Does Fiduciary Liability Cover Health Plans?

ERISA can apply to private-sector employee health plans, and DOL explains that fiduciary status depends on plan structure and the discretion exercised. A policy may define welfare or health plans specifically: the Travelers specimen includes certain employer-sponsored welfare plans and describes administration tasks such as enrollment, records, and benefit communications. Its definitions and eligibility restrictions illustrate why the label alone is not enough.

Some public-sector and church-sponsored plans are outside ERISA, and an insurance policy may have its own plan eligibility rules regardless. Tell the broker whether the health arrangement is fully insured, self-funded, a health reimbursement account, or another design, and identify the plan sponsor and administrators. Check whether the actual quote includes that plan and whether it addresses administrative errors, benefit disputes, defense costs, and any relevant exclusions or endorsements.