ERISA

The Employee Retirement Income Security Act of 1974 governs most employer-sponsored (self-funded) health plans. Self-funded plans are generally exempt from state insurance laws but are subject to federal MHPAEA, ERISA's claims and appeals procedures (29 CFR § 2560.503-1), and CAA 2021. When appealing a denial from a self-funded employer plan, you invoke federal law rather than your state's insurance code.