ERISA's Impact On Employee Benefits

If you work for a private sector employer, it is likely that your employer's benefit plans are governed by the Employee Retirement Income Security Act of 1974, or ERISA. This act was put in place to protect employee access to their benefits and ensure that employers act responsibly in the distribution of the benefits.

Carla N. McKain, the founding attorney at McKain Law PLLC, has deep experience in ERISA-related legal matters, including a period spent reviewing employer plans for ERISA compliance. As your lawyer, she can advise you on your rights if your benefit claim is denied, and she can explain your options if an administrative appeal of your claim is also denied.

What Does ERISA Regulate?

ERISA laws provide oversight for private sector employers who offer health insurance coverage, pensions/retirement plans, and certain other employee benefits. It does not mandate that employers offer a particular type of benefit, but it does set forth minimum standards if an employer does offer benefits. Some of those standards include:

  • 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.
  • Accountability: ERISA requires employers to provide detailed reporting of benefit administration to the federal government.
  • Conduct: The act regulates the governance of managed care and other fiduciary agents who are financially responsible for how the plan performs and operates.

Overall, ERISA requires employers and claims processors to closely follow a set of rules designed to protect the participants and beneficiaries of their benefit plans. As an employee, these rules are very complex and sometimes confusing. Our firm can explain your rights as a plan enrollee and how to appeal your claim if it is denied.

We Protect Your Rights Under ERISA

Call us at 800-724-3208 today to start the process with a case evaluation, or email us by using our online intake form. We are located in Ithaca and serve clients throughout New York.