What is ERISA?
If you work for a private sector employer, your employer's benefit plans are governed by a federal law called the Employee Retirement Income Security Act of 1974, or “ERISA.” This law was put in place in order to protect employee pension and health and welfare benefits from misappropriation or underfunding by an employer. ERISA's primary purposes are to provide employees with clear information about their benefits and a claims process that "levels the playing field" when individual participants appeal a denied claim. ERISA requires plan sponsors to act responsibly and fairly in the distribution of benefits.
Benefits Governed by ERISA
Your employer may provide some or all of the following types of benefits:
Medical and surgical coverage
Behavioral health care, including residential treatment coverage
A 401(k), 403(b), cash balance, or other defined contribution plan
A pension plan
Long-term disability income
Life insurance
A legal services or child care expense plan
ERISA does not mandate that employers offer these benefits, but if offered, employers must follow minimum standards, including:
Procedural safeguards: The act requires that companies provide written policies for how claims should be filed and the process to be followed when a claim is denied.
Disclosures: ERISA requires that plan participants receive disclosures that include a plan summary and other key descriptions of the coverage and limitations of the plan.
Conduct: Under the Act, certain individuals are "fiduciaries" that must carry out their responsibilities for the exclusive benefit of participants and beneficiaries of the plan. Fiduciaries can be held accountable for breaching their fiduciary duties under ERISA.
Because ERISA is a federal law, you may work with an attorney anywhere in the country. While it may be preferable to have someone close to you, most legal work in the area of ERISA is done remotely, because there are so few attorneys who practice in this area, particularly on the employee side.