Some benefits are mandated by statute and cannot be altered or dropped by the organization. Mandated benefits include the following:
- Social Security/Medicare
- Unemployment insurance
- Workers’ compensation
- The Consolidated Omnibus Budget Reconciliation Act (COBRA)
- The Health Insurance Portability and Accountability Act (HIPAA)
- The Family and Medical Leave Act (FMLA)
Voluntary benefits
The list of benefits that employers may offer is extensive and can be creative, and may include the following:
- Health care benefits — health, dental, vision, prescriptions
- Retirement benefits
- Profit sharing
- Severance packages
- Life insurance
- Employee Assistance Program (EAP)
- Paid time off
- Tuition reimbursement
- Bonuses
- Wellness programs
- Legal insurance
- Child care subsidies
- Company vehicle
This list is not exhaustive, but provides some voluntary benefits. Please note that state statutes may require some forms of benefits.
Laws governing benefits
When a company decides to offer benefits to its employees, it must contend with regulatory requirements. Some of the laws that govern employee benefits includes the following:
- Employee Retirement Income Security Act (ERISA) (1974) — Ensures that employee benefit plans are established and maintained in a fair and financially sound manner.
- Revenue Act (1978) — Added sections 125 and 401(k) to the tax code. Section 125 allows employers to offer employees favorable tax treatment on health and welfare benefits. Section 401(k) allows employees to make tax-favored pay deferrals toward retirement savings through payroll deductions.
- Tax Reform Act (1986) — Implemented new limits on salary deferral contributions and compensation in employee benefit programs such as qualified retirement plans.
- Securities and Exchange Act (1934) — Affects company stock option and employee stock purchase plans.
- Older Worker’s Benefit Protection Act (OWBPA) (1990) — Prohibits age discrimination in employee benefits.
- Mental Health Parity Act (1996) — Requires group health plans to adopt the same annual and lifetime dollar limits for mental health benefits as for medical benefits.
- Sarbanes-Oxley Act of 2002 — Requires administrators of defined contribution plans to provide notices to affected participants of covered blackout periods.
- Affordable Care Act — Provides for penalties if large employers do not offer certain group health coverage to full-time employees.
ERISA
Of all these acts, ERISA stands out as having a continual impact on employee benefits. ERISA is a federal law that sets minimum standards for most voluntarily established pension and health plans in private industry to protect individuals in these plans.
ERISA does not require any employer to establish a health or pension plan. It requires only that those who establish plans must meet certain minimum standards. The law generally does not specify how much money a participant must be paid as a benefit.
Most private-sector employee benefit programs are subject to some provisions of ERISA. The rules apply to and regulate private retirement plans and welfare plans such as employer-sponsored group medical programs, group life insurance, and long-term disability coverage.
Among other things, ERISA provides protections for participants and beneficiaries in employee benefit plans, including providing access to plan information. Also, those individuals who manage plans (and other fiduciaries) must meet certain standards of conduct under the fiduciary responsibilities specified in the law.
The Employee Benefits Security Administration (EBSA) of the Department of Labor is responsible for administering and enforcing these provisions of ERISA.
Regulations that cover ERISA can be found under 29 CFR Parts 2509-2589.
General rules under ERISA
An ERISA plan must be operated for the exclusive benefit of the participants and their beneficiaries. The employer sponsor must follow the prudent person rule with respect to its handling, investment, and management of the plan’s assets. According to this rule, the employer cannot take more risks than a reasonably knowledgeable, prudent investor would under similar circumstances. Benefit plan assets must be segregated from other company assets such as trust agreements, insurance company accounts, and individual policies. The employer has legal and financial obligations not to misuse the funds set aside in trust to provide specific benefits.
Under titles I and IV of ERISA, and the Internal Revenue Code, pension and other employee benefit plans are required to file annual returns/reports concerning the financial condition and operations of the plan. These requirements are generally satisfied by filing the Form 5500 Series.
ERISA does the following:
- Requires plans to provide participants with plan information including important information about plan features and funding;
- Provides fiduciary responsibilities for those who manage and control plan assets;
- Requires plans to establish a grievance and appeals process for participants to get benefits from their plans; and
- Gives participants the right to sue for benefits and breaches of fiduciary duty.
For example, if your company maintains a pension plan, ERISA specifies when employees must be allowed to become participants, how long employees have to work before they have a non-forfeitable interest in their pension, how long they can be away from their job before it might affect benefits, and whether a spouse has a right to part of the employee’s pension in the event of his or her death. Most of the provisions of ERISA are effective for plan years beginning or after January 1, 1975.
Affordable Care Act
Applicable large employers are subject to the employer shared responsibility provisions and may be subject to one of two potential payments for a given month if at least one full-time employee received the premium tax credit for purchasing coverage through a health insurance marketplace for that same month the employer either:
- Did not offer coverage to at least 95% full-time employees (and their dependents), or
- Offered coverage, but at least one full-time employee received the tax credit (because the coverage was unaffordable, did not provide minimum value, or the employee was not offered coverage).
Applicable large employers are subject to certain reporting requirements for their full-time employees.