An employer-sponsored employee welfare benefit plan under the Employee Retirement Income Security Act of 1974 (ERISA) that also provides medical benefits (for example, a major medical plan). Group health plans are subject to extensive requirements in addition to ERISA's generally applicable compliance rules, which include reporting requirements (such as Form 5500), disclosure obligations (such as summary plan descriptions (SPDs)), and fiduciary standards of conduct. For example, group health plans also must satisfy requirements under:

Congressional legislation, as implemented by the federal administrative agencies, has expanded the group health plan requirements over the years. In December 2021, for example, federal spending legislation—the Consolidated Appropriations Act, 2021 (CAA-21)—added new group health plan requirements intended to prevent surprise medical billing with regard to emergency services and certain related services (Pub. L. No. 116-260 (Dec. 27, 2021)).

For more information, see Group Health Plans Toolkit.