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Legal Requirements for Insurance Claims Translation

The Employee Retirement Income Security Act of 1974 (ERISA) was amended in 2016, and now these new provisions have gone into effect for 2018. Insurance companies offering plans for employees should learn about the new translation requirements and be ready to implement them.

This post introduces the ERISA translation requirements and explains how insurance companies can stay in compliance, so that you know what to expect and how a translation service can be beneficial for your business. High-quality translation from professionals familiar with your business empowers you to concentrate on insurance claims and stay compliant with federal law, all while providing better customer service.

ERISA Requirements

Specifically, ERISA requires that insurance companies provide translation services whenever appropriate to do so. These exact circumstances are defined by the new Final Rule provided by the Department of Labor.

As it turns out, these standards are the same as those established by the Affordable Care Act (ACA) and used for health benefit notices, so these are not entirely new requirements. Essentially, the translation requirements are just being expanded to apply in other insurance situations.

Here are the details:

  • These requirements apply for plan subscribers in a specific county if more than 10% of that county is literate only in a language other than English
  • Companies are required to have translation services available for that language
  • A “prominent statement” in that language mentioning that translation is available must be placed on benefit denial notices

  • Spoken customer assistance must be made available in that language
  • Upon request, written notices must be made available in that language as well

Why ERISA Translation Regulations Matter

In an effort to ensure claimant access to insurance claims documents that they can read and understand, the US Department of Labor has established consumer protections requiring the availability of translation services in certain instances. Insurers must follow these standards to ensure that people with limited English proficiency have full access to their plan benefits.

Without translation, many plan enrollees would be unable to fully participate in their plans and may struggle to access the benefits their plan entitles them to. Language barriers should not prevent your customers from using your plans--this is why we offer professional translation to the insurance industry.

Our country is very diverse and is becoming more diverse every year. There are many US counties where 10 percent of more of the population speaks a language besides English, and in many cases these other languages are the only ones insurance subscribers are fluent in. The ERISA requirements are intended to reflect that growing diversity and respond to it by ensuring that everyone has access to insurance information they can understand and use.

Translation Services Can Help You Comply With ERISA

Using a translation service makes it possible to access high-quality translation at scale. Translators who are familiar with insurance terminology and processes can help with claims management by taking care of the language translation side for you.

Translation is available when you need it, so if your translation needs fluctuate, you have it available at the right times and locations for your business. There is no need to hire your own in-house translation team when you can hire a translation service and immediately access assistance with hundreds of different languages.

With professional language support, you can offer customer service in your customers’ languages that is accurate and compliant with ERISA.

Services we offer for insurers:

  • On-site interpreting 

  • Over-the-phone interpreting

  • Transcription and translation

  • Document translation

On-demand interpretation from a translation company familiar with the insurance industry can help you address the needs of your customers. This allows you to focus on what you do best--insurance.

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