ERISA

Columbus ERISA Attorneys

Ohio residents who have problems with health insurance access, health insurance coverage, or the approval of disability benefits denied for themselves, their spouses, or their children can feel helpless. Fortunately, a federal law called ERISA can offer much-needed tools for making insurance companies and disability plans live up to their legal duties and contractual obligations.

Exercising one’s rights under the law officially called the Employee Retirement Income Security Act of 1974 is not easy, however. Partnering with an experienced and dedicated Columbus Ohio ERISA lawyer will increase the chances that an insurer or disability program provides the financial assistance a participant had counted on receiving when the need arose.

ERISA Basics

As explained by the U.S. Department of Labor, the main provisions of ERISA require voluntary health, disability, and pension/retirement plans to:

  • Share written information on features and funding with participants,
  • Exercise proper control over the money that participants pay into the plan,
  • Establish procedures for participants to file grievances and appeals,
  • Recognize participants’ rights to sue over the alleged misuse of funds, and
  • Recognize participants’ rights to sue over the denial of benefits.

Amendments to ERISA have introduced COBRA, which requires employers that offer workers health insurance to allow people who leave the organization to purchase an equivalent policy for a fixed period, and HIPAA, which, in parts, prohibits denial of health insurance access on the grounds of certain preexisting conditions.

The Columbus, Ohio based ERISA attorneys with Agee Clymer Mitchell & Portman primarily help clients who need to file appeals of coverage and benefits denials. We also consult with workers on COBRA rights and options.

ERISA and Health Insurance in Ohio

Filing an ERISA health insurance lawsuit in Ohio could become necessary when an insurer denies coverage for the first time and informs the covered individual or family that it will not permit an appeal. Taking legal action under ERISA may also be necessary when none of the permitted appeals result in the approval of coverage.

An ERISA health insurance lawyer in Columbus, Ohio will know how to interpret plan details and how to apply court rulings in similar cases in ways that make the case for the insurer having a legal obligation to provide coverage.

ERISA and Disability Benefits

An ERISA disability lawyer in Columbus, Ohio can help a client fight the plan’s determination that no disability exists or that the claimed disability is not severe enough to merit the payment of benefits. Succeeding with an ERISA disability lawsuit in Ohio requires both interpreting confusing legal language on what constitutes a compensable disability and submitting medical evidence that the plan cannot dismiss as incomplete or inconclusive.

A Note on the Ohio Public Employees Retirement System (OPERS)

ERISA generally only applies to what the federal government calls “voluntary” — meaning, private — health insurance, disability, and pension/retirement plans. As a result, a state employee plan like OPERS does not need to answer for alleged ERISA violations.

Public employee retirement plans do, however, have legal duties to plan participants under their own rules and under laws other than ERISA. Any Ohio state government, local government, or public school employee who has been denied disability benefits should seek advice and representation from a Columbus disability attorney.

Let the ERISA lawyers in the Columbus, Ohio, offices of Agee Clymer Mitchell & Portman know how we can be of service to you and your family. Request a free consultation online or call (614) 221-3318 for a no-pressure appointment with one of our insurance and disability lawyers.



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Worker’s Comp Lawyers Columbus, Ohio - Agee Clymer

140 E. Town St. #1100
Columbus, OH 43215