Claims Procedure for Plans Providing Disability Benefits. Final rule
Federal Register
|December 29, 2016
Summary
New Employee Retirement Income Security Act (ERISA) regulations strengthen disability benefit claims procedures. These updates adopt protections from group health benefits, enhancing safeguards for participants and plan administrators.
Area of Science:
- Labor Law
- Employee Benefits Law
- Administrative Law
Background:
- The Employee Retirement Income Security Act of 1974 (ERISA) governs employee benefit plans in the private sector.
- Current claims procedure regulations for disability benefits under ERISA require revision to enhance participant protections.
- The Affordable Care Act introduced procedural safeguards for group health benefit claims.
Purpose of the Study:
- To revise and strengthen the claims procedure regulations for employee benefit plans providing disability benefits under ERISA.
- To adopt procedural protections and safeguards for disability benefit claims, aligning them with those for group health benefits.
Main Methods:
- Review and amendment of existing ERISA claims procedure regulations.
- Incorporation of specific procedural protections and safeguards previously applied to group health benefit claims.
- Publication of a final regulation detailing the revised claims procedures.
Main Results:
- Final regulation issued, revising ERISA claims procedure regulations for disability benefits.
- Strengthened procedural protections and safeguards are now applicable to disability benefit claims.
- Procedures are aligned with those established for group health benefits under the Affordable Care Act.
Conclusions:
- The revised regulations enhance the claims process for disability benefits under ERISA.
- Participants and beneficiaries of disability plans will benefit from strengthened procedural safeguards.
- Plan administrators and service providers must adhere to the updated claims procedure requirements.
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