Hi. I’m Nick Ortiz. I’m a board-certified disability insurance attorney. Today, I’m here to answer the question of what is an ERISA disability plan?
Many medium to large-size companies offer benefits through an ERISA-governed disability plan. But some people ask the question what’s the difference between an insurance policy and an insurance plan. Typically, the long-term disability policy is one part or a component of an overall benefit plan. The benefit plan may include other benefits like life insurance, health insurance, disability benefits and other types of group plan benefits.
In ERISA, which is short for the Employee Retirement Income and Securities Act of 1974 has certain requirements for plan administrators like your employer who’s offering these benefits. Specifically, ERISA requires that the plan administrators to provide participants with key information about the plan benefits, the funding of the plan, their fiduciary responsibilities, management of the plan, the grievance process and appeals process for denials under the plan, because one thing that’s really crazy is that ERISA allows plan administrators to interpret the plan provisions so long as there’s a clause in the policy that allows them to interpret the plan provisions. What that means is the insurance company is allowed to determine whether or not you meet the requirements of the policy.
In short, when you were first hired with the company, they probably gave you either a summary plan description or the entire plan packet that had all the information about your benefits. So, if you no longer have that packet, it is very important that you go back and you request a complete copy of your long-term disability insurance policy and even the whole plan from your human resources department. That way you have all the information you need to determine what your benefits and rights are under the policy because every policy and plan may be different from employer to employer. That’s why it’s important for you to have your individual plan or policy.
If you’d like to talk to someone who’s experienced in reviewing plans and policies, then we encourage you to give our office a call at 850-898-9904. Thank you for watching. We look forward to hearing from you.