Effective April 1, 2018, the Department of Labor (DOL) implemented new handling regulations for disability claims under the Employee Retirement Income Security Act of 1974 (ERISA).

In addition to claims under disability benefit plans, these new rules may also apply to other plans that provide disability benefits—such as pension, 401(k), or 403(b) plans.

The regulations mimic the claims and appeals requirements added to group health plans by the Patient Protection and Affordable Care Act (ACA). They are procedural in nature and require that plans:

  • Ensure claims and appeals for benefits are decided independently and impartially.

  • Include certain items in benefit denial letters explaining the basis for denial and rights of plan participants.

  • Provide participants with new evidence collected or created during the claims appeal process.

  • Inform participants that assistance in their native language is available in certain areas of the country.

  • Inform participants of contractual limitations on filing suit under the plan.

American Fidelity Assurance Company has followed many of these rules for several years and has implemented all additional requirements. As a result, we are prepared to help employers offering our short- and long-term disability plans governed by ERISA remain compliant with the DOL’s new regulations.

For more information, please contact your American Fidelity account manager.

 

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