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Many employees do not think much about their workplace benefits until they suddenly need them. A serious illness, injury, or medical condition can quickly force an employee to investigate whether they have disability insurance through work—only to discover that obtaining basic information from their employer can be surprisingly difficult.

Several employees have reached out to our office with a common frustration: they asked for details about their employer’s group disability benefits but received little or no reply from human resources. In some instances, employees were unsure if they were enrolled in the company’s long-term disability (“LTD”) plan or aware of the insurance provider that funded the employer’s group disability plan.

Fortunately, federal law generally gives employees important rights to obtain information regarding employer-sponsored benefit plans. Employers and plan administrators are not permitted to simply ignore legitimate requests for plan information.

This article explains:

• The types of benefits employers commonly provide;
• How employees can determine whether they are covered by a group disability plan;
• What documents employers must provide upon request;
• The laws governing these obligations;
• Potential consequences for failing to comply; and
• What employees can do if their employer refuses to cooperate.

Common Types of Employer-Provided Benefits

Many employers provide benefit packages as part of an employee’s compensation. These benefits may include:

• Group health insurance;
• Dental and vision insurance;
• Life insurance;
• Short-term disability (“STD”) benefits;
• Long-term disability (“LTD”) benefits;
• Retirement benefits such as 401(k) plans;
• Pension plans;
• Accidental death and dismemberment coverage; and
• Supplemental voluntary insurance products.

Most employer-sponsored disability and retirement plans are governed by the federal law known as the Employee Retirement Income Security Act of 1974, commonly referred to as “ERISA.” Employee Retirement Income Security Act of 1974

ERISA imposes strict disclosure obligations on employers and plan administrators concerning employee benefit plans.

Understanding Short-Term vs. Long-Term Disability Benefits

Short-Term Disability Benefits

Short-term disability benefits generally provide income replacement for temporary disabilities that prevent an employee from working for a limited period of time. Coverage periods commonly range from several weeks to six months.

Some short-term disability programs are:

• Fully insured through a private insurance company;
• Self-funded by the employer; or
• Administered alongside state disability programs, such as California State Disability Insurance (“SDI”).

Long-Term Disability Benefits

Long-term disability benefits typically begin after short-term disability benefits end. LTD benefits may continue for years—or even until retirement age—depending on the terms of the plan.

These plans are often funded through insurance companies such as:

• Unum Group
• The Hartford
• Lincoln Financial Group
• MetLife
• Prudential Financial
• Sun Life Financial
• New York Life Insurance Company

In many situations, employees do not even know which insurance company provides the LTD coverage because enrollment occurs automatically through payroll or employee onboarding materials.

How Can an Employee Determine Whether They Are Covered Under a Group LTD Plan?

Employees often assume they have disability coverage, only to later discover they were never enrolled—or that coverage ended unexpectedly.

To determine whether you are a participant in your employer’s LTD plan, employees should request:

• The Summary Plan Description (“SPD”);
• Benefit enrollment records;
• Open enrollment confirmations;
• Payroll deduction records;
• Insurance certificates;
• Employee benefit booklets;
• Any plan participation or eligibility documents; and
• The formal insurance policy or plan document.

In many cases, payroll records showing deductions for disability insurance premiums can help establish participation in the plan.

Employees should also review:

• Offer letters;
• Employee handbooks;
• Benefits portals;
• Annual enrollment materials; and
• Prior communications from human resources.

How to Identify the Insurance Company Funding the LTD Plan

One of the most important pieces of information is identifying the insurance company that funds and/or administers the LTD plan.

The insurance carrier is often identified in:

• The Summary Plan Description;
• Insurance certificates;
• Enrollment materials;
• Claim forms;
• Benefits guides; or
• Payroll records.

Under ERISA, the Summary Plan Description is required to identify:

• The plan administrator;
• The insurer (if insured);
• The claims administrator; and
• Procedures for submitting claims and appeals.

If an employee cannot identify the insurance company, it becomes extremely difficult to file a claim, appeal a denial, or determine applicable deadlines.

What Documents Must Employers Provide Upon Request?

