16. ERISA/Long-term Disability

ERISA/Long-term DisabilityEmployee Retirement Income Security Act of 1974, commonly referred to as “ERISA” is a set of laws that governs employee retirement funds. These laws are interpreted and enforced across three agencies: IRS, Department of Labor, and Pension Benefit Guaranty Corporation. ERISA regulations concern the actual fiduciary responsibility of the funds once an employee pension has been established, not whether employers have a pension plan to begin with. Similarly, health benefits under ERISA plans are regulated once those have been established. There are attorneys that specialize in this area of law. Terms associated with ERISA health care include COBRA, which allows employees to continue their health insurance by paying for it themselves after they leave a company; HIPPA, which protects employees with pre-existing conditions from being denied coverage when switching health policies; and LTD, or “long-term disability”. If you become disabled long-term (usually longer than 24 months) and your health coverage offers “group long-term disability” under an ERISA plan, there are limitations on the benefits you may receive. In other words, procedures or conditions that seem like they should be covered under the health plan may be denied even after appeals in the ERISA bureaucracy. Many people look to an attorney who knows ERISA Long Term Disability laws and procedures in order to navigate the system and try to obtain a favorable outcome.