In the most basic terms, does an employer-based plan that says it’s an ERISA plan mean it is protected from state law, such as a state law requiring pro-rata reduction of their lien? So basically I need to pay the lien in full after a settlement, vs negotiating it down? And would I only need to consult with an “ERISA specialist” when I need help in determining (and potentially disputing) whether they actually are in-fact an ERISA plan?

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forget the statutory scheme of it, (also i am in NJ) the ERISA lien must be paid but it doesn’t have to be the full amount. it can be negotiated but you’re essentially at their will when it comes to how much they’ll take off. you don’t need to consult anyone. make them provide you the form 5500 in effect on DOA and it’ll demonstrate it’s a legit ERISA lien

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Yes, explain to them why this is a win for everyone. They don’t have to accept that, but it’s worked for me in a handful of cases. Or they can get paid now or wait three years to be paid half.

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Most ERISA plans have a contractual first right of recovery, especially self funded ones. Very hard to get around. Not subject to common fund or any state law Re: reductions. But you need to read the plan and make sure that all the Ts are crossed and Is are dotted.

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Plan language controls their right of recovery. Some are worst than others.

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Erisa preempts state law and the contract language prevails. So get a copy of the contract and see what it says about repayment

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What does it generally say? That they allegedly have a right to recover the full amount?

They can be negotiated but most of the time they won’t reduce. I only negotiate it if it’s an outrageous amount like $10k and over. But to determine if it’s truly erisa you should ask for the plan language, form 5500 and their proof of right to reimbursement.

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