ERISA imposes disclosure obligations on plan administrators. Under 29 U.S.C. § 1024(b)(4), plan administrators are generally required to provide certain plan documents upon written request from a participant or beneficiary.

These documents may include:

• The Summary Plan Description (“SPD”);
• The formal plan document;
• Insurance policies;
• Trust agreements;
• Annual reports (Form 5500 filings);
• Collective bargaining agreements affecting the plan; and
• Other instruments under which the plan is established or operated.

The Summary Plan Description is particularly important because it explains:

• Eligibility requirements;
• Definitions of disability;
• Benefit amounts;
• Exclusions and limitations;
• Claim procedures;
• Appeal deadlines; and
• Termination provisions.

Who Is Legally Responsible for Providing the Information?

Under ERISA, the “plan administrator” bears primary responsibility for furnishing plan documents.

In some cases:

• The employer itself is the plan administrator;
• A designated benefits department acts as administrator; or
• A third-party administrator manages disclosures.

Importantly, employers cannot avoid ERISA disclosure obligations simply by failing to respond to employees or directing employees in circles between HR and insurance carriers.

What Happens If the Employer or Plan Administrator Fails to Provide the Documents?

Failure to comply with ERISA disclosure obligations can carry significant consequences.

Under 29 U.S.C. § 1132(c)(1), a court may impose statutory penalties against a plan administrator that fails or refuses to provide requested plan documents within 30 days after a written request.

Potential consequences may include:

• Statutory penalties of up to $110 per day;
• Attorneys’ fees and costs;
• Court orders compelling disclosure; and
• Adverse inferences in litigation.

Courts may consider factors such as:

• Whether the failure was intentional;
• The length of delay;
• Prejudice to the employee; and
• Whether the administrator acted in bad faith.

In disability cases, delays in obtaining plan information can be extremely harmful because LTD claims are governed by strict contractual deadlines.

Best Practices for Requesting LTD Plan Information

Employees should always request plan documents in writing.

A written request should:

• Clearly identify the documents being requested;
• State that the request is made pursuant to ERISA;
• Be dated;
• Be sent to HR, benefits administrators, or the designated plan administrator; and
• Be preserved for future reference.

Employees should also:

• Keep copies of all correspondence;
• Save emails and screenshots;
• Document phone calls; and
• Track response deadlines.

Sending requests by certified mail or email with delivery confirmation can help establish proof of receipt.

What Can Employees Do if Their Employer Refuses to Respond?

Before contacting an attorney, employees may consider several options:

1. Submit a Formal Written ERISA Request

Many employees initially make only verbal requests to HR. A formal written request referencing ERISA often receives more serious attention.

2. Escalate Internally

Employees can escalate concerns to:

• Human resources directors;
• Corporate benefits departments;
• In-house legal departments; or
• Company executives responsible for compliance.

3. Contact the Insurance Company Directly

If the insurer’s identity is known, employees may contact the insurance carrier directly to request claim forms or coverage information.

4. Request Payroll and Enrollment Records

Payroll deductions for disability insurance may help establish participation in the plan.

5. Contact the U.S. Department of Labor

The United States Department of Labor, through its Employee Benefits Security Administration (“EBSA”), investigates ERISA compliance issues and assists employees with benefit-related concerns.

Employees may file complaints with EBSA when employers or plan administrators refuse to provide required plan information.

6. Preserve Evidence

Employees should preserve:

• Emails;
• Benefits materials;
• Pay stubs;
• Medical leave records; and
• Any communications relating to disability benefits.

These records can become critical if litigation later becomes necessary.

Contact an ERISA Disability Attorney

If you are having difficulty obtaining information regarding your employer-sponsored disability benefits, you may have important legal rights under ERISA.

An experienced ERISA disability attorney can help:

• Identify the proper plan administrator;
• Obtain plan documents;
• Determine whether coverage exists;
• Evaluate claim deadlines;
• Address disclosure violations; and
• Protect your rights to long-term disability benefits.

If your employer or plan administrator is refusing to provide information regarding your LTD coverage, it is important to act quickly before critical deadlines expire.