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Simply put – ERISA stands for the Employment Retirement Income Security Act.

ERISA is a federal law that sets minimum standards for most voluntary established pension and health plans. It protects the interests of employees’ benefit plans and their beneficiaries. ERISA requires that your employer notify you of any rules that you must meet in order to be vested. It also protects you from any wrongdoing from anyone who has authority to manage your plan. COBRA and the Newborns’ and Mothers’ Health Protection act also fall under ERISA.

Filing a claim under ERISA can be difficult and confusing. You must file a claim, then exhaust the plan’s administrative process before you can file a lawsuit. If you file your lawsuit too early, it may be dismissed, and your claim can be barred. Your claim can also be barred if you miss your time limits for complying with your plan’s administrative process.

There are two general types of ERISA claims – a benefit claim and a breach of fiduciary duty claim. Benefit claims can include health insurance claims, disability claims, life insurance claims, COBRA claims and vacation claims. Breaches of fiduciary duty arise when the person responsible for running the investments engages in unlawful acts, misrepresents the plan, or fails to follow instructions.

Claimants are usually only provided with a short hearing that is based on a paper trail. If your claim goes to trial, the judge will look at this paper trail to determine if you submitted all of the proper paperwork to the insurance company before you filed suit. Further, under ERISA, your case is decided by a Federal Judge, and you are not allowed to request a jury. In addition, you cannot claim any state law violations such as negligence and fraud – they are all preempted by ERISA. There are a few exceptions which include (see below).

ERISA Exceptions

  • Insurance policies and benefits issued by government employers or entities. This includes local government, city government, state government and the federal government. If you work for the government in any capacity, your pension and benefits are likely not covered by ERISA. Teachers and employees of state colleges or universities, for example, are likely not covered. Workers at state parks or public parks; police officers; those who work at fire departments; and those who work in public transportation are also among those who are generally not covered by ERISA.
  • Insurance policies and benefits issued by churches or religious organizations. This can also include certain non-profit organizations that are run by churches, even though most nonprofits are covered under ERISA.
  • Insurance policies that you purchase on your own. If you buy an insurance policy yourself, including a health insurance policy or a disability or life insurance policy, then ERISA likely does not apply.
  • Insurance policies issued only to business owners. If you own a business and have an insurance policy that is not issued to your employees and that your employees do not participate in, then the policy is likely not covered by ERISA.
  • Insurance policies not endorsed or supported by employers. If you and your co-workers purchase an insurance policy using funds deducted from your checks or pooled together with no contributions from your employer, then this policy is probably not covered under ERISA as long as your employer doesn’t sponsor or endorse the policy.

If you feel that you may be a victim of ERISA claims, don’t hesitate to contact the offices of Alabama Personal Injury Lawyers – Lewis & Feldman, LLC today to schedule a free initial consultation and case evaluation by calling the Birmingham personal injury law firm of Lewis & Feldman, LLC locally at 205-896-6410, toll-free at 888-705-3997 or complete our contact form. You can also email us at jon@LewisAndFeldman.com and dfeldman@LewisAndFeldman.com. We’re the ERISA Claim lawyers serving Birmingham, Bessemer, Hoover and the surrounding Alabama communities who can help you receive the justice you deserve.