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What Kinds Of Employer-Provided Insurance Policies Are Not Controlled By ERISA?

While the vast majority of employer-provided life, health and long-term disability (LTD) insurance claims fall under ERISA law, some types of insurance policies do not. Unless your policy falls within one of these five general categories, your claim is, in all likelihood, controlled by ERISA.

Excluded from ERISA are:

  • Insurance policies issued to employees of government entities — local, county, city, state, or federal. This can include employees of state-run colleges and universities, historic sites, public parks, police and fire departments.
  • Insurance policies issued to employees of religious organizations, which can include nonprofit organizations run by churches.
  • Insurance policies that you purchased individually and not as part of your employment.
  • Insurance policies issued to you as the owner of a business which does not cover employees of that business.
  • Insurance policies issued to you by your employer but where your participation is purely voluntary, you pay your own premiums, and the employer has not endorsed the coverage.

The Benefits Of Non-ERISA Policies

If your policy is not subject to the restrictions of ERISA, you have a much broader range of action you can take should you be denied benefits under your life, health or disability policy. Among your policyholder rights is the right to sue the insurance company for insurance bad faith and you may even be able to seek punitive damages.

The ERISA attorneys at Pillsbury & Coleman, LLP, protect policyholders bringing ERISA and non-ERISA disability claims appeals.

Don't Be Vulnerable To Misinformation

Many insurance claimants are told that their long-term disability claims are subject to ERISA when they are not. In these instances, the plans were not subject to ERISA because the premiums were paid, in full or in part, by a governmental entity or other ERISA-exempt employer.

It's to the benefit of the insurance company to claim that a case must be considered under ERISA rules because your protections as a policyholder are severely restricted in such cases.

If your long-term disability or health insurance or life insurance claim has been denied, delayed or underpaid, call Pillsbury & Coleman, LLP, at 415-655-1549 or send us an email. From our San Francisco law offices, we represent policyholders across California.