Employee Benefit Plan Checklist

In order to comply with the nondiscrimination requirements of the American With Disability Act pertaining to employee benefits, employers should consider taking the following seven steps as part of a thorough benefit plan review: Step 1: Review each employee benefit plan or policy for restrictions or limitations that could affect participants differently based upon medical conditions. In addition to group health plans, employee benefit plans include group life and disability plans. Step 2: If a plan or policy provision is identified as adversely affecting individuals with disabilities, consider whether the provision is justified as constituting a uniform plan limitation. Step 3: If the particular plan limitation or exclusion does not apply uniformly, determine whether the limitation or exclusion is justified on the basis of recognized risk classification. Consider engaging a group actuary directly or through the plan administrator to assist in making this determination. Step 4: During the process of soliciting bids for new group insurance, be cautious in disclosing medical information of plan participants. Use of medical information during the bid solicitation process can create problems under the ADA. The information should be disclosed only after a careful review of the ADA implications. Step 5: Before instituting cost containment programs, consider the ADA requirements. The Act may require actuarial justification for the use of special classifications of employees for premium contributions, deductible limits, and co-payments. Step 6: Insurance companies, utilization review companies and other third parties may take actions in administering group health plans that result in discrimination against employees with disabilities. An employer is liable for violations of the ADA by those entities with which it has a contractual arrangement. Hence, an employer should review carefully its contractual arrangements and administrative practices for possible ADA issues and allocation of legal liability. Step 7: Alert those persons responsible for administering benefit plans to possible ADA issues and problems. Ensure that those individuals keep up to date with the developing ADA law, particularly as it pertains to benefit plans.