The Employee Retirement Income Security Act (ERISA) requires private employers who offer pension plans and other retirement benefits to their employees to comply with specific disclosure and reporting requirements. For instance, ERISA requires companies to have a clear, written policy available to employees on how to file a claim for benefits.
Before filing a claim, it is important for employees to review a document known as the summary plan description (SPD). SPD’s provide a detailed overview of an employer’s specific plan and include important information, including:
Employers are required by law to provide these documents, so if you don’t have a copy of your plan’s SPD, you can obtain one by sending a written request to the plan’s administrator.
Once an employee has ensured that he or she meets the plan’s requirements and understands the necessary procedures, he or she can begin the process of filing a claim for retirement benefits. However, if that information is not contained in the SPD, the employee should write to the plan’s administrator, the employer’s human resource department, or the employer’s office to notify them that he or she is filing a claim. Under ERISA, a plan’s administrator has 90 days to evaluate the claim and respond to a request.
If a claim is denied, the administrator must send a written notice that contains certain information, including:
Whatever the reason for denial, an employer or administrator must give employees at least 60 days to file an appeal. Again, employees should refer to their SPDs and their denial letters for specific details about filing an appeal. ERISA also requires that employers provide claimants with all documents, records, and information relevant to their claim upon request and free of charge.
Once an appeal has been submitted, plan officials have 60 days to review it, although this deadline can be extended an additional 60 days in certain circumstances. However, if a committee or board of trustees reviews appeals and that entity only meets on a quarterly basis, the appeal may take longer. Once a decision has been made, the reviewer will send a written explanation of the decision that must include the following information:
At this point, it is important to contact an experienced ERISA attorney and the Department of Labor’s Employee Benefits Security Administration (EBSA) if the claimant believes that a plan failed to follow ERISA’s requirements.
If you are attempting to file a claim for retirement benefits or have had your claim denied, please contact Michael Bartolic, LLC at (312) 635-1600 to speak with an experienced ERISA attorney today.