Under a group health plan, which factor cannot be used to offer additional benefits to classes of employees?

In the context of group health plans, the determination of additional benefits for different classes of employees must comply with various legal and regulatory requirements, most notably the provisions of the Affordable Care Act (ACA) and other non-discrimination laws. While employers have the discretion to differentiate benefits based on factors such as job seniority, health status, and geographic location, they cannot use gender as a basis for offering additional benefits.

Using gender to determine eligibility for benefits can lead to discriminatory practices, which is prohibited under Title VII of the Civil Rights Act and related laws. This prevents employers from creating an inequitable benefits structure based solely on the gender of employees, thereby ensuring fairness and equality in the provision of healthcare benefits.

The process of determining additional benefits based on job seniority, health status, and geographic location is generally permissible as long as it aligns with the overarching legal requirements and does not create discriminatory barriers that violate equal treatment mandates. Thus, gender stands out as the factor that cannot be used to offer additional benefits in a group health plan.