The law of employee benefits is governed largely by the Employee Retirement Income Security Act of 1974 (“ERISA”). ERISA is a very complicated area of law that has the potential to create liability for employers, unions, and employee benefit plans. The provisions contained within ERISA also affect whether and how much personal injury plaintiffs may have to pay back to health insurers who make payments for case-related medical bills.

ERISA attorneys in St. Louis, MO and Southern Illinois

ERISA Fiduciary Litigation

Under ERISA, administrators of employee benefit plans (like health insurance plans or retirement plans) are “fiduciaries,” meaning they have the duty to run the benefit plan solely for the interest of participants and beneficiaries.  ERISA fiduciaries are obligated act for the exclusive purpose of providing benefits and paying plan expenses.  This includes a duty to communicate truthfully with plan participants about their benefits, to diversify the plan’s assets, and to manage the fund prudently. The law contains a provision allowing plan participants, beneficiaries, and others to sue fiduciaries if they breach this duty of loyalty.

ERISA Class Actions

Oftentimes, ERISA fiduciary litigation cases involve situations where a plan fiduciary decides to make risky investments with the benefit plans funds.  A plan administrator who takes risks with the funds intended for employee benefits can put workers’ retirement funds in jeopardy.  The law allows pursuing these breach of fiduciary duty cases as class actions, on behalf of all employees who are damaged by the breach.

Employee Benefit Plan Claims Requirements

ERISA requires employee benefits plans to have reasonable procedures to process claims, including allowing participants and beneficiaries to challenge a plan’s decision about whether to provide benefits. If a participant goes through this process and their claim for benefits is still denied, ERISA allows the participant to file a lawsuit.  But if the participant has failed to “exhaust” all the administrative procedures set up by the plan, the case may be dismissed.

ERISA Liability for Employers

ERISA can be a minefield for employers.  An employer who sponsors and ERISA-governed health care plan owes no fiduciary duty to plan beneficiaries, unless the employer is also acting a plan administrator.  However, even if the employer is not formally an “administrator,” it still may be liable if it exercises discretionary authority or discretionary control over the plan.

ERISA Attorneys

Keane Law LLC handles ERISA cases, including class actions, both on the plaintiff and the defense side.  Contact us for a free initial consultation regarding your ERISA matter.