Department of Labor rules for employer health plans, in one place.
The Department of Labor oversees most private employer health plans under ERISA. That means the annual Form 5500, plan documents and notices, COBRA, and parity rules. Start with the area that matches your question. Related: Transparency in Coverage machine-readable files and the price comparison tool.
Three areas, and the page for each.
Form 5500
The annual return of a benefit plan, who files it, and what happens when it is late.
COBRA
Notices, deadlines and coverage periods for employers.
Plan Documents And Notices
The documents and notices a plan has to have, and what a benefits guide is not.
Filing, extensions and late filings.
Form 5500 Past And Future Filings
Catching up on missed years and staying current.
Form 5500 Late Filing Penalties
What a late filing can cost.
Form 5500 Late Filing Penalty Examples
Worked examples of the penalty.
Form 5500 Delinquent Filer Program
The voluntary program for late filers.
Form 5500 Extension And Form 5558
How to extend the due date.
Form 5500 Small Plan Exemption
When a small plan does not have to file.
Form 5500 Department Of Labor Notice
What to do if you receive a notice.
Form 5500 And Plan Documents
How the filing ties to your plan documents.
Late ACA And Form 5500 Filings
Handling late filings of both kinds.
Notices, elections and billing.
COBRA Law
Notices, deadlines and coverage periods.
Notice And Election Administration
Getting the notices out and elections in.
Premium Billing And Collection
Billing and collecting COBRA premiums.
State Mini-COBRA Coordination
Where state continuation rules apply.
COBRA-To-Medicare Transitions
What changes when a qualified beneficiary becomes eligible for Medicare.
COBRA Cost Calculator
Work out a COBRA premium.
What a plan has to have and say.
Summary Of Benefits And Coverage
What the SBC is and when it is due.
SPD Vs. Benefits Guide
Why a benefits guide is not a summary plan description.
Required Employee Notices
The notices employees must receive.
Gag Clause Attestation
What the annual attestation is.
Mental Health Parity Compliance
The parity requirements for group plans.
Michigan Mental Health Parity Law
The Michigan law, for employers.
Proposed Rule On Electronic Delivery
The proposed DOL rule on delivering health plan notices electronically.
FMLA Penalties For Employers
What a violation can cost.
DOL And IRS Audits
What an audit looks like and how to prepare.
Common Questions About DOL Rules For Employer Plans
What does the Department of Labor regulate?
Most private-sector employer benefit plans under ERISA, including the annual Form 5500, plan documents, participant notices and claims procedures. It also enforces certain COBRA and parity requirements.
Who files the Form 5500?
The plan administrator, which is usually the employer. Some small plans are exempt, so check the small plan exemption page.
Is our benefits guide the same as the summary plan description?
No. A benefits guide is not an SPD, and a carrier certificate is not one either. The SPD page explains the difference.
Does COBRA apply to us?
Federal COBRA generally applies to employers with 20 or more employees. State continuation rules can reach smaller employers, covered on the mini-COBRA page.
We received a notice about our Form 5500. What now?
Read it for the response date and the filing years it names, then gather your filing history and send us a copy. The notice page walks through the steps.
Is this legal advice?
No. For a question specific to your company, involve your counsel. We can help you frame the question and bring the plan facts.
The rules in one place.
IRS Rules For Employer Health Plans
The ACA forms, IRS letters and tax rules for employer plans, in one place.
ERISA For Employer Health Plans
Plan documents, fiduciary duties, claims and the litigation climate.
FMLA And Leave Rules For Employers
Eligibility, penalties, benefits during leave and disability, in one place.
Transparency And Pharmacy Rules
Gag clauses, PBM contracts and disclosures, in one place.
Medicare Rules For Employer Health Plans
Part D notices, COBRA to Medicare and retiree coverage, in one place.
Medical Loss Ratio Rebates
What an employer should do with one.
Mental Health Parity
The comparative analysis your plan has to show.
Section 1557 Nondiscrimination
How the rule reaches group health plans.
HIPAA Special Enrollment
When employees can join outside open enrollment.
Newborns’ Act And WHCRA
Required maternity and mastectomy terms and notices.
CHIP Premium Assistance Notice
What employers in states with premium assistance must send.
Dependent Coverage To Age 26
What the rule requires of your plan.
90-Day Waiting Period Limit
What counts and what does not.
Preventive Services At No Cost
What the plan must cover and what it may not.
Grandfathered Health Plans
What the status exempts and what it does not.
Rescission Of Coverage
The narrow case where coverage can be cancelled retroactively.
HIPAA Nondiscrimination
The health factors a plan cannot use.
ACA Patient Protections
Choice of provider, OB-GYN access and emergency care.
Claims, Appeals And External Review
What a plan must offer when a claim is denied.
Balance Billing Protections
Surprise bill protections for employees.
Provider Directory Accuracy
Keeping network information current.
Broker And Consultant Compensation Disclosure
ERISA 408(b)(2)(B) basics.
Medical Child Support Orders And QMCSOs
What a qualified order requires.
National Medical Support Notice: Employer Steps
What to do when the notice arrives.
Medical Support Withholding And Payroll Limits
What payroll can and cannot withhold.
QMCSO Enrollment Rules
Open enrollment, waiting periods and effective dates.
Clinical Trial Coverage
What plans cannot do for trial participants.
Lifetime And Annual Dollar Limits
What is banned and what is still allowed.
Section 105(h) Nondiscrimination
Self-insured plan testing for highly compensated individuals.
ERISA Fidelity Bond Rules
Who handling plan funds must be bonded.
Voluntary Fiduciary Correction Program
How plan officials can correct fiduciary breaches.
Participant Requests For Plan Documents
The 30-day rule when an employee asks.
Preexisting Condition Exclusions
Why group plans cannot impose them.
COBRA And Medicare
How the timing rules interact.
Marketplace Coverage Options Notice
The model notice for new hires.
COBRA Disability Extension
11 more months for disabled beneficiaries.
COBRA Second Qualifying Event
Extending to 36 months for family members.
Annual And Lifetime Dollar Limits
No dollar caps on essential health benefits.
EAP Excepted Benefit Rules
The four conditions an EAP must meet to be an excepted benefit.
Health FSA COBRA Rules
When a health FSA must offer COBRA and how the remaining-benefit test works.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
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