The Employee Retirement Income Security Act, more commonly known as ERISA, is a collection of laws put into place by the federal government to protect employees of private organizations that offer health insurance, profit sharing, pension, and retirement plans. The laws establish a minimum set of standards the companies must remain in compliance with when it comes to the plans. However, there are situations when the employer violates one or more of these laws and a minimum of one employee, often more, is negatively affected. What are some common ERISA violations to watch for?
Pension Plan Changes
No employer is required to establish a pension plan for employees. Nevertheless, once a plan of this type is in place, limitations are placed on what the employer must do to ensure the plan is funded. Furthermore, ERISA outlines what changes are allowed. In the event the employer attempts to reduce benefits promised to the employees, tries to convert this plan into a lump sum, or otherwise violates ERISA, the employee or employees need to file a complaint.
Mental Health Coverage
Men and women with certain mental health conditions receive protection under the law. Measures such as the Americans with Disabilities Act and the Mental Health Parity Act are designed to ensure these individuals are treated fairly. Companies need to make certain their insurance plans are in compliance when it comes to giving parity to these conditions, which include numerous developmental disabilities and conditions. This includes autism spectrum disorder and depression among others. A failure to do so violates the law as the employer is breaching his or her fiduciary duties under ERISA.
Denial of Disability Coverage Claims
Employees may find the insurance company working on behalf of the employer denies a claim to collect on disability coverage. ERISA covers individuals when the policy is provided by the employer and investigates matters related to this denial. Men and women may file a complaint, but individuals might likewise wish to consult with an attorney because there are provisions in place that may restrict their ability to prove their claim. For instance, employees may find they can only use the information contained in their medical record when appealing a decision. An attorney can be of help in challenging the denial and ensuring the proper facts are shared with those responsible for determining the outcome of the claim.
Discontinuation of Healthcare Benefits
Employees who are laid off may continue their health insurance coverage for a period of time if they pay the applicable premiums. In certain situations, an employer may not allow this individual to retain the coverage and violates ERISA in the process. Former employees need to be aware of COBRA and their rights to health insurance coverage through a former employer to ensure they receive this protection until new coverage may be obtained.
Failing to Protect Former Employees
Former employees receive protection under ERISA just as current employees do. There are situations in which a former employee finds his or her rights are being violated and may assume there is nothing that can be done. This is not the case. A failure to protect former employees violates these laws and should be reported to the Employee Benefits Security Administration.
Any time a company interferes with employee rights, denies benefits improperly to current or former employees, or does not live up to its fiduciary duty, employees need to report the violation to the proper authorities. When it is found the employer did not fulfill his or her duties in this area, civil and/or criminal penalties may be imposed. This is only fair, as the employee is entitled to what he or she was promised and deserves nothing less.