ERISA – the Employee Retirement Income Security Act of 1974 – regulates most employee group benefits. But there are exceptions. The biggest exception is that public employer plans are not subject to ERISA. So, if you are a public employee, your group benefit plan is probably not subject to ERISA.
But there are exceptions to that, too. Some public employees group benefits plans are subject to ERISA because the benefits are provided by an insurance policy issued to their union, not to their employer. Unions are private entities, not government entities. Therefore, a group plan with an insurance policy benefit plan issued to a union is subject to ERISA.
That stated, it is common for insurance companies to issue policies to government entities, which are not subject to ERISA, and to claim that those policies and claims made under those policies are subject to ERISA.
ERISA provides different and more limited remedies that non-ERISA claims and often requires more and different procedures before filing suit to enforce your rights. Remedies are what you can get if you sue. Therefore, if your group benefits are denied, and you are a public employee, and the insurance policy for your group benefits was issued to your employer and not to your union, you may be able to pursue a lawsuit seeking not just the value of your benefits, but also compensatory damages for emotional distress and perhaps punitive damages, remedies not available under ERISA.
We have found that insurance companies often falsely claim that group disability policies issued to school districts, junior colleges, California public hospital districts, or other government entities are subject to ERISA with its more limited remedies and more stringent procedures.
If you are a California public employee, the ERISA Law Center can help you fight to get your long term disability benefits which have been denied or terminated by an insurance company, whether or not your claim is subject to ERISA. We have helped numerous public employees whose group long term and short term disability benefits were provided through their union obtain disability benefits through the ERISA process. We have also helped numerous public employees whose benefits were provided through their public employer to obtain their benefits and sometimes obtain damages above and beyond the value of those benefits. If you are a California public employee whose long term or short term disability benefits have been denied, the ERISA Law Center will fight for you to get the benefits to which you are entitled.