The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for employee benefit plans maintained by private-sector employers. ERISA includes requirements for both retirement plans (for example, 401(k) plans) and welfare benefit plans (for example, group health plans). ERISA has been amended many times over the years, expanding the protections available to welfare benefit plan participants and beneficiaries.
The Department of Labor (DOL), through its Employee Benefits Security Administration (EBSA), enforces most of ERISA’s provisions. Violating ERISA can have serious and costly consequences for employers that sponsor welfare benefit plans, either through DOL enforcement actions and penalty assessments or through participant lawsuits.
This Legislative Brief includes a set of frequently asked questions (FAQs) to help employers understand how ERISA’s requirements for welfare benefit plans are enforced.
How does the DOL enforce ERISA?
The DOL has broad authority to investigate or audit an employee benefit plan’s compliance with the ERISA. The DOL’s EBSA division handles audits of employee benefit plans. To perform these audits, EBSA employs over 400 investigators working out of field offices, many of whom are lawyers or CPAs or have advanced degrees in business or finance.
DOL audits often focus on violations of ERISA’s fiduciary obligations and reporting and disclosure requirements. The DOL may also investigate whether an employee benefit plan complies with ERISA’s protections for plan participants. Recently, the DOL has been using its investigative authority to enforce compliance with the Affordable Care Act (ACA).
Traditionally, DOL audits of employee benefit plans have focused primarily on retirement plans, such as 401(k) plans. However, now that the DOL has started enforcing compliance with the ACA, health plan audits are on the rise.
Enforcement Statistics: During the 2014 fiscal year, EBSA closed 3,928 civil investigations. Of these, 64.7 percent resulted in monetary results for employee benefit plans or other corrective action. In addition, EBSA filed 107 civil lawsuits and closed 365 criminal investigations. EBSA’s criminal investigations led to the indictment of 106 individuals—including plan officials, corporate officers and service providers—for offenses related to employee benefit plans.
What are the possible consequences of a DOL investigation?
Being selected for a DOL audit can have serious consequences for an employer. According to a DOL audit report for the 2014 fiscal year, approximately 5 out of 8 investigations resulted in penalties or required other corrective action, such as paying amounts to restore losses, disgorging profits and ensuring claims were properly processed and paid. In addition, a DOL audit may negatively affect an employer’s normal business operations because the audit process can be both stressful and time-consuming.