The GLOBO Blog

The month of April introduced new procedural requirements for private sector employee benefit plans.

On April 1, 2018, the final rule amending the claims procedure for disability benefits plans under Section 503 of the Employee Retirement Income Security Act (ERISA) took effect.

Section 503 of ERISA outlines procedural requirements for employee benefit plans regarding the filing of benefit claims, notification of benefit determinations and appeal of adverse benefit determinations. The final rule amends the procedural requirements to include additional rules and protections for disability claimants, comparable to the protections for group health plan claims under the Affordable Care Act (ACA). 

The final ruling of Section 1557 of the Affordable Care Act (ACA) put major changes in motion regarding individuals’ ability to access health care and coverage. The law prohibits discrimination based on age, sex, disability, race, color and national origin, which includes the language an individual speaks.

The enhancement of language assistance for individuals classified as Limited English Proficient (those who speak English less than "very well”) is just one piece of the puzzle in the law's efforts to reduce disparities in healthcare. Since the final rule was implemented, language services have been a hot topic for many health insurers and providers. However, the rule, which is extensively outlined in a whopping 99-page document, isn’t entirely easy to digest.

Questions such as ‘Does Section 1557 affect me?’ and ‘How do I comply with the language access requirements?’ often arise. To help make sense of the law (and answer these questions), we’re breaking down exactly who the law affects, and how those affected can become compliant with the language access requirements, with two simple flowcharts: