Division III · Health and Welfare

Part 16. FMLA, USERRA, and Wellness Programs

This Part applies whenever a leave of absence, a protected status, or a wellness program reaches a benefit plan: FMLA group health maintenance under 29 C.F.R. §825.209, the premium-payment arrangements and the 15-day mailed notice that must precede any lapse, the narrow §825.213 right to recover the employer's premium share, and the §825.215(d)(4) pension rule (FMLA preserves service, it does not credit it — with the last-day-condition trap); the state paid-family-leave substitution question under Opinion Letter FMLA2025-01-A; USERRA reemployment, the §4316(a) escalator and the §4316(b) paid-military-leave and benefit-accrual litigation, §4318 pension crediting and the employer's funding liability and make-up window, the Code §414(u) qualification mirror and its loan-suspension rule, the HEART Act items (differential wage payments, the mandatory §401(a)(37) death benefit, qualified reservist distributions), and §4317 health continuation; wellness program design across the HIPAA/ACA nondiscrimination rules, the ADA, and GINA, including the fact that no ADA or GINA numerical incentive limit currently exists (GINA still bars any inducement for providing genetic information itself, 29 C.F.R. §1635.8(b)(2)(ii)); and the residual protected-status overlays — the ADEA equal cost or equal benefit rule, disability-based plan distinctions, pregnancy comparability, and ERISA §510.

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Related Parts

• Part 13. COBRA, HIPAA, and Welfare Benefits — the companion Part: COBRA qualifying events on failure to return, §125 payment options during leave, USERRA/COBRA parallel continuation, and HIPAA handling of wellness data
• Part 5. Qualified Plan Testing, Eligibility, and Vesting — service crediting, break-in-service rules, and the distinction between §825.215(d)(4) and the 501-hour rule
• Part 6. Distributions, Loans, Rollovers, and RMDs — the loan-suspension divergence between FMLA leave and qualified military service
• Part 21. Plan Corrections: EPCRS, VFCP, and DFVCP — definition-of-compensation failures from differential wage payments, and missed USERRA make-up windows
• Part 15. Health Plan Parity, CAA, and Transparency — the parity constraints that now reach many disability-based distinctions in group health plan design (MHPAEA does not reach disability-income plans)
• Part 14. ACA Employer Mandate and Health Reform — measurement-period and stability-period status during leave, and the preventive-services mandates
• Part 26. Severance, WARN, and Workforce Restructuring — OWBPA, window programs, and the §510 selection documentation that both Parts depend on
• Part 23. ERISA Disputes, Enforcement, Preemption, and Remedies — ERISA §510 interference doctrine
• Part 11. Multiple-Employer and Small-Employer Arrangements — staffing, PEO, and franchise structures, where the FMLA joint-employer test is its own test and is not the ERISA or §414 aggregation rules
• Part 1. Controlled Groups and Affiliated Service Groups — staffing, PEO, and franchise structures, where the FMLA joint-employer test is its own test and is not the ERISA or §414 aggregation rules
• Part 17. Fringe Benefits and Employment Taxation — taxation of wellness rewards and the ERISA plan-status analysis for disability and life coverage during leave