|| Frequently Asked Questions
A group health plan is an employee welfare benefit plan established or
maintained by an employer or by an employee organization (such as a union), or
both, that provides medical care for participants or their dependents directly
or through insurance, reimbursement, or other means.
Most private sector health plans are covered by the
Employee Retirement Income Security
Act (ERISA). Among other things, ERISA provides protections for
participants and beneficiaries in employee benefit plans
rights), including providing access to
Also, those individuals who manage plans (as well as other fiduciaries) must meet
certain standards of conduct under the fiduciary responsibilities specified in
The U.S. Department of Labor's Employee Benefits Security
Administration (EBSA) is responsible for administering and enforcing these
provisions of ERISA.
Asked Questions about HIPAA - Questions and answers about HIPAA, which amended ERISA to provide new rights
and protections for participants and beneficiaries in group health plans.
Participants and Beneficiaries:
- 1996 Changes in Health Care
Law - Provides an overview of recent changes in
federal law that can affect the health benefits of workers and their families. (PDF)
- elaws Health Benefits Advisor
- Helps workers and their families better understand employer and employee
organization (such as a union) provided group health benefits and the laws that
govern them, especially when they experience changes in their life and work
situations such as marriage, childbirth, job loss or retirement; also assists
employers in understanding their responsibilities under the applicable
- Form M-1
Online Filing System - An electronic filing system for the Form M-1 annual
report for multiple employer welfare arrangements that allows filers to
complete the form and submit it at no cost.
Retirement Income Security Act of 1974 (ERISA) - Sets uniform minimum standards to ensure that employee benefit plans are established and maintained in a fair and financially sound manner. In addition, employers have an obligation to provide promised benefits and satisfy ERISA's requirements for managing and administering private pension and welfare plans.
- 29 CFR Parts 2509 to 2590 - EBSA (formerly known as the Pension and Welfare Benefits Administration) regulations, including interpretive bulletins related to ERISA (29 CFR Part 2509).
- Employee Benefits Security Administration (EBSA)
200 Constitution Avenue, NW
Washington, DC 20210
Tel: 1-866-444-EBSA (3272)
- For questions on other DOL laws,
please call DOL's Toll-Free Help Line at 1-866-4-USA-DOL. Live assistance is available in English and Spanish, Monday through Friday from 8:00 a.m. to 8:00 p.m. Eastern Time. Additional service is available in more than 140 languages through a translation service.
*Pursuant to the U.S. Department of Labor's Confidentiality Protocol
for Compliance Assistance Inquiries, information provided by a telephone caller
will be kept confidential within the bounds of the law. Compliance assistance
inquiries will not trigger an inspection, audit, investigation, etc.