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?
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?
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. Is there a statute of limitations regarding the filing of my claim?
Yes. The statutes are based on state laws under civil procedure, and
statutes vary by state.
9. 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.
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