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Plan Document Requirements


A plan document describes, in writing, the plan's terms and conditions and is a requirement for each plan which is subject to ERISA. Typically, the plan document is not written in an easy to read format. The plan document usually provides more details than contained in the Summary Plan Description and will need to be referred to and amended as necessary.

 

There is little guidance on what must be contained in the plan document. The guidance only states that the plan must operate and be maintained with a written document.

 

Contents of the Plan Document

Below is a table of ERISA plan document requirements which should be contained within a plan document:

 

Name of Plan Administrator

Terms of Minimum Hospital Stay after Child Birth

Named Fiduciary

Procedure for Allocation of Responsibilities

Funding Policy

How payments are made to and from plan

Overview of benefits offered and eligibility rules

Claims Procedures

Amendment procedures including employers right to terminate

Distribution of Assets on Plan Termination

Group Health Mandates

HIPAA Portability, HIPAA Privacy & Security

QMCSO, COBRA & USERRA

Other Federal Mandates which apply to health plans

 

Distribution

The plan document does not need to be distributed to any plan participant unless it is requested.

 

This content is being provided as an informational tool. It is believed to be accurate at the time of posting and is subject to change. It is recommended that plans consult with their own experts or counsel to review all applicable federal and state legal requirements that may apply to their group health plan. By providing this information, Meritain Health is not exercising discretionary authority or assuming a plan fiduciary role, nor is Meritain Health providing legal advice.