For those who have experienced issues with their employer-provided benefits, like their retirement accounts and health insurance, they have likely heard of ERISA. That is because ERISA is the law that set the minimum standard for these types of employer-provided programs. But, know an acronym does not necessarily help anyone, so the question is, what is ERISA?
An ERISA overview
In 1974, the Employee Retirement Income Security Act (also called the Pension Reform Act) was passed, and it has been amended many times since its original enaction. Originally, and over the years, the U.S. Congress sought out to set minimum standards for employer-provided benefit programs, like health insurance, retirement accounts and pensions, life insurance, disability insurance and other welfare benefit programs, like apprenticeship plans.
Before its passage, employees were at the mercy of their company’s whims and had little recourse if their companies unilaterally decided to change those programs. ERISA sought to end that one-sided benefit system. Though, it did not mandate those employers provide such programs.
Pretty much any private company that offers one of these employer-provided benefits must follow those ERISA minimums. This even includes non-profit organizations, but it does not apply to governmental entities or churches.
So, what could be a violation?
The biggest violation is breach of fiduciary duty for those who run the program, or the misappropriation of the benefit assets. These violations can infer personal financial responsibility onto a benefit plans administrator. There is also disclosure, reporting and accountability requirements that can cause liability for plan administrators. And, every plan must include procedural safeguards, like written policies to address claims and complaints, written appeal process and a requirement of fair and timely processing.
For those in the Washington, D.C., metro area that need help with ERISA benefits claims and appeals, call an attorney immediately. There is help available, but it often requires jumping over many procedural and legal pitfalls.