Brief Case
Pension Resource

ERISA § 503 (29 U.S.C. § 1133)

Claims procedure
USC 2024 ed., current through 2025-01-06 · current · last amended by Pub. L. 93-406
PrintCompare datesAsk AI about this sectionOfficial source ↗
Back to current
In accordance with regulations of the Secretary, every employee benefit plan shall—
(1) provide adequate notice in writing to any participant or beneficiary whose claim for benefits under the plan has been denied, setting forth the specific reasons for such denial, written in a manner calculated to be understood by the participant, and
(2) afford a reasonable opportunity to any participant whose claim for benefits has been denied for a full and fair review by the appropriate named fiduciary of the decision denying the claim.
Source credit, amendments & notes

(Pub. L. 93–406, title I, §503, Sept. 2, 1974, 88 Stat. 893.)

Statutory Notes and Related Subsidiaries
Regulations

Secretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.

ERISA § 503 (29 U.S.C. § 1133) — Claims procedure · USC 2024 ed., current through 2025-01-06 · https://pensionresource.website/EAMain?content=EAMain.Law&id=usc29-1133&asof=1995-01-04 · printed Oct 16, 2026
Cited by (code & regs)
Department of Labor Regulations
Guidance addressing this section
IRS / Treasury
Final Rules
  • 89 FR 88642 Nov 8, 2024 — Extension of Certain Timeframes for Employee Benefit Plans, Participants, Beneficiaries, Qualified Beneficiaries, and Claimants Affected by Hurricane Helene, T… (h)(h)(2)(i)(h)(3)(i)(h)(4)
  • 85 FR 26351 May 4, 2020 — Extension of Certain Timeframes for Employee Benefit Plans, Participants, and Beneficiaries Affected by the COVID-19 Outbreak (h)(h)(2)(i)
  • 83 FR 19431 May 3, 2018 — Clarification of Final Rules for Grandfathered Plans, Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, Dependent Coverage, Appeals, a… (b)(4)(h)(2)
  • 80 FR 72192 Nov 18, 2015 — Final Rules for Grandfathered Plans, Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, Dependent Coverage, Appeals, and Patient Protec… (b)(c)(3)(f)(2)(i)(f)(2)(ii)(g)(h)(2)
  • 78 FR 68240 Nov 13, 2013 — Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; Technical Amendment to External Review for Multi-…
  • 76 FR 37208 Jun 24, 2011 — Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and External Review Processes (f)(2)(i)(h)(2)(iii)(m)(1)
  • 75 FR 43330 Jul 23, 2010 — Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and External Review Processes Under the Patient… (b)(c)(3)(f)(2)(i)(f)(2)(ii)(g)(h)(2)
  • 75 FR 5410 Feb 2, 2010 — Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008
Department of Labor (EBSA)
Information Letters
  • DOL Info. Ltr. 06-14-2021 Jun 14, 2021 — Information Letter concerning whether the provisions of the claims procedure regulation at 29 CFR 2560.503-1 require the plan to provide to a claimant, a copy … (b)(m)(8)
  • DOL Info. Ltr. 02-27-2019 — Application of the authorized representative provisions of 29 CFR 2560.503-1, regarding the designation of an authorized representative for the initial claim f… (b)(4)
Final Rules
Proposed Rules
  • 82 FR 47409Proposed Oct 12, 2017 — Claims Procedure for Plans Providing Disability Benefits; Extension of Applicability Date Comments due Oct 27, 2017
  • 80 FR 72014Proposed Nov 18, 2015 — Claims Procedure for Plans Providing Disability Benefits Comments due Jan 19, 2016 (g)(1)(iv)(i)(1)(ii)(i)(3)(i)
Also cited in 34 other documents
Department of Labor (EBSA)
Proposed Rules
  • 91 FR 46602Proposed Jul 23, 2026 — Electronic Disclosure by Group Health Plans Under ERISA Comments due Sep 21, 2026 (g)(1)(j)
  • 91 FR 9213Proposed Feb 25, 2026 — Requirement To Provide Paper Statements in Certain Cases-Amendments to Electronic Disclosure Safe Harbors Comments due Apr 27, 2026 (g)(1)
  • 84 FR 56894Proposed Oct 23, 2019 — Default Electronic Disclosure by Employee Pension Benefit Plans Under ERISA Comments due Nov 22, 2019 (1)(g)(1)
  • 81 FR 47534Proposed Jul 21, 2016 — Proposed Revision of Annual Information Return/Reports Comments due Oct 4, 2016 (f)(2)(iii)(A)(f)(2)(iii)(B)(m)(m)(4)
  • 76 FR 76235Proposed Dec 6, 2011 — Ex Parte Cease and Desist and Summary Seizure Orders-Multiple Employer Welfare Arrangements Comments due Mar 5, 2012
