ERISA Claims Get DOL Scrutiny: Fair Appeals for All?
Published Date: 4/3/2026
Notice
Summary
The Department of Labor is asking for public feedback on how employee benefit plans handle claim denials and appeals under ERISA. This affects anyone with a retirement or health plan, ensuring they get clear, written reasons if their claim is denied and know how to appeal. Comments are open until May 4, 2026, with no new costs but a focus on keeping the process clear and fair.
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Clear Written Notices for Denied Benefit Claims
If you have an employee retirement or health plan covered by ERISA, the rule requires plans to give you a written or electronic notice when a claim is denied that explains the specific reasons, cites the plan provisions used, tells you what extra information is needed to fix the claim, and explains how to appeal. It also requires that any adverse decision on review be in writing with specific reasons and plan references. The Department is requesting OMB review of this information collection and will consider comments received on or before May 4, 2026.
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