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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 otherwise.
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 (participant rights),
including providing access to
plan information.
Also, those individuals who manage plans (and other fiduciaries) must meet
certain standards of conduct under the fiduciary responsibilities specified in
the law.
The Department of Labor's Employee Benefits
Security Administration (EBSA) is responsible for administering and
enforcing these provisions of ERISA. Click on the agency to find out more about
the agency's program. As part of carrying out its responsibilities, the agency
provides consumer information on
health plans as well as compliance assistance for
employers, plan service providers, and others to help them comply with
ERISA.
For questions about the tax provisions in the Internal Revenue
Code relating to health plans, please contact the
Internal
Revenue Service.
For questions about the provisions under the Public Health
Service Act, contact the Center for Medicare and Medicaid Services in the
Department
of Health and Human Services (HHS).
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