Summary Plan Descriptions under ERISA

Summary Plan Descriptions under ERISA from Setnor Byer Insurance & Risk

By: Setnor Byer Insurance & Risk  06/25/2014
Keywords: Health Insurance, Affordable Care Act

The Employee Retirement Income Security Act (ERISA) is a federal law that sets minimum standards for most voluntarily established employee pension and welfare plans in the private sector. To protect individuals in these plans, ERISA requires plan administrators, which are oftentimes the employers, to provide plan participants and their beneficiaries with a Summary Plan Description (SPD). SPDs are used to give plan participants and beneficiaries important information about pension plans, like 401(k) and profit sharing plans, and welfare plans, like group health, disability and pre-paid legal plans. SPDs provide information about the plan, what benefits are available under the plan, the rights of participants and beneficiaries under the plan, and how the plan works. SPDs must generally be given to each plan participant and each beneficiary receiving benefits under the plan within 90 days after first becoming covered by the plan. Under ERISA, SPDs must generally: identify the plan name, plan number and employer identification number (EIN) describe the type of plan (ex. 401(k), profit sharing, group health, disability) describe the type of plan administration provide contact information for the plan administrator and service of process describe the plan’s eligibility requirements describe circumstances which may result in disqualification, ineligibility, denial, loss, forfeiture, suspension or reduction of benefits state the date of the plan’s fiscal year describe the procedures governing claims for benefits, applicable time limits and remedies if claims are denied describe provisions governing termination of the plan a statement of rights available to plan participants under ERISA

Keywords: Affordable Care Act, Health Insurance

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