Employee Health

Different Types of State and Federal Employee Health Requirements

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Different employers provide different levels and types of cover for their employee health. The type of healthcare benefit can vary depending on the size and type of business, the laws applying to the business, and the state laws.


Patient Protection & Affordable Care Act

The 2010 Patient Protection & Affordable Care Act regulates health insurance, coverage requirements and employee health benefits. It requires that all qualified health benefit plans must provide minimum basic health benefits package as laid out by the Secretary of Health and Human Services.

Family & Medical Leave Act

While the Patient Protection & Affordable Care Act applies to the larger population, the Family & Medical Leave Act (FMLA) applies to employee health. There are many regulations under this law. It provides employees with a maximum of 12 weeks of unpaid leave per year. It also keeps the health benefits in power even when such employees are in leave.

An employee is eligible for such leave only if he or she meets the following requirements:

  • Should have worked for the employer for a minimum of 12 months.
  • Should have worked for a minimum of 1,250 hours during the last year.
  • Should have worked at a location of the employer that has minimum of 50 workers or should have worked within 75 miles of such a location.

This law allows workers to maintain a balance between their work and personal life. it allows them to take unpaid leave for specific medical and family reasons. The objective of the FMLA is to achieve its purposes in a way that the employer interests aren’t affected. It also aims to eliminate any kind of employee discrimination based on gender.

The scope of the FMLA extends over different types of employers who fall into the following category:

  • Private employers with at least 50 workers for minimum of 20 weeks during the current or previous year.
  • Public agencies – local, state or federal departments.
  • Local schools

The federal employees fall under the Office of Personnel Management for FMLA.

State Regulations

State mandates are the laws at the state level that guide employers about employee health benefits. Among other types of coverage, they can also include coverage for alcohol, mammograms, substance abuse, home health care, infertility treatment or infant care. The regulations and the kind of coverage will vary from one state to another.

Many states have special employee health reforms that allow small business to get health insurance at relatively lower rates. The reforms can include regulations guaranteeing renewals, providing low-cost and basic policies excluding costly benefits, and requiring insurers to provide coverage without concern for the health condition of your employees. The types of reforms are different for different states.

It is important to note that the coverage and employee health benefits laid down by the Patient Protection & Affordable Care Act could affect the state mandates. So take all these laws into consideration when you plan the benefits for your employees.

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