Employee Benefits Programs and Plans
Structure of a public benefits program
Typical offerings include retirement (defined benefit vs. defined contribution), deferred compensation such as a 457(b), health/dental/vision, life insurance, flexible spending or health savings accounts through a Section 125 cafeteria plan, leave programs, workers' compensation, and unemployment insurance. Public plans often coordinate with Social Security and Medicare, and pension/OPEB obligations carry their own accounting disclosure requirements.
COBRA essentials
Applies to employers with 20+ employees. A qualifying event includes termination (other than gross misconduct), reduction in hours, divorce, death, and dependent status changes. Coverage generally continues 18 months (29 if a disability determination is made during the first 60 days; 36 for certain dependent events). The qualified beneficiary has 60 days to elect and 45 days to pay after electing. The plan may charge up to 102% of the premium. The employer must notify the plan within 30 days of the event.
Health plan compliance
HIPAA governs privacy and special enrollment rights; ACA sets the 30-hour-per-week full-time threshold and limits waiting periods to 90 days. FMLA and ADA interact with benefit continuation and accommodation obligations.
Traps
- Treating a voluntary drop in coverage as a COBRA event - it usually is not.
- Assuming FMLA leave must be paid leave; it is job-protected, not necessarily compensated.
- Missing that a cafeteria plan election is generally irrevocable absent a qualifying status change.
- Confusing vesting (ownership of employer contributions) with eligibility (when you may participate).
Rule of thumb
For any benefits question, identify the plan, the triggering event, the notice deadline, and who pays.
Worked example: An employee resigns on March 1; the employer notifies the plan by March 31. The beneficiary has 60 days from the notice to elect COBRA, then 45 days to remit the first premium.