Employee Benefits, Leave, and Retirement
This domain tests ERISA's fiduciary and reporting structure, COBRA continuation rights, FMLA leave, and the ACA employer mandate.
ERISA
ERISA governs pension and welfare plans. Fiduciaries owe duties of loyalty and prudence, must act exclusively for participants, and face prohibited-transaction rules under §406 plus co-fiduciary liability. Certain plans file Form 5500, and claims procedures must meet the regulation's timelines. §510 bars interference with benefit rights. Employer contributions vest under a three-year cliff or six-year graded schedule; SECURE 2.0 pushed required minimum distributions to age 73. ERISA §514 preempts state laws that relate to covered plans.
COBRA and HIPAA
The employer must have 20 or more employees. Qualifying beneficiaries get 18 months for termination or hour reduction, 29 months for disability, and 36 months for other events, with 60 days to elect, 45 days to pay, and a premium capped at 102%.
FMLA
Covered employers have 50 or more employees within 75 miles. Eligible employees have 12 months of service and 1,250 hours in the prior year and receive 12 weeks (26 for military caregiver leave) for a serious health condition, birth, or family care, with continued group health coverage and reinstatement to the same or an equivalent position.
Worked example
A 60-person employer terminates an employee at week eight of FMLA leave for surgery and cancels her health coverage at month's end. Analysis: she is eligible (over 12 months, over 1,250 hours, employer over 50), so the termination is unlawful interference and likely retaliation. Coverage must continue on the same terms during leave. If coverage does end, COBRA notice obligations arise. Because the timing suggests an intent to prevent benefit accrual, an ERISA §510 interference claim should be pleaded as well.
Traps
- Counting total employees instead of those within 75 miles for FMLA.
- Assuming COBRA applies to small employers.
- Confusing vesting schedules with eligibility.
- Missing the 60-day COBRA election and 45-day premium windows.
- Ignoring that leave may run concurrently under FMLA, ADA, and state law only if properly designated.