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The Corporate CounselorFeaturesLJN Newsletters

DOL Issues Final Regulations on Disability Benefits Claims Procedures

By Jennifer S. Kiesewetter

As has been the case for several months now, health care legislation has been front and center. However, the Department of Labor (DOL) has recently issued final regulations impacting health and welfare plans that will become law, and are not up for debate, as are other health care changes. On Dec. 16, 2016, the DOL published final regulations on disability benefits claims procedures for any group plans governed by the Employee Retirement Income Security Act of 1974, as amended (ERISA) that provide for disability benefits (the “Final Rule”). This Final Rule applies to any disability claims filed on or after Jan. 1, 2018, and will apply not only to health and welfare plans that provide for disability benefits, but also any qualified retirement plans that may offer disability benefits.

The DOL originally proposed amendments on Nov. 18, 2015, to align disability benefits claims procedures with those for group health and welfare plans under the Affordable Care Act. The Final Rule, issued just a month later, is substantially the same as the proposed November rule. In revising the claims procedures, the DOL concluded that enhancements in procedural safeguards similar to those required by the Affordable Care Act in group health plans were just as important in the case of claims for disability benefits. This article reviews some key provisions of the Final Rule.

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