ERISA–Employee Retirement Income Security Act o 1974

Introduction 

ERISA (every ridiculous idea since Adam) 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}

• Wikipedia 
• dol.gov/erisa
• Additional Protections
• General Compliance Assistance

ERISA Enhancements

• COBRA ^{(Consolidated Omnibus Budget Reconciliation Act)} provides some workers and their families with the right to continue their health coverage, in general for 18 months after losing their job.  See also Cal COBRA, which provides a total of 36 months for CA Residents.
  

• HIPAA ^{(Health Insurance Portability and Accountability Act)} provides important protections for working Americans and their families who have preexisting medical conditions or might otherwise suffer discrimination in health coverage based on factors that relate to an individual’s health.

   

• Newborns’ and Mothers’ Health Protection Act

• Mental Health Parity Act,

• Women’s Health and Cancer Rights Act 1988.

Consumer Resources

• DOL Overview Page
• dol.gov/EBSA/
• EBSA FAQ’s
• chcf.org/91 pages CA Law & ERISA
  • Do self insured plans have to comply with ERISA?  California Insurance Code?
• wikipedia.org on ERISA
• basic online.com/our-services/erisa-essentials
• Our webpage on 6055 & 6056 Reporting Requirements 

USC ^{(United States Code)}
Chapter 18 ERISA
law.cornell.edu/uscode/29/chapter-18

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

MEWAs
Multiple Employer Welfare Arrangements under the
Employee Retirement Income Security Act (ERISA):
A Guide to Federal and State Regulation