How does the Americans with Disabilities Act (ADA) affect employer-sponsored group health plans?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The ADA protects qualified individuals with disabilities from discrimination in employment, including the terms and conditions of benefit plans. An employer may not deny an otherwise qualified employee access to the group health plan, or treat the employee worse, because of a disability. The ADA does not dictate plan design, require identical plans for all employers, or mandate coverage of specific treatments; it focuses on nondiscrimination in access to and administration of benefits. The ADA's nondiscrimination principle applies to the terms, conditions, and privileges of employment, including the health benefit plan. What it prohibits is disability-based exclusion; it does not prevent plans from containing uniform coverage limits that apply equally to all employees, and it requires reasonable accommodation in the workplace itself.
Why the other options are wrong
- B) The ADA is a nondiscrimination law, not a mandate that all employers offer the same plan regardless of cost. The ADA does not compel identical plans or prohibit cost-based plan design; it bars disability-based exclusion from the benefits an employer actually offers.
- C) The ADA does not exempt small employers from group health coverage rules. The ADA applies to employers with 15 or more employees and does not create an exemption for small employers from group health coverage rules.
- D) The ADA does not require plans to cover experimental treatments for disabled employees. Equal access is the ADA's demand; mandating experimental treatments for disabled employees goes beyond anything the statute requires.
Memory hook
ADA says the group health door must open for qualified disabled employees, not that every treatment is covered.