Health Insurance
ERISA
ERISA sets minimum standards for employer-sponsored health plans and generally shields self-funded plans from state insurance mandates.
Last reviewed: May 2026 · Editorial methodology
Definition
The Employee Retirement Income Security Act (ERISA) is a comprehensive federal law enacted in 1974 that governs employer-sponsored employee benefit plans, including most group health insurance plans. ERISA establishes fiduciary responsibilities for plan administrators, mandates certain disclosures to participants (such as the Summary Plan Description), and creates a federal claims and appeals process for benefits disputes. One of ERISA's most consequential features is its preemption of state insurance laws: because ERISA plan documents are federal instruments, states generally cannot require ERISA plans to cover specific benefits, follow state prompt-pay laws, or comply with state external review mandates — though fully-insured ERISA plans are partially subject to state insurance regulation through a savings clause. Self-funded ERISA plans, where the employer bears the financial risk of claims, enjoy virtually complete preemption from state health insurance mandates. ERISA also governs the COBRA continuation rights that allow departing employees to maintain group coverage temporarily. Federal agencies including the DOL, IRS, and HHS share jurisdiction over ERISA health plan compliance.
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Cover Forge USA Editorial Team
Editorial Lead
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed 2026-06-14
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