ERISA
ERISA Section 607 defines the term group health plan as an employee welfare benefit plan providing “medical care” to participants or beneficiaries:
This blog was originally posted on July 13, 2017.
Group health plans are almost always subject to the Employee Retirement Income Security Act of 1974, also known as ERISA.
This means employers must follow certain rules, such as:
- Providing participants with important information in writing about plan features and funding.
- Establishing an appeal and grievance process for participants to receive benefits from the plan.
The Employee Retirement Income Security Act of 1974 (ERISA) requires most employers who offer health and welfare benefits to maintain and distribute Summary Plan Descriptions (SPDs) to all plan participants. This SPD must include certain disclosures and information, such as when the employer may amend or terminate the plan(s).
Group health plans are almost always subject to the Employee Retirement Income Security Act of 1974, also known as ERISA.
This means employers must follow certain rules, such as:
- Providing participants with important information in writing about plan features and funding.
- Establishing an appeals and grievance process for participants to receive benefits from the plan.
- Providing fiduciary responsibilities for those who manage and control plan assets.
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According to a DOL website, “The Form 5500 Series is an important compliance, research, and disclosure tool for the Department of Labor, a disclosure document for plan participants and beneficiaries, and a source of information and data for use by other Federal agencies, Congress, and the private sector in assessing employee benefit, tax, and economic trends and policies.
The Employee Retirement Income Security Act of 1974 (ERISA) requires most employers, who offer health and welfare benefits, to provide a written plan document to participants. The plan documents that are issued by insurance companies and other benefits providers are typically standardized and don’t include all of the customized, employer-specific language that the ERISA law requires.
The IRS and other agencies have issued three different sets of guidance making it clear that employers cannot give actively employed workers pre-tax dollars through a Health Reimbursement Arrangement (HRA) ,or any other type of arrangement, to purchase individual coverage on their own.
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