Mastering Self-Funded ERISA Plans
ERISA Plans can be intimidating, but they don’t have to be. Educating yourself on how they operate is an essential step to achieving the best results for your case.
In general, lien resolution can be a time-consuming and tedious process. But (because of recent power via the US Supreme Court) self-funded ERISA Plans can be more difficult. They are saying “no” to reduction arguments of their liens.
Common responses on ERISA liens include:
- “The Plan has to consider all of the Plan members and not just your client. If we offer a reduction to your client, all of the other plan members suffer as their rates will go up.”
- “Sorry but our Plan has strong language and is not required to reduce.”
- “I understand your position, but this Plan disagrees and will not agree to a reduction.”
The key to getting a reduction is knowing ERISA law and reviewing all aspects of the Plan to find the weaknesses. Did you ask if you can get state law to apply? Does the Plan disavow the Made Whole rule properly? Is the Plan truly self-funded? Is there separate subrogation and reimbursement provisions, and why does that matter? Asking questions like these is an important step that many miss in the process.
The attorneys at MASSIVE have reviewed hundreds of self-funded ERISA Plans to craft persuasive arguments and have even participated in helping draft plans. If you are not 100% positive you are able to handle the ever-changing world of self-funded ERISA law, consider someone who can assist with this task and allow you to handle the other important daily activities of your cases. Here is a recent Success Story of how we reduced a complicated ERISA lien for a customer. Let us do the same for you!
We are the lien resolution experts. If you have questions about the process or need help reviewing a case, contact us today.