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ERISA Health Plan

Meaning

An ERISA Health Plan is a health and welfare benefit program established or maintained by a private-sector employer that is governed by the Employee Retirement Income Security Act of 1974. In the hormonal health space, this designation is clinically relevant because ERISA preempts many state laws, creating a complex federal regulatory landscape that dictates how benefits for hormonal diagnostics, treatments, and therapies are administered and contested. For the patient, understanding whether their plan is ERISA-governed is crucial for navigating coverage denials, appeals processes, and understanding their rights to access specialized endocrine care. It is the legal backbone for many employer-sponsored health benefits.