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Department of Labor Overview Page

 ERISA–Employee Retirement Income Security Act —  1974


sets minimum standards for most voluntarily established pension and health plans (self insured) in private industry to provide protection for employees and their dependents.

ERISA requires plans to provide participants with plan information including important information about plan features and funding; provides fiduciary responsibilities for those who manage and control plan assets; requires plans to establish a grievance and appeals process for participants to get benefits from their plans; and gives participants the right to sue for benefits and breaches of fiduciary duty.

In general, ERISA does not cover group health plans established or maintained by governmental entities, churches for their employees, or plans which are maintained solely to comply with applicable workers compensation, unemployment, or disability laws. ERISA also does not cover plans maintained outside the United States primarily for the benefit of nonresident aliens or unfunded excess benefit plans.  (Department of Labor’s Web Site)  *  poynerspruill.com

ERISA Enhancements

Consumer Resources

DOL Overview Page

dol.gov/EBSA/

CNA Third Party ERISA coverage reimburses covered plans for loss due to fraud by a trustee, officer, employee, administrator or a manager including administrators or managers who are independent contractors

wikipedia.org

Technical & Research Resources

Definitions (DOL)

USC (United States Code) Chapter 18 ERISA

  • § 1001. Congressional findings and declaration of policy
  • § 1001a. Additional Congressional findings and declaration of policy
  • § 1001b. Findings and declaration of policy
  • § 1002. Definitions
  • § 1003. Coverage
    …any employee benefit plan …except …governmental plan or … church plan
  • part 1—reporting and disclosure (§§ 1021—1031)
  • § 1022. Summary plan description
    Workers’ Right to Health Plan Information
  • part 2—participation and vesting (§§ 1051—1061)
  • part 3—funding (§§ 1081—1085a,_1085b,_1086)
  • part 4—fiduciary responsibility (§§ 1101—1114)
  • part 5—administration and enforcement (§§ 1131—1148)
  • part 6—continuation coverage and additional standards for group health plans (§§ 1161—1169)
  • part 7—group health plan requirements (§§ 1181—1191c)
    Small Group Health Plans AB 1672
  • § 1181. Increased portability through limitation on preexisting condition exclusions
  • § 1182. Prohibiting discrimination against individual participants and beneficiaries based on health status
  • § 1183. Guaranteed renewability in multiemployer plans and multiple employer welfare arrangements
  • § 1185. Standards relating to benefits for mothers and newborns
  • § 1185a. Parity in mental health and substance use disorder benefits
  • § 1185b. Required coverage for reconstructive surgery following mastectomies
  • § 1185c. Coverage of dependent students on medically necessary leave of absence
    § 1191. Preemption; State flexibility; construction
    § 1191a. Special rules relating to group health plans
    § 1191b. Definitions
    § 1191c. Regulations

     

     

Cross Reference USC vs. ERISA
Cross Reference ERISA v US Code

 

Code of Federal Regulations

 

ERISA Enforcement, Civil & Criminal  DOL Site

TITLE 29 – LABOR (Findlaw)
CHAPTER 18 – EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM

Sec. 1182 ERISA . – a group health plan, and a health insurance issuer offering group health insurance coverage in  connection with a group health plan, may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan based on any of the following health status-related factors

Sec. 1182(b) (1) In general A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than such premium or contribution for a similarly situated individuals see also AB 1672

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2 comments on “ERISA Employee Retirement Income Security Act — 1974

  1. What’s this about ERISA self funded groups not having to comply with CA State Law or the Department of Insurance?

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