disabilities Act reaches more than hiring and accommodations. It also applies to benefits. This page covers where it touches group health, leave, disability coverage and wellness, and where to bring in counsel.
Who the ADA covers.
Coverage depends on employer size and on who is protected.
Employers With 15 or More Employees
Title I of the ADA applies to employers with 15 or more employees. Michigan’s Persons with Disabilities Civil Rights Act applies more broadly, so a smaller employer can still have obligations.
Benefits Count
The ADA bars discrimination in the terms, conditions and privileges of employment. Health coverage, leave, disability plans and wellness programs all fall under that language.
Who Is Protected
Qualified individuals with a disability, including people with a record of one or who are regarded as having one. The ADA also bars discrimination based on a relationship with someone who has a disability.
Group health plan design.
The ADA does not require an employer to offer health coverage or any particular level of benefits. It does limit how a plan treats disability.
Equal Access
Employees with disabilities generally need the same access to the health plan as other employees, including the same eligibility rules and employer contribution.
Plan Terms
A limit that applies to every condition, such as a visit cap on a type of therapy, is treated differently from a cap aimed at one disability. The second kind draws scrutiny.
Insurance Safe Harbor
The ADA lets insurers and plan sponsors follow risk classification consistent with state law, but not as a way around the Act. Have counsel review any disability-specific limit.
Leave and accommodation.
Leave is one of the most common accommodation questions in benefits.
Leave as an Accommodation
Unpaid leave can be a reasonable accommodation when it does not cause undue hardship, including after FMLA leave runs out. A fixed maximum leave policy deserves a second look.
Coverage During Leave
An employee on accommodation leave generally should keep health coverage on the same terms as others on comparable leave.
The Interactive Process
When an employee asks for an accommodation, the employer and employee talk through what would work. Document the conversation and the result.
Medical information, wellness and disability coverage.
Three areas that often get mixed together.
Confidential Records
Medical information collected for accommodations or benefits is kept confidential and separate from personnel files, with narrow exceptions.
Voluntary Wellness
A wellness program that asks health questions or requires exams must be voluntary. The ADA and GINA wellness guide covers design and incentives.
Disability Insurance Is Separate
Short-term and long-term disability coverage is a benefit, not an accommodation. Plan terms and the duty to accommodate are separate questions.
Questions Employers Ask About the ADA and Benefits
Does the ADA require us to offer health insurance?
No. The ADA does not require any particular benefit. When benefits are offered, they are offered without disability-based discrimination. Other laws, such as the ACA employer mandate, address whether coverage must be offered.
Can a health plan cap or exclude a specific condition?
It depends on how the limit is written and applied, and the insurance safe harbor has limits. Ask counsel before adopting one.
Does an employee on long-term leave keep health coverage?
Generally the employer treats them like others on comparable leave. FMLA has its own coverage rules, and COBRA may apply when coverage ends.
Do the ADA and FMLA overlap?
Yes. One leave can fall under both laws, and the employer has to meet both. FMLA leave that runs out may still need to be considered as an accommodation.
Related guides.
ADA and GINA Wellness Program Rules
Voluntary design and incentives.
FMLA and Leave for Employers
Eligibility, notices and benefit continuation.
Short-Term Disability Insurance
How the benefit works.
Have a disability-related benefit question?
We can walk through how your plan and leave policies line up and bring in your employment counsel where the question is legal. This page is general information, not legal advice.
Your plan type
Employee count
The policy or situation
Your state
Rough answers are fine. We build the numbers from there.
Laws and rules referenced
42 U.S.C. § 12111 — ADA definitions, including covered employer.
42 U.S.C. § 12112 — Discrimination in terms, conditions and privileges of employment; medical examinations.
42 U.S.C. § 12201 — Insurance provisions.
EEOC: Employer-Provided Leave and the ADA — Leave as a reasonable accommodation.
EEOC: Disability-Related Inquiries and Medical Examinations — Voluntary wellness programs and confidentiality.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
Switch to CFH. Unhappy with your broker? Your employees won’t notice. You will. →
Cookies on This Site
We use cookies to keep the site working properly and to understand how it is used. You can decline anything that is not essential. See our Privacy Policy for the detail.
- Essential — needed for the site to load and for you to move around it. These cannot be switched off.
- Analytics — tell us which pages get read, so we know what is worth writing more of.
- Advertising — set by third parties such as ad and social platforms to measure and target campaigns.