ERISA Tip:

1. Get the Plan Documents (All of Them).
   Use 29 U.S.C. §1024(b)(4) to demand the master plan document and summary plan description. Don’t accept summaries or partial PDFs from a TPA.

2. Use the $110/Day Penalty as Leverage.
   If the plan administrator fails to produce requested documents under 1024(b)(4) within 30 days, they may be liable for statutory penalties—potentially your only bargaining chip in a self-funded plan.

3. Check Form 5500.
   Determine whether the plan is self-funded or insured. Box 9 is critical. If both “general assets of the employer” and “insurance” are checked, you’ll need to dig deeper into the attached schedules and review all plan documents to determine funding status.

4. Closely Examine Plan Language.
   Even valid ERISA plans can lose recovery rights if the plan’s reimbursement provisions aren’t written tightly enough. A good lien resolution expert will spot weak or unenforceable provisions in the plan.

5. Determine if Equitable Doctrines Apply
   “Made whole,” “common fund,” and similar doctrines may not apply unless the plan language leaves room for them. Courts won’t rewrite ERISA contracts for equity’s sake.

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