The Employee Retirement Income Security Act of 1974, also known as ERISA, is a federal law applicable to most employee benefit plans, excluding state and federal employees and religious organizations. The Department of Labor estimates that ERISA applies to more than 2.5 million group health plans. Because these plans are exempt from most state regulations, it is important to know and use the ERISA Claim Procedure Regulations and related protections in both treatment verification and appeals.
Topic Areas for ERISA:
Understanding the ERISA Effect
Why do ERISA benefits vary greatly from plan to plan? The ERISA effect on health benefits has been profound. See what it is all about and what you should be doing. . . .more >>
The ERISA Claims Procedure Regulation
ERISA has important claim processing protections. Here is an outline of those protections and a number of ERISA-specific appeal letters. . . .more >>