Employee Benefits and ERISA Claims

The Employee Retirement Income Security Act of 1974 (“ERISA”) is a federal law that protects employees and retirees who receive benefits through employer-sponsored plans. These benefits commonly include pension benefits, 401(k) plans, health insurance, disability insurance, and other welfare benefits provided by employers, including many Fortune 500 companies.

ERISA establishes strict rules governing how employee benefit plans must be designed, administered, and communicated. Employers and plan fiduciaries have legal obligations to act in the best interests of participants and beneficiaries. When employers violate those obligations, participants may have the right to recover improperly withheld benefits, challenge discriminatory plan terms, and secure equitable and monetary relief.

Unfortunately, many employees unknowingly lose valuable benefits due to unlawful plan designs, discriminatory practices, or improper administration. Common violations include:

• Unlawful tobacco surcharge, smoking surcharge, or nicotine surcharge programs that charge employees higher health insurance premiums based on tobacco use without complying with federal rules;
• Improper pension formulas that reduce retirement benefits below their true actuarial equivalent value;
• Failure to properly disclose plan terms, including Summary Plan Descriptions and benefit calculations;
• Denial or underpayment of pension benefits, retirement benefits, or health benefits;
• Mismanagement of employee benefit plans by plan fiduciaries.

ERISA prohibits discrimination in employee benefits, including discrimination based on health factors such as tobacco use. For example, employers may not impose a tobacco surcharge or nicotine surcharge unless strict regulatory requirements are met. Likewise, pension plans must calculate benefits using lawful actuarial assumptions that do not systematically reduce participant benefits.

If you work for, or previously worked for, a Fortune 500 company or any employer that provides health insurance or pension benefits, and believe your employer imposed an unlawful tobacco surcharge, nicotine surcharge, or improperly calculated your pension benefits, you may have a claim under ERISA.

Participants or retirees are generally told to follow the plan’s internal claims and appeals procedures. These procedures are governed by federal regulations and must provide a fair and meaningful opportunity to challenge benefit denials or unlawful plan practices.

The ERISA claims process typically involves:

• Submitting a claim for benefits or requesting correction of improper charges, such as a tobacco surcharge or nicotine surcharge;
• Receiving a written determination from the plan administrator;
• Filing an administrative appeal if the claim is denied;
• Obtaining and reviewing plan documents, including Summary Plan Descriptions, actuarial calculations, and benefit formulas;
• Pursuing litigation in federal court if the plan fails to comply with ERISA.

Strict deadlines apply to ERISA claims and appeals. Failure to act within these deadlines may result in the permanent loss of your right to recover benefits.

Our attorneys assist employees and retirees throughout the entire ERISA claims and litigation process, including reviewing plan documents, evaluating pension benefit calculations, and challenging unlawful tobacco surcharge or nicotine surcharge programs.

ERISA is a complex set of federal laws, and employers often rely on that complexity to deny or reduce benefits.

An experienced ERISA attorney can:

• Review your pension benefits and retirement calculations;
• Evaluate whether a tobacco surcharge, smoking surcharge, or nicotine surcharge was lawfully imposed;
• Obtain and analyze plan documents and actuarial formulas;
• Assist with administrative claims and appeals;
• File lawsuits to recover improperly withheld benefits;
• Hold plan fiduciaries accountable for unlawful conduct.

If you believe your employer improperly charged you a tobacco surcharge, smoking surcharge, or nicotine surcharge, or if you are concerned that your pension benefits were calculated improperly, you may be entitled to relief under ERISA.

Our attorneys have extensive experience representing employees and retirees in ERISA litigation involving Fortune 500 companies and other employers. We routinely evaluate benefit plans, identify unlawful practices, and pursue claims to recover improperly withheld benefits.

If your employer improperly denied or reduced your benefits or if you would like to have your benefits checked or your pay stubs reviewed to determine whether you have a potential claim, including a tobacco surcharge claim, actuarial equivalence claim, or other ERISA benefits claim, we encourage you to contact Siri & Glimstad.

There is no cost for an initial consultation. We get paid only if we recover benefits on your behalf.

Contact Siri & Glimstad today to speak with an experienced ERISA attorney and determine whether you have a claim.