If you are like most people, you likely had never heard of the term ERISA until you tried to file for disability or needed to use other types of employer-sponsored insurance benefits. However, understanding which laws and regulations your employer and insurance company are governed by is important to upholding your rights.
If you need help determining whether your Louisiana long term disability plan is covered by ERISA, talk with an experienced attorney. You may learn you have more rights than you originally thought which may help you win your claim.
The Employee Retirement Income Security Act of 1974 is a federal labor and tax law that governs most employer-sponsored and voluntarily established retirement and insurance plans. When ERISA is administered correctly, it should protect the interests of the insured. Under ERISA, plans must have a grievance and appeals process for their participants. ERISA also gives participants the right to sue for access to their benefits and for any fiduciary breaches of duty.
When determining if a Louisiana long term disability plan is covered by ERISA, several factors should be considered. Sometimes it is not a clear-cut answer. Generally, group and health plans that are owned or maintained by governmental agencies, churches, or those that are in place to comply with workers’ compensation, unemployment, or other disability laws are not governed by ERISA. If an insured person has such a plan, ERISA is not likely to apply. A knowledgeable lawyer could help an individual understand long-term plans.
Federal Courts all over the nation have asserted that there are five points a policy must have to be governed under ERISA. These requirements can be found in their statement below:
It is important to note that ERISA policies have the option to mandate employee contributions such as a copay.
Although the above statement from the federal courts helps determine whether a plan may fall under ERISA, it does not provide the final answer. The Department of Labor (DOL) has put in place safe harbor regulations that exempt certain plans from ERISA governing. To have safe harbor, four qualifications must be met, there must be no plan contributions from an employer and the program must also be voluntary.
Furthermore, the employer must not endorse the program but solely allow the insurance carrier to work with their employees for their insurance needs. Finally, the employer may not get any financial consideration or other benefits from the plans.
If you need assistance determining whether your Louisiana long term disability plan is covered by ERISA, you may want to consult with a dedicated attorney. Lawyers have experience in how to determine which plans are covered and which are not.
Regardless of whether you have an ERISA plan or not, a skilled attorney may be able to help you access the benefits that you deserve. Call today to learn more about how a lawyer can help with your long term disability plan.
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