Workers' comp: a third exemption
Government and church plans are not the only coverage ERISA leaves out. A plan solely complying with workers' comp or state disability law is exempt too.
Most discussion of non-ERISA disability coverage focuses on government employer plans and church plans, and for good reason: they are the exemptions a searcher most often needs. But 29 U.S.C. section 1003(b) lists a third exemption that is easy to miss: a plan maintained solely for the purpose of complying with applicable workers' compensation laws, unemployment compensation laws, or disability insurance laws is not covered by ERISA Title I.
This exemption is narrow. It applies to a plan that exists solely to satisfy a state-law compliance requirement, not to an employer's general group LTD plan that happens to coordinate benefits with a state disability program. Most private-sector group long-term disability plans are ordinary ERISA plans even where a state also runs its own short-term disability insurance program alongside them.
If your coverage genuinely is a state-mandated disability insurance arrangement, rather than an employer-purchased group LTD policy, the ERISA claims-procedure rules this site describes, including the 180-day appeal floor, generally do not apply to that coverage, and the state's own program rules control instead. If you are not sure which kind of coverage you have, use the self-assessment as a starting point, and check your plan document or your state disability program's own materials directly, since this exemption depends on how the specific plan is structured, not only on which state you live in. The statute lists two further exemptions beyond this one, for foreign plans covering nonresident aliens and for unfunded excess benefit plans: see foreign and excess benefit plans.
Why this is easy to get wrong
A plan can mention a state disability insurance law without being maintained solely to comply with it, and the exemption only reaches the narrower case. If your denial letter or plan document does not clearly say your coverage exists purely to satisfy a state compliance mandate, treat it as an ordinary ERISA group LTD plan unless a plan administrator or an attorney confirms otherwise.