ERISA Lawyer Near Me

The Employee Retirement Income Security Act (ERISA), is a federal law that establishes minimum standards for retirement plans, health insurance, and other welfare benefit plans, such as disability insurance plans that are provided by certain private employers. Although the law does not require employers to offer plans, it does set standards for employers who do choose to offer them. Understanding ERISA’s requirements can be difficult, so if you have questions or concerns about your own employer-provided benefits, it is critical to speak with an experienced ERISA attorney who can evaluate your case.

Covered Employers

Only non-government, private employers who voluntarily offer pension plans or other benefits must abide by ERISA’s requirements. Those who are self-employed or who are part of a partnership where only they and one other partner are covered under a plan are not subject to ERISA. ERISA also does not cover the following types of plans:

  • Group health plans established or maintained by governmental entities or churches;
  • Plans that are maintained only to comply with workers’ compensation, unemployment, or disability laws;
  • Plans maintained outside of the U.S. primarily for the benefit of nonresident aliens; or
  • Unfunded excess benefit plans.

Covered Benefits

ERISA requirements apply to any plan, program, or fund maintained by an employer to provide the following services:

  • Medical, surgical, or hospital care;
  • Benefits for sickness, accident, disability, or death;
  • Unemployment benefits;
  • Vacation benefits;
  • Training programs;
  • Day care centers;
  • Scholarship funds;
  • Prepaid legal services;
  • Holiday or severance pay; and
  • Retirement plans.

Plans that are offered by private employers and fall under these categories must comply with specific federal standards.

Disclosures

According to ERISA, certain disclosures must be made to plan participants, such as:

  • A list of offered benefits;
  • The rules for receiving those benefits;
  • A plan’s limitations; and
  • Guidelines for collecting benefits such as obtaining referrals in advance of surgical operations or doctor’s visits.

ERISA also requires plan administrators to share information with the Department of Labor (DOL) upon request.

Procedural Safeguards

ERISA requires private employers who offer retirement benefits and pension plans to create a written policy that establishes how claims should be filed and how appeals will be processed for denied claims. Claims appeals must also be conducted in a fair and timely manner.

Reporting Requirements

Finally, ERISA requires plan administrators to file certain informational returns with the DOL and the Internal Revenue Service (IRS). The information should include a summary plan description that describes coverage levels and claims procedures. Administrators must also report when modifications, such as increased or decreased coverage to a plan have been made.

When employers or administrators fail to comply with these requirements, employees or beneficiaries can file claims against the responsible parties in federal court.

Contact an Experienced ERISA Attorney Today

Among the legal rights offered by ERISA is the right to sue for denied benefits and breaches of fiduciary duty. Unfortunately, this process can be difficult, so if you have not been granted benefits according to the terms of a pension plan or other retirement plan, please contact Roberts Bartolic, LLP at (312) 635-1600 to schedule a free consultation with an experienced ERISA attorney.