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Decoding ERISA and healthcare

All jobs seem to come with an alphabet soup of acronyms: BCBS, COBRA, ERISA and many more. While some of these acronyms soon come to make complete sense to anyone working for the company, others require a little more explanation.

ERISA stands for Employee Retirement Income Security Act. It was passed in 1974 and determines how private employers must administer a host of employee benefit plans including retirement plans, health care and severance pay. The act does not require employers to offer these benefits in the first place, it only governs the employers who chose to do so.

In recent years, ERISA has been amended to include a number of laws that offer greater protection to employees. These include:

  • Mandated offering of COBRA
  • Ensuring that individuals with preexisting medical conditions are eligible for healthcare when they switch jobs (assuming they previously had health care coverage)
  • Covering hospital stays for mothers after they give birth (note: these particular laws vary a bit from state to state; an employment law attorney can help you understand the laws in your state)
  • Guaranteeing that employers with ongoing mental health problems receive the same coverage as those with other physical health problems.

Whether you have been in your job for months or years, you should know your employee rights. Denial of coverage to eligible parties is a fairly common ERISA violation. If you have been denied health care benefits to which you believe you are entitled, you may wish to speak with an attorney. An attorney can review your claim and help you enforce your rights.

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