Authored by Dannae L. Delano
Jan 27, 2017
In light of new regulations, employers should immediately evaluate their disability benefits claims procedures. The Department of Labor issued final regulations revising the required claims procedures effective Jan. 1, 2017 for disability claims filed on or after Jan. 1, 2018.
The new rules are similar to the claims and appeals requirements added to group health plans by the Affordable Care Act and add the following requirements to the claims and appeals process for disability benefit claims:
These new requirements apply to all disability claims, including disability claims under pension or 401(k) plans where the availability of the benefit is conditioned on a determination by the plan administrator that the participant is disabled. If the disability determination is based on a finding by the Social Security Administration or an employer’s long-term disability insurance carrier, the new requirements do not apply.
Employers must evaluate their plans and benefits related to disability in 2017 for possible amendment to ensure compliance with these new requirements for claims made on or after January 1, 2018. This would involve evaluating terms for disability benefits under retirement plans, reviewing disability benefit plan procedures, and working with service providers engaged for the claims and appeal process.
If you have any questions about ERISA claims and appeal procedure requirements or any other employee benefits matter, please do not hesitate to contact Dannae Delano.