The Employee Retirement Income Security Act of 1974, commonly known as ERISA, regulates pension plans established by private employers. ERISA also regulates other types of benefits your employer might provide, including group health insurance and disability plans.
If you were improperly denied disability benefits or if you believe that any of your rights under ERISA have been violated, you may be able to pursue remedy through an ERISA claim.
In some cases, however, your employer may be exempt from the terms of ERISA. Because ERISA does not apply in every case, you may need to pursue fair compensation in another way.
Understanding ERISA: What the Law Does and Does Not Do for Employees
Originally, Congress purportedly implemented ERISA to help protect employee benefits.
In 1974, however, the U.S. government prioritized the welfare of corporations and insurance companies above the welfare of employees—much as is the case today. Rather than providing powerful protections, ERISA often provides justification for insurance companies to deny employee benefits claims.
You can pursue an ERISA claim in an attempt to get the benefits you’re owed. However, the law limits the scope and extent of your legal options and tilts the scales in favor of the insurance company.
If you believe you have been wrongly denied an employer-provided benefit, having an attorney can be beneficial to a successful claim under ERISA. Another way that an ERISA lawyer can help you is by exploring the possibility that you can pursue a claim under an ERISA exemption.
Who Is Exempt from ERISA?
Most employer-provided, -sponsored, and -endorsed benefit plans fall under the broad umbrella of ERISA. Some notable exceptions do exist, however.
The benefits of anyone who is employed in any capacity by a government body, including city, county, state, and federal government entities, may not be subject to ERISA. Although you might not consider your employer to be a government entity, this exception is worth exploration if you believe you need to file a claim to get your benefits.
Although most employees of non-profit entities fall under the ERISA umbrella, any employer that is a church or religious organization does not fall under this law’s provisions.
Plans That Aren’t Employer Sponsored
Another potential exemption is any insurance coverage that you purchase, even if you do so through payroll deductions, that is not sponsored or endorsed by your employer. If you are a business owner or independent contractor who purchased your own insurance, it may be exempt if no employees participate in the coverage.
Other exemptions might exist. The best way to know whether your benefit plan is subject to ERISA is to talk to an experienced ERISA claims and denial attorney.
Should You File an ERISA Claim for Denied Benefits?
If you were unfairly denied insurance benefits, you may have the right to pursue a claim. Whether you must follow the ERISA procedures or not depends on whether your coverage is exempt.
If ERISA does not apply to your denied benefits, you may have more freedom to pursue a bad faith claim directly through the insurance company—which you cannot do if the coverage is subject to ERISA.
Getting Help for Your Greenville, SC ERISA Claim
If you believe you have been unfairly denied benefits, talking to a group benefits lawyer can be invaluable. In Greenville, SC, ERISA claim attorney John Peace and the Peace Law Firm can help.
We assist clients in both North Carolina and South Carolina, providing help for employees who have had benefit claims denied. We can assist you with short- or long-term disability claim denials, life insurance claim denials, issues with accessing your retirement benefits, and more.
We provide a free, no-obligation evaluation of your case. We will explain your options, answer your questions, and help you make the right decision about pursuing an ERISA or non-ERISA (exemption) claim. Contact us now to learn more or to schedule your free consultation with a South Carolina ERISA lawyer.