  • 75 FR 70625Proposed Nov 18, 2010 — Annual Funding Notice for Defined Benefit Plans Comments due Jan 18, 2011 (c)
Final Rules
  • 85 FR 31884 May 27, 2020 — Default Electronic Disclosure by Employee Pension Benefit Plans Under ERISA (1)
  • 83 FR 28912 Jun 21, 2018 — Definition of “Employer” Under Section 3(5) of ERISA-Association Health Plans
  • 81 FR 43430 Jul 1, 2016 — Department of Labor Federal Civil Penalties Inflation Adjustment Act Catch-Up Adjustments (a)(1)
  • 80 FR 5626 Feb 2, 2015 — Annual Funding Notice for Defined Benefit Plans (c)
  • 78 FR 13797 Mar 1, 2013 — Ex Parte Cease and Desist and Summary Seizure Orders-Multiple Employer Welfare Arrangements
  • 75 FR 8796 Feb 26, 2010 — Civil Penalties Under ERISA Section 502(c)(8)
Technical Releases
IRS / Treasury
Notices
  • Notice 2024-86 Dec 23, 2024 — Extension of Certain Timeframes for Employee Benefit Plans, Participants, Beneficiaries, Qualified Beneficiaries, and Claimants Affected by Hurricane Helene, T… (h)(4)
Proposed Rules
  • 89 FR 85750Proposed Oct 28, 2024 — Enhancing Coverage of Preventive Services Under the Affordable Care Act Comments due Dec 27, 2024 (b)(2)(ii)(B)(m)(1)
  • 88 FR 51552Proposed Aug 3, 2023 — Requirements Related to the Mental Health Parity and Addiction Equity Act Comments due Oct 2, 2023 (h)(2)(iii)
  • 84 FR 65464Proposed Nov 27, 2019 — Transparency in Coverage Comments due Jan 14, 2020
  • 79 FR 78578Proposed Dec 30, 2014 — Summary of Benefits and Coverage and Uniform Glossary Comments due Mar 2, 2015
  • 77 FR 16501Proposed Mar 21, 2012 — Certain Preventive Services Under the Affordable Care Act Comments due Jun 19, 2012
Final Rules
  • 89 FR 77586 Sep 23, 2024 — Requirements Related to the Mental Health Parity and Addiction Equity Act
  • 86 FR 55980 Oct 7, 2021 — Requirements Related to Surprise Billing; Part II (b)(f)(2)(i)(f)(2)(ii)(g)(h)(2)(i)
  • 86 FR 36872 Jul 13, 2021 — Requirements Related to Surprise Billing; Part I
  • 85 FR 72158 Nov 12, 2020 — Transparency in Coverage (b)(4)
  • 84 FR 28888 Jun 20, 2019 — Health Reimbursement Arrangements and Other Account-Based Group Health Plans
  • 80 FR 41318 Jul 14, 2015 — Coverage of Certain Preventive Services Under the Affordable Care Act (h)(2)(iii)
  • 80 FR 34292 Jun 16, 2015 — Summary of Benefits and Coverage and Uniform Glossary
  • 79 FR 51092 Aug 27, 2014 — Coverage of Certain Preventive Services Under the Affordable Care Act
  • 78 FR 39870 Jul 2, 2013 — Coverage of Certain Preventive Services Under the Affordable Care Act
  • 76 FR 44491 Jul 26, 2011 — Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and External Review Processes; Correction (f)(2)(i)(m)(1)
Revenue Procedures
  • Rev. Proc. 2015-36 Jul 6, 2015 — This revenue procedure modifies Rev. Proc. 2011–49 by expanding the scope of the pre-approved program to include defined benefit plans containing cash balance …
  • Rev. Proc. 2011-49Modified Oct 31, 2011 — This procedure sets forth the procedures of the Service for issuing opinion and advisory letters regarding the acceptability under sections 401 and 403(a) of t…
    Modified by Rev. Proc. 2013-6; Modified by Ann. 2013-37; Modified by Rev. Proc. 2012-6; Modified by Ann. 2012-3
Treasury Decisions
  • T.D. 9166 Feb 22, 2005 — Final regulations under section 9801 of the Code provide guidance on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) portability requir…
Announcements
  • Ann. 2004-33 May 3, 2004 — Pre-approved employee plans; proposed revenue procedure; request for comments. This announcement describes and contains a draft proposed revenue procedure pert…
Tax Court (0) · DOL/Federal (1)
DOL and federal courts (1)
Also cite this provision (1)

No private letter rulings in the library cite this provision yet.

Each row is a version of the text as published by the official source. Code dates are the edition/release point that first reflected the change; regulation dates are eCFR effective dates. The library checks the official sources automatically, so new versions appear here on their own; “run” opens the sync that recorded a version.

EffectiveThroughSourceAmended by
Jan 4, 1995currentUSC 2024 ed., current through 2025-01-06 run 1Pub. L. 93-406View
Provision-level history (blame)