‘ERISA’ Law

ERISA is the acronym for the Employee Retirement Income Security Act, a federal law that provides pensions, insurance companies, and private employers with guidelines regarding the administration of employee benefit plans. Although ERISA doesn’t require private employers to provide pension plans it sets minimum standards for those that do.

ERISA Amendments

• Consolidated Omnibus Budget Reconciliation Act (COBRA) ensures that employees that voluntarily resign or are let go under certain circumstances continue to receive healthcare coverage for a certain period of time
• The Health Insurance Portability and Accountability Act (HIPAA) limits the pre-existing medical condition exception for health insurance coverage and established a period of 6 months prior to enrollment where the development of a new condition could not be deemed preexisting.
• The Newborns’ and Mothers’ Health Protection Act (The Newborns’ Act) provides mothers with minimum coverage that permits at least 48 hours in a hospital following childbirth and a minimum of 96 hours hospital stay following a cesarean section.

ERISA Violations

ERISA violations commonly include employers improperly denying benefits to employees. When there is a violation of the ERISA obligations of an employer there are two ways that penalties may be incurred:

• An aggrieved plan beneficiary can file a complaint against a violator, beginning with the administrative procedures to seek corrective action and eventually filing a lawsuit when the administrative remedies are exhausted.
• The Department of Labor’s Employee Benefits Security Administration (EBSA) can initiate an action against the employer. Both civil and criminal penalties may result from ERISA violations.

Changes may occur in this area of law. The information provided is brought to you as a public service, and is intended to help you better understand the law in general. It is not intended to be legal advice regarding your particular problem or substitute for the advice of a lawyer.