Washington D.C. Benefits Law Blog

Employees in Washington, D.C., may be interested in the outcome of an ongoing case in which a group of ERISA plan participants are pursuing claims for a breach of fiduciary duty. The Court of Appeals for the Ninth Circuit upheld a ruling that the participants were not required to go to arbitration despite the existence of employment agreements requiring arbitration of disputes. The court said that the claimants were not representing their own interests but those of the ERISA plan itself.

Nine current and former employees of the University of Southern California are pursuing a claim against the university, its retirement plan and one fellow member of the Retirement Plan Oversight Committee. They accuse them of failing to live up to their responsibilities to reduce the fees and expense of the plan; they also accuse those parties of failing to use good judgment in selecting investments for the plan. In their lawsuit, the claimants are seeking both monetary compensation and equitable actions that can benefit the plan as a whole.

It can be particularly important for public and federal sector workers in the District of Columbia to understand the protections and rights attached to employee benefits. Since benefits packages for public employees can often be quite valuable, they are a major incentive convincing people to prefer a government job to a corporate alternative. The dedication to community -- and, at times, lower salaries -- of government workers are rewarded with secure, generous benefits that include health insurance, disability protection and extensive retirement plans.

Because these benefits programs can be significantly different than those in the private sector, you may need to know more about government programs to successfully appeal a denied benefits claim. When you're struggling to pay medical bills, being denied treatment can be a serious blow. However, it is possible to successfully appeal benefits denials and receive the compensation or coverage that is rightfully yours.

The Department of Labor has changed a rule about health benefits that could affect workers in the District of Columbia and across the country, particularly those who work for small businesses. The rule change was prompted by a 2017 executive order by President Trump and is intended to promote the creation of Association Health Plans or AHPs. These plans are designed to provide a form of group health insurance for small employers who come together to form an association. Because they can be considered large group policies rather than small group or individual policies, they are exempt from some of the provisions of the Affordable Care Act.

This means that AHPs may be a more affordable benefits option for some small businesses, self-employed people and related individuals, but members of the plan may lack some of the consumer protections provided for in the ACA. The Department of Labor's new rule eliminated certain restrictions on the formation of AHPs that were in place by promulgating a new understanding of the definition of "employer" under the Employee Retirement Income Security Act. ARPs are considered a form of joint employee welfare benefit plan shared among multiple employers.

There are many laws that protect workers' rights with regard to pensions and healthcare benefit plans. However, workers in Washington, D.C., should be aware of the Employee Retirement Security Act of 1974 and how the ERISA preemption can affect certain protections provided by local and state laws.

ERISA is a complicated federal law that is intended to prevent mismanagement and fraud in private health and pension plans. However, because the regulations take priority over any similar or conflicting local and state laws, individuals may find that the protections they have against unfair claim denials in the state in which they reside might not be applied.