ERISA FAQs
1. What does ERISA stand for?
Employee Retirement Income Security Act.
2. What is ERISA and what benefits does it cover?
This set of federal laws regulates employee benefits for most employees in the United States. Nearly any type of employee benefit can be covered by ERISA, including:
- Pensions and 401K Plans
- Health Insurance
- Long Term Disability Insurance
- Life Insurance and Accidental Death & Dismemberment Insurance
3. Can my employer exclude me from any part of the plan?
Yes, under certain circumstances. Many plans exclude employees under age 21 or employees who haven't yet been credited with number of service hours. In addition, plans can specify specific classifications of employees who will be excluded. You should read you employer's benefit documents to know your rights.
4. Are there any employers that are not subject to ERISA?
Yes. Government entities and churches are examples of employers not subject to ERISA. Usually, if you worked for a private employer and you participated in one of that employer's insurance or retirement plans, it will be subject to ERISA.
5. Does ERISA apply to individual insurance policies?
No. If you bought insurance through a private insurance agent and pay for the premiums yourself, it probably is not covered by ERISA.
6. When is the best time to hire an attorney?
The best time to hire an attorney is as soon as possible. There is a need to have more technical or legally correct information sent to the insurance company or administrator, and your attorney can help you compile this information.
7. What is a "Standard of Review?"
This is the method a court uses to decide a case. In ERISA cases, there are 3 different types of review that a court may use:
De Novo: When a court takes a fresh look at a case, and pays no attention to what has occurred before the lawsuit was filed.
Abuse of Discretion: If the language of the plan gives the administrator discretion, then the administrator's decision will only be reversed if there is no reasonable basis for the decision.
Heightened Abuse of Discretion: If the plan is insured, the administrator is given less deference because it has a conflict of interest.
8. I work for the government, but I'm not aware of an ERISA plan.
Government, church and foreign plans are exempt from ERISA.
10. What should I know before filing a claim?
Before filing a claim you should be aware that your case will likely be held in a federal courtroom; a judge will make the decision in your case, not a jury; and ERISA litigation takes time, so be prepared for the long process.
