ERISA protects individuals who partake in employer-sponsored benefit plans and their beneficiaries. Requirements for ERISA law include distributing accurate information and standards of conduct for plan managers. It offers broad protections for most workers but not all.

In what situations do ERISA regulations not apply?

  • Insurance policies provided by government employers or entities. If you work for the local, state or federal government, your benefits are likely not covered under ERISA. Teachers, firefighters and government officials are just a few examples of roles outside of ERISA law.
  • Insurance policies issued by churches. Churches are totally exempt from ERISA.
  • Insurance policies purchased privately—not through your employer. ERISA does not apply to individual plans not regulated or sponsored by an employer.
  • Insurance policies for business owners. If you have a policy that is different from your employees, you may not be covered under ERISA.
  • Insurance policies not supported by employers. If you and your coworkers choose to go in on a benefit plan, it will not be covered unless it is officially sanctioned and provided by your employer.

While some other exemptions may apply, these are the main causes for exclusion. Generally speaking, ERISA covers all other benefit plans provided by employers.

Why it matters

ERISA claims are different from a claim made directly against an insurance company, like a bad faith claim. ERISA guidelines determine what action you can take and how much you can receive in damages. The type of benefit policy you have, therefore, is extremely relevant to how successful your claim will be.