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How does ERISA affect health benefits?

Judging from the name of the Employee Retirement Income Security Act, you may feel confused about what it has to do with the health benefits that you receive from your employer. It is true that ERISA provides protections to employees enrolled in retirement plans provided by employers in private industry, but it also provides protections for individuals enrolled in employer-provided health plans. 

According to the United States Department of Labor, participants in health benefit plans and their beneficiaries have received extended protections due to amendments to ERISA pertaining specifically to health plans. The Health Insurance Portability and Accountability Act prevents discrimination on the basis of health-related factors when it comes to obtaining coverage as well as protecting the confidentiality of personal health data. The Consolidated Omnibus Budget Reconciliation Act provides for continuation of coverage under certain circumstances after you leave a job, whether voluntarily or involuntarily. Additional amendments to ERISA that have affected health care benefits include the following: 

  • The Affordable Care Act
  • The Mental Health Parity and Addiction Equity Act
  • The Newborns' and Mothers' Health Protection Act
  • The Women's Health and Cancer Rights Act

Not all health care plans provided by employers are subject to ERISA, however. It does not apply to plans maintained for the sole purpose of compliance with laws pertaining to unemployment, disability or workers' compensation. Additionally, if your employer is a church or a government entity, ERISA does not cover it. 

The information in this article is not intended as legal advice but provided for educational purposes only.

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