Do you have an employer plan such as a pension, disability plan, life insurance, or retirement account? If so, you may have heard of ERISA. Also known as the Employee Retirement Income Security Act, ERISA was put into place in 1974 to help protect the assets in these plans so they are available to you if and when you need them. ERISA safeguards the money in these accounts so that it is not improperly spent, which is a common issue among certain insurance plans.
While employers are not required by law to provide any type of benefit plan for employees, when they do, these plans must meet strict standards. When the employer or plan administrator attempts to deny employees their benefits even though they clearly meet the requirements, they can face serious penalties.
ERISA has several requirements that must be met by plan administrators. First, all employees must be given important information about their plans. This information must include the plan’s specific features. In addition, employees must be given information about eligibility and vesting, as well as how the plan is funded and how benefits are accrued.
In the event that the employee needs to use the plan, there must be guidelines in place on how to file a claim or appeal. Also, every plan must have at least one fiduciary, which refers to a person who takes care of the money so that it is used appropriately.
Criminal violations are not as common as civil violations, which often occur as a result of benefit denials. A common civil violation is to operate the plan without benefiting participants. Some administrators, for example, operate the plan so it benefits those who run it. This is in violation of ERISA and can lead to fines.
In addition, any breach in the plan terms and guidelines would be considered a violation. If an employee follows the rules for filing a claim, for example, and the administrator claims that different rules have to be followed, even those these rules are not outlined anywhere, this would also be a violation.
An employer could also face penalties for discriminating against an employee who files a claim. Every employee needs to be treated fairly and should not face retaliation for exercising their rights to file a claim.
An employer could also face penalties for denying benefits to employees. If an employee is eligible for benefits and has met all the requirements, their claim should not be denied solely because the employer does not want to pay the benefits owed.
ERISA is supposed to protect the rights of employees. However, insurers will often go to great lengths to deny injured employees of their benefits, and sometimes ERISA refuses to step in and advocate for the employee.
Need an advocate on your side? Seek legal help from a Dallas ERISA lawyer. The Law Offices of J. Price McNamara can help you fight back if your claim has been denied. We will gather the evidence needed to win your case while protecting your interests. To schedule a free consultation, contact our office today.
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