Employee benefit plans subject to ERISA (the Employee Retirement Income Security Act of 1974, as amended) must establish and maintain reasonable claims and appeals procedures governing the filing of benefit claims, notification of benefit determinations and appeal of adverse benefit determinations.
The U.S. Department of Labor issued final regulations amending the claims procedures for employee benefit plans — including nonqualified deferred compensation plans, top hat plans, 401(k) plans, health and welfare benefit plans, and pension plans — that provide or condition benefits (e.g., vesting or payment) on a determination of a participant’s disability. The regulations are effective for disability benefit claims filed after April 1, 2018. These benefits claims procedures do not apply to employee benefit plans that provide benefits upon a determination of disability made by a third party (e.g., the Social Security Administration) or the employer’s long-term disability plan.
If these new claims procedures apply to your plan, we recommend that you amend your plan by the effective date of the regulations to reflect these new claims procedures. You may also amend your plan at any time in 2018 retroactive to the effective date, as long as your plan administrators are aware of and comply with the regulations for disability claims filed on or after the effective date.
If the regulations apply to your plan, Loeb & Loeb can provide a simple plan amendment that will bring your plan into compliance with these new claims procedures.
If you have any questions, please contact Marla J. Aspinwall (at 310-282-2377 or firstname.lastname@example.org) or Megan A. Stombock (at 212-407-4226 or email@example.com).