All private employers and employee organizations, such as unions, that offer health plans to employees have to follow ERISA. Only churches and government groups are exempt. If you offer your employees health coverage, you'll have to follow certain rules and procedures as a result of ERISA.
As a federal law, ERISA's main purpose is to protect the interests of workers who participate in qualified plans. These include certain employer-sponsored healthcare and retirement plans, such as 401(k)s and pensions.
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.
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.
By statute, only four classes of plaintiffs may sue under ERISA: plan participants, plan beneficiaries, the Secretary of Labor, and plan fiduciaries. In general, the only proper defendant is the plan itself.
Filing an ERISA Claim: Step-by-Step Guide Step 1: Review Your Plan. The first step in filing an ERISA claim is to review your disability insurance policy thoroughly. Step 2: Gather Evidence. Step 3: File Your Claim. Step 4: Wait for a Decision. Step 5: Appeal if Necessary.
The Employee Benefits Security Administration is an agency within the Department of Labor that administers and enforces the provisions of Title I of the Employee Retirement Income Security Act (ERISA). ERISA established fiduciary and other standards for employee benefit plans sponsored by private-sector employers.
In general, ERISA does not cover group health plans established or maintained by governmental entities, churches for their employees, or plans which are maintained solely to comply with applicable workers compensation, unemployment, or disability laws.
Types of ERISA Claims Consider the following examples, which is not exhaustive: An employee who has a long-term disability plan that provides benefits if she is totally disabled. After suffering a serious fall at work, the employee struggles with a traumatic brain injury and other impairments.
An ERISA claim refers to a legal action taken under the Employee Retirement Income Security Act (ERISA) of 1974. This law protects employees' rights to their benefits, such as retirement and health plans, ensuring fair treatment by employers.