The Department of Labor's (DOL) final rule for disability claims procedures, issued December 19, 2016, will take effect April 1, 2018. The regulations will apply to disability claims filed on or after that date.
These regulations impose standards to any ERISA benefit determinations based on a participant’s disability status — similar to what already applies for health plan claims rules (developed under the ACA).
The new rule ensures, for example, that disability claimants receive a clear explanation of why their claim was denied as well as their rights to appeal a denial of a benefit claim, and to review and respond to new information developed by the plan during the course of an appeal. The rule also requires that a claims adjudicator could not be hired, promoted, terminated, or compensated based on the likelihood of denying claims.
Please see this notice for more information.