New York City Employee Retirement Income Security Act Lawyer
Helping New York Workers With Disability Claims Fight Insurance Company Breaches of Duty
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that governs employee benefit plans, such as retirement and health plans, set up by private employers. If the company you work for has a health plan or retirement plan, it is likely covered by ERISA. On the one hand, ERISA protects employees by requiring the plan providers to make certain disclosures and imposing fiduciary duties on the providers to act in the interests of plan participants. On the other hand, ERISA protects employers and insurance companies by imposing strict claims and appeals procedures on employees who are having trouble getting benefits under their plan. Failing to understand and follow these procedures can result in a loss or reduction of benefits.
At Mansell Law, our NYC employment lawyers understand the rights and duties of employees and employers under ERISA plans, as well as the complex and intricate procedures required to appeal a denial of benefits or other problems you might be having with your employer-sponsored health or retirement plan. Learn more about ERISA below, and call Mansell Law if you believe your rights under the law are being violated.
What Types of Plans Does ERISA Cover?
ERISA covers employer-sponsored employee welfare benefit plans, including health and retirement plans. The types of employment plans most often the subject of ERISA violations in New York include:
- Employee health insurance
- Life insurance
- Long-term disability insurance
- Accidental death policies
What Does ERISA Require?
ERISA sets minimum standards for retirement and health plans that are voluntarily established by private sector employers. In theory, ERISA was established to protect workers, although in practice ERISA has come to be seen as protecting employers and insurance companies instead. Some of the most prominent features of ERISA are:
- Requires plans to provide participants with information regarding plan features and funding
- Imposes fiduciary duties on those who manage and control plan assets
- Requires plans to establish a grievance and appeals process for participants to seek disputed benefits from their plans
- Gives participants the right to sue for benefits and breaches of fiduciary duty
- Requires plan administrators to report and disclose plan benefits to plan participants as well as government agencies
- Plan administrators must manage plans exclusively for the benefit of plan participants and their beneficiaries
- Plans must comply with rules regarding investments in employer-affiliated securities
- Administrators must follow applicable laws and plan rules when funding benefits
- ERISA protects plans from mismanagement and misuse of assets through its fiduciary provisions.
What Do I Need to Know About ERISA Claims?
ERISA has very strict claims and appeals procedures. Failure to follow those procedures can result in a loss or reduction of your benefits.
You must follow ERISA procedures before filing a lawsuit in court. Generally, this requires you to first go through any internal administrative appeals process with the insurance company or benefit plan. You’ll only have limited access to discovery (gathering evidence through litigation) in this process, but you can’t take these steps lightly. Whatever evidence you gather and introduce into the administrative record becomes the basis of what you can present in court. Attorneys who are unfamiliar with ERISA rules can harm your case by not paying serious attention to develop the record at the administrative level.
ERISA preempts state laws, and you can’t sue for bad faith or recover punitive damages under ERISA. However, you can still recover benefits that are due to you under the plan or policy, and you can force employers and plan administrators to change their bad habits by filing an ERISA class action against them.
Bring Your ERISA Claim to a Team of Talented New York Employment Lawyers
The New York employment lawyers at Mansell Law are equipped to negotiate a settlement of your ERISA claims and advocate for you at the administrative level, as well as provide solid, professional representation as needed in New York federal courts. For help with denial of long-term disability benefits or other ERISA claims, call Mansell Law in New York City for a free consultation with a team of skilled and knowledgeable ERISA attorneys.
