The Employee Retirement Income Security Act (ERISA), sets minimum standards with which private employers who offer retirement benefits, pensions, and health insurance to their employees must comply. It also grants employees who are covered by ERISA-qualifying plans certain rights to appeal denials as well as protections from discrimination or retaliation based on an entitlement to benefits.
Employers who fall under the purview of ERISA are required to:
While many employers are careful to comply with these obligations and duties, others unfortunately do not and:
What the plaintiff is required to establish depends primarily on the action alleged. For instance, plaintiffs who file a claim because they were denied benefits, must prove that they:
To demonstrate that a plan’s administrator breached a fiduciary duty, however, plaintiffs are only required to prove that:
Unlike a claim for denial of benefits, a plaintiff attempting to demonstrate a breach of a fiduciary duty does not have to exhaust internal administrative appeals before filing a claim in court. Employers can also be held accountable for interfering with an employee’s rights to benefits if a plaintiff can provide evidence that an employer retaliated or discriminated against an employee who exercised a right under a plan.
Plan administrators who fail to fulfill their obligations may be required to:
Unlike other causes of action, plaintiffs who file claims under ERISA are not eligible to receive monetary damages. Instead, successful plaintiffs can expect to receive equitable relief, such as the reinstatement of benefits. However, an employer who violates ERISA may also face criminal penalties, the severity of which depends upon the type of violation. Typically, criminal penalties involve hefty fines and in some cases, jail time.
When employees with ERISA-qualifying plans are wrongfully denied benefits, claimants can appeal their denied claims in court. Unfortunately, this can be a difficult process that requires compliance with a number of procedural requirements, so if you have questions or concerns about your own rights to benefits, please contact an experienced ERISA attorney at Roberts Bartolic LLP today. A member of our legal team can be reached by calling (312) 635-1600 or by completing and submitting one of our standard contact forms.
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