What’s all this stuff about ERISA?

What’s all this stuff about ERISA lately.  What the heck is it and how do I know if it applies to me?  That’s the $64 million question lately.  This is all thanks to …PPACA (Patient Protection and Affordable Care Act).

FINALLY A SOLUTION FOR INSOMNIA

Here’s the technical stuff about ERISA  http://www.dol.gov/ebsa/compliance_assistance.html.  Be sure and thank me for putting you to sleep if you’re having that issue!

ERISA IS A GOOD THING

The last course I took that included ERISA was back in 1995 and a lot has happened since then.  Basically ERISA (Employee Retirement Income Security Act) is about disclosure, at least that’s what it was back when it was written in 1974.  Plans have to publish the financials for pension plans (it shows solvency) and have to disclose benefit information on health plans (cuz that’s the right thing to do).  As the years have passed things have been added to ERISA, like COBRA in 1985 and HIPAA in 1996.

Kaiser has been the biggest culprit of this inquiry.  Seems like they are trying to kill two flies with one swat: determine if your plan is subject to ERISA and if your employees need assistance with language when it comes to the health plan you provide for them.

Health Net also sent a letter to employer groups about Language Translation Guidelines.  In their collection of information they just ask if the employer is more than 100 employees or less than 100 employees and they also address the language threshold of the group.  Health Net never mentions ERISA in their letter, but that’s because Health Net has been collecting this information all along.  If you’ve ever enrolled your group plan with Health Net (or Anthem Blue Cross or Blue Shield for that matter), they ask for the industry code, which will tell them if you are either a government or church group which are exempt from ERISA.  Kaiser hasn’t done this in the past, but they will now.  (I complete that information for you when the employer paperwork is completed.)

So, it’s no big deal.  Unless you are a church group or government group, yes, you are subject to ERISA.

PAY ATTENTION – THIS IS IMPORTANT!

Here’s what you need to do.  If you have a Kaiser plan, check either yes or no for the ERISA question.  There are a couple of church groups out there who should check NO, but everyone else should check “My group is subject to ERISA”.  For the threshold language (again this is for Kaiser clients) there are different options in case you offer more than one plan.  For instance if you offer a $30 co-pay and $50 co-pay plan, you would mark the primary language for each of the plans.  Some employers have different plans for different groups of employees.

P.S.

If you still need help, please call me.