what is the difference between erisa and non erisa health plans

 

Aspect	ERISA Health Plans	Non-ERISA Health Plans
Regulatory Framework	Governed by the Employee Retirement	Not subject to the ERISA regulations
	Income Security Act of 1974 (ERISA).	and may be regulated by state laws,
		federal laws, or other regulations.
Coverage Type	Typically offered by employers to	Can be offered by employers,
	provide employee benefits, including	but also by other entities such as
	health insurance, retirement plans,	individual consumers or non-profit
	and other welfare benefit plans.	organizations.
Plan Administration	Subject to strict federal regulations	Generally have more flexibility in
	and compliance requirements under	plan design and administration.
	ERISA, including reporting and
	disclosure rules.
Fiduciary Responsibilities	Plan sponsors and administrators have	Fiduciary responsibilities may vary
	fiduciary responsibilities to manage	based on the plan's structure and
	the plan in the best interest of	legal requirements.
	plan participants and beneficiaries.
Reporting and Disclosure	ERISA plans must adhere to strict	Non-ERISA plans may have more
Requirements	reporting and disclosure requirements	limited reporting and disclosure
	set forth by the Department of Labor.	requirements, depending on state
		laws and regulations.
Appeals and Litigation	ERISA provides a structured process	Non-ERISA plans may have more
Process	for appealing benefit denials and	flexibility in their appeals and
	allows participants to sue for	litigation processes.
	benefits in federal court.
Portability and Continuation	Offers COBRA (Consolidated Omnibus	Non-ERISA plans may or may not
	Budget Reconciliation Act) coverage	offer COBRA coverage, depending on
	for continued coverage after certain	state and federal requirements.
	qualifying events.
Benefit Coverage	Typically provides comprehensive	Coverage may vary widely and can
	health benefits, often with a	include a range of options, from
	range of plan choices.	basic to comprehensive coverage.
Employer Responsibilities	Employers must adhere to ERISA's	Employers may have more discretion
	strict requirements regarding plan	in plan design and contributions.
	management, funding, and
	communication with participants.