This form is a Complaint For Declaratory Judgment To Determine ERISA Coverage. Adapt to your specific circumstances. Don't reinvent the wheel, save time and money.
Erisa Complaint Sample Form In Suffolk
Category:
State:
Multi-State
County:
Suffolk
Control #:
US-000273
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Word;
Rich Text
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FAQ
For assistance you may call (631) 853-4600 Monday through Friday, from 9am to 4 pm. Note: To initiate a complaint, you must complete and sign the complaint form and then send it back to us with the required documentation.
Conclusion: Going to small claims court may be worth it for $500, but it will determine how you weigh your costs versus benefits. At a minimum, it is worth it to send a demand letter.
Be on your best behavior But be prepared to wait for your case to be called. Your judge will be hearing several other cases on the same day as yours. If your case is called and you are not there, the judge may dismiss it. Show respect to the judge by calling him or her “your honor." Don't use profanity.
Filing your complaint starts your case, but the summons is the document that is issued under the court's authority that notifies your defendant they are being sued and that they need to take action.
File Complaint Online: Mail/Fax: Mailing Address: NYC Department of Consumer and Worker Protection. Consumer Services Division. 42 Broadway, 9th Floor. New York, NY 10004. Fax: (212) 487-4482.
For assistance you may call (631) 853-4600 Monday through Friday, from 9am to 4 pm. Note: To initiate a complaint, you must complete and sign the complaint form and then send it back to us with the required documentation.
Contact your regional EBSA office to file a complaint or an appeal after exhausting your insurance appeals process. You can also find ERISA information through the U.S. Department of Labor online at .dol/ebsa.
Common ERISA violations include denying benefits improperly, breaching fiduciary duties, and interfering with employee rights under the plan.
ERISA governs the claim only if ERISA covers the plan involved in the claim. ERISA applies to most employee benefit plans, including employee health and retirement plans. ERISA does not cover certain plans, such as government plans and church plans.