ERISA compliance continues to be a very important topic in health care. Often, we forget many non-compliance infractions, penalties, and audits can be driven by a civil lawsuit or investigation. Here are some interesting statistics relative to civil investigations as recorded by the Department of Labor and the Employee Benefits Security Administration (EBSA).
In FY 2015, EBSA closed 2,441 civil investigations with 1,640 of those cases (67.2%) resulting in monetary results for plans or other corrective action. That exhibits EBSA’s ability to effectively target ERISA violators in the employee benefit plan universe.
EBSA often pursues voluntary compliance as a means to correct violations and restore losses to employee benefit plans. However, in cases where voluntary compliance efforts have failed, or that involve issues for which voluntary compliance is not appropriate, EBSA forwards a recommendation to the Solicitor of Labor to initiate litigation.
In FY 2015, 136 cases were referred for litigation. Together, EBSA and the Solicitor of Labor determine which cases are appropriate for litigation, considering the ability to obtain meaningful relief through litigation, cost of litigation, viability of other enforcement options, and agency enforcement priorities. EBSA cases referred to the Solicitor’s office for litigation are frequently resolved with monetary payments, short of litigation. Nationwide in FY 2015, the Department filed suit in 89 civil cases.
- Civil Investigations Closed – 2,441
- Civil Investigations Closed with Results – 1,640
- Percent Civil Investigations Closed with Results – 67.2%
- Civil Investigations Referred for Litigation – 136
- Civil Cases with Litigation Filed – 89
The purpose of ERISA plan document requirements is to demonstrate a strong, fair, and effective program that protects the benefits of America’s workers. The compliance aspect of ERISA distribution, maintenance, or recording practices is more relevant today than ever before. Are your clients’ groups in compliance?