Benefits Administration: Overview

Purpose

This document describes the benefits administration function, the intent of the Research Foundation's (RF's) benefits administration policies, and the regulations that apply to benefits administration.

Benefits Administration Function

Benefits administration consists of managing employee benefits in compliance with RF policies, procedures, and federal and state regulations, as well as educating employees on available benefits and helping them to obtain benefits to which they are entitled.

Central office is responsible for determining the plan design and creating the framework for benefits administration. Operating locations manage the day-to-day operations of benefits administration.

Fringe Benefit Rate

Employee benefit costs are paid from a predetermined "fringe benefit rate" that is negotiated with the Department of Health and Human Services (DHHS) and is charged against all employee salaries.

Benefit Information

The RF must comply with federal regulations mandating that employers provide employees with information on new benefits and changes in existing benefits. The RF disseminates new policy or policy changes to operating locations and employees as a routine practice prior to the implementation of the change.

Policy Intent

The RF has developed policies and procedures for benefits administration that

Regulations

As a private, not-for-profit organization, the RF is subject to the following regulations that apply to benefits administration:

Regulation

Description

Internal Revenue Service (IRS) and Department of Labor (DOL) regulations

IRS and DOL regulations govern retirement and other benefit plans. They require that employers design and operate plans in a nondiscriminatory way, prepare annual reports on all benefit plans, and inform employees about their benefits.

Employee Retirement Income Security Act of 1974 (ERISA)

ERISA is a complex law governing the establishment, operation, and administration of retirement and other employee benefit plans.

Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)

COBRA regulations mandate that employers allow employees and dependents the opportunity to continue health, dental, and vision benefits under the employer's plan after losing eligibility. Refer to Continuation of Benefits in EPSS under Employees: Benefits and Retirement, Procedures and Guidance.

Health Insurance Portability and Accountability Act of 1996 (HIPPA)

This law requires that health plans

  • provide members with written certification of prior health insurance when health coverage ends, and
  • protect the privacy of individual health information. Refer to Privacy and Security of Protected Health Information in EPSS under Employees: Benefits and Retirement, Procedures and Guidance.

Family and Medical Act (FMLA)

This law requires that employers allow employees to continue health benefits when on leave under FMLA. Refer Continuation of Benefits in EPSS under Employees: Benefits and Retirement, Procedures and Guidance.

NYS Labor and Workers' Compensation Laws

These laws require that employers provide employees with unemployment, Workers' Compensation, and Disability Benefits and with information on how to obtain benefits. Refer to the Disability Benefits and Unemployment Insurance in EPSS under Employees: Benefits and Retirement, Procedures and Guidance.

Review of Eligibility and Benefit Changes

New appointments, changes in appointments, and requests for coverage changes must be carefully reviewed to ensure that employee's receive the benefits for which they are eligible and that policies and procedures are followed.

Change History

 

 

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