What Benefits Can I Receive as an Employee?

Many employers and companies offer benefits packages to their employees, some including health care, dental care, and disability insurance. Congress passed the Employee Retirement Income Security Act (also known as ERISA) to help regulate these benefits and ensure that employees are getting what they pay for. The law does not require a private employer to offer benefits, but ERISA regulates the plan once it is established. 

Employers & ERISA

Most employers are required to follow ERISA. The following benefits plans are not subject to ERISA’s laws:

• Plans established by churches for their employees.
• Plans established or maintained by governmental groups.
• Plans maintained outside of the United States that are designed to benefits “non resident aliens or unfunded excess benefit plans.”​

An ERISA claim can be “preempted” if coverage falls into one of these categories or isn’t properly obtained through the employer. An insurance dispute under ERISA may still have merit in this situation, but the complaint is filed in state court because no federal law has been broken.

Retirement or pension plans are also regulated by ERISA. The employer must:

• Meet minimum funding requirements of the pension plan
• Fund the plan despite the employee’s age if they are over 21
• Provide notice if the plan is going to be changed or amended
• Specify how long the employee must work before they can participate in a plan
• Allow employees to participate if they’ve been working for over a year

Coverages Available to Employees

The Consolidated Omnibus Budget Reconciliation Act (COBRA) and the Health Insurance Portability and Accountability Act (HIPPA) let employees continue or obtain health care insurance through their employers. COBRA was passed in 1985, and it lets employees to continue group coverage for a period of time after their employment has ended. HIPPA keeps employers from excluding employees from health insurance coverage based on preexisting conditions.

Disability Insurance for Employees

Disability insurance benefits may be essential if an employee is seriously injured or diagnosed with a disabling illness. Under ERISA, employers can set up an “Employee Welfare Benefit Plan,” which protects employees from the financial strain caused by medical bills and lost wages. Group disability plans need to be clear and straightforward so employees know exactly what they are entitled to.

ERISA is intended to help prevent employers or insurance companies taking advantage of employees and their contributions towards benefits plans. If you think that your employer sponsored disability insurance plan is not paying benefits when it should, contact an ERISA attorney to know how and when employers aren’t giving their employees maximum benefits.