Key workplace benefits compliance requirements for HR teams

A number of major federal laws define the foundation of employee benefits compliance in the United States. HR teams should be familiar with the core requirements of the following laws.

Affordable Care Act (ACA)

The Affordable Care Act is a pivotal law shaping employer-sponsored health benefits . Its primary goals are to expand health care coverage, control costs, and improve service delivery.

Employer obligations under the ACA vary based on the size and structure of an employers workforce. For example, applicable large employers must offer coverage that meets the ACA’s affordability and minimum value requirements and also comply with annual reporting requirements. 

Employers are also required to maintain a written group health plan which can follow a calendar year or be based on another 12-month period such as a fiscal/tax year. This matters because many ACA requirements are based on an employer’s plan year.

In addition, the ACA requires special enrollment periods. Job-based plans must provide 30 days for employees to enroll after certain life events such as marriage or birth of a child, or after a loss of other health coverage.  

Consolidated Omnibus Budget Reconciliation Act (COBRA)

COBRA provides a temporary option for employees and their dependents to maintain their health insurance coverage when they would otherwise lose it under certain circumstances. 

An employer’s group health plan is subject to COBRA if 20 or more employees were employed on more than 50 percent of typical business days in the previous calendar year. When determining whether a group health plan is subject to COBRA, both full-time and part-time employees should be counted. 

COBRA also applies to group health plans maintained by state and local government employers but does not apply to group health plans maintained by the federal government or by most church employers.

Employee Retirement Income Security Act of 1974 (ERISA)

ERISA, enacted in 1974, sets minimum standards for pension and welfare benefit plans offered by employers. Most ERISA rules focus on pension plans and require employers to ensure compliance with key requirements for qualified pension plans, including eligibility, participation, vesting, benefit accrual, coverage, and funding standards. These are baseline protections, and employers may provide benefits beyond what ERISA mandates.

ERISA does not apply to certain plans, such as government or church plans, IRAs, voluntary employee-funded plans and plans for select management employees or those created to meet state workers’ compensation, disability or unemployment laws.

Family and Medical Leave Act (FMLA)

The FMLA, effective since 1993, gives eligible employees of covered employers the right to take unpaid, job-protected leave for specific family and medical reasons. These include the birth or adoption of a child, caring for a family member with a serious health condition, an employee’s own serious health condition, and certain military-related needs.

The FMLA requires employers to maintain group health insurance under the same terms as if the employee were working and, in most situations, to restore the employee to their previous position. Employers are also prohibited from interfering with FMLA rights, and compliance is enforced by the U.S. Department of Labor.

How does state law impact employee benefits requirements?

State law significantly impacts employee benefits requirements by establishing additional regulations and standards that employers must follow. 

These rules often go beyond federal requirements, shaping obligations around paid leave, health insurance mandates, disability benefits, continuation coverage and more. For employers, especially those with a multi-state workforce, understanding these variations is critical to avoid compliance risks and penalties.

States and localities can significantly expand employee rights, examples include:

• State-specific continuation coverage rules beyond COBRA
• Paid family and medical leave laws with unique contribution and notice requirements
• State mandates for disability insurance or paid sick leave
• Local ordinances that expand employee rights related to benefits and time off.

HR teams should stay up to date on both federal and state laws, as requirements can change quickly. Regularly audit benefit policies to ensure compliance with state-specific mandates, such as paid family leave or disability insurance. Communicate clearly with employees about their rights under applicable laws, and make use of compliance tools, legal updates, and professional networks to stay informed.