ERISA Group Size Eligibility Requirements

by Maria McCarron; Updated September 26, 2017

The Employee Retirement Income Security Act group size eligibility requirements for health and pension plans were created in 1974. A company's benefits are subject to ERISA requirements if the company is U.S.-based, is not part of a church or government organization, covers 50 or more group benefit participants or the employer uses an insurer carrier to administrate its health and retirement benefits.

ERISA Requirement Benefits Reporting

Companies with employees of 50 or less may have to comply under small benefit group coverage if they use an insurance company. Any companies with self insured plans or fully insured plans with at least 50 participants must regularly provide information about group benefit plans to participants as part of their fiduciary duty. Under the regulations, company administrators must provide a benefit plan summary, coverage levels and claims procedures to The Department of Labor and the IRS.

Translation of Benefits

Translation of group benefits must be provided to 100 or more employees that are covered by a healthcare plan and if 10 percent or more of the participants write or read in the same non-English language. Translation must also be provided if 25 percent or more of 99 employees read and write in the same non-English language.

Multiple Employer Benefits

Small businesses may also partner up to offer group health insurance coverage to employees through Multiple Employer Welfare Arrangements. There are usually employee benefits within an industry or trade association, according to the United States Department of Labor's website. The benefits may qualify under ERISA Single Employer Small Group Benefits Plans if the employers in the MEWA have 50 or fewer people. The cooperative may qualify for larger group benefits if the companies have more than 50 employees. In addition MEWAs must be non-profit entities and require another purpose besides health care to be eligible to participate in ERISA.

COBRA Health Coverage

Employers with 20 or more employees must offer Consolidated Omnibus Budget Reconciliation Act coverage under ERISA and notify employees the coverage. COBRA are health plans sponsored by most state and local governments that offer benefits coverage if an employee is laid off, fired, becomes divorced from an employee who provided insurance for them or if an employee passes away. Beneficiaries may be required to pay for COBRA.

About the Author

Maria McCarron has been covering Wall Street and merger and acquisitions since 2006. She's been published in "The Deal," "The Financial Times" and online at TheStreet. McCarron studied journalism at Boston University and holds a Master of Arts and Letters from Drew University.