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So You Have a Plan Doc. Now What?
So You Have a Plan Doc. Now What?

Who needs copies, when and how.

Dana Stoerkel avatar
Written by Dana Stoerkel
Updated over a week ago

Congratulations! You took an important step in your benefits compliance journey, and you invested in a wrap plan document. Now you're wondering what you do with this freshly minted document. Let's break it down.

Who Needs It

New Hires and Other Newly Eligible Folks

The wrap document (which is a combined plan document and summary plan description (SPD)) is supposed to be provided to newly covered employees, along with copies of the underlying benefit booklets or insurance contracts, within 90 days of first becoming covered by one of the benefits under the plan. Most employers don't wait to see who will elect one or more benefits under the plan, so they just provide it to all new hires and to other folks who are newly eligible for benefits (e.g., to folks promoted from part-time to full-time).

Open Enrollment

ERISA also requires that a combo plan-document-and-SPD be distributed to all benefits-eligible employees once every five years. Keeping track of an every-fifth-year requirement is next to impossible, so the best practice recommendation is to provide it annually during open enrollment along with all the other benefits documentation (SBCs, benefits booklets, insurance policies, benefit summaries, etc.). 

If the open enrollment process is how notices and other disclosures are made, keep in mind that COBRA beneficiaries, who are often former employees, may not have the same access to the same resources or portals that active employees have, and special arrangements may need to be made to distribute the wrap doc (and all other notices and disclosures) to COBRA beneficiaries during open enrollment.

Upon Request

A plan document must also be provided upon request by a plan participant (that is, an employee) or beneficiary (a spouse or dependent child) or by a former participant or beneficiary (for example, a COBRA continuation coverage beneficiary). Sometimes a healthcare provider will ask for copies of the plan document. Often the patient intake forms that employees and their dependents sign include language appointing the provider as the person's authorized representative, a special ERISA term that allows the provider to ask for documents and take other actions on behalf of the patient.

How to Provide It

If you can take advantage of the DOL electronic delivery safe harbor—and given the volume of information that must be distributed, it's becoming increasingly harder for employers to not take advantage of it—distribution at open enrollment and during the new hire process is as simple as providing a notice telling employees where to get important documents (e.g., on a company intranet site or third-party enrollment platform).

If for whatever reason you can't take advantage of the DOL electronic delivery safe harbor, then you're left distributing paper copies by first-class mail, hand delivery or overnight courier. 

For more on the DOL electronic delivery safe harbor, click here

Notice to Employees and COBRA Beneficiaries: The Summary of Material Modification

Adopting a wrap doc (along with all of its legal jargon) is arguably a material change in the plan, and ERISA requires that benefits-eligible employees and COBRA beneficiaries be given notice of material changes. That notice can be given in one of two forms: either by providing the wrap doc/SPD itself, or by providing a separate summary of material modifications (SMM). Whether you distribute the wrap doc/SPD itself or a SMM, it must be provided within 210 days after the end of the plan year in which it was adopted. For calendar year plans, that's July 29 of the year following the year of adoption.

You Might Not Need a SMM After All

Most times, there will be an open enrollment period that occurs at some point between adoption of a wrap doc and 210 days after the end of the year in which the wrap doc is adopted. If so, and you can take advantage of the DOL electronic delivery safe harbor, problem solved. Just "distribute" the SPD by providing a notice during open enrollment that tells employees where to get important benefits documents, such as on a company intranet site or third-party enrollment platform. Note that separate arrangements will need to be made for COBRA beneficiaries who are most often former employees and do not have access to employer intranet sites.

For more on the DOL electronic delivery safe harbor, click here

Can't Use the DOL Electronic Delivery Safe Harbor, That's OK.

If you've got an open enrollment period between adoption of the wrap doc and the SMM deadline but you can't use the DOL electronic delivery safe harbor, then you'd just include a short SMM in your open enrollment guide or annual notices packet. We've provided an example below.

No Open Enrollment Between Now and Then? That's OK, Too.

If between adoption of the wrap doc and the SMM deadline you won't have had open enrollment, no worries; just provide a SMM. It doesn't have to be long or complex, and it could be combined with something else you're distributing such as a summary annual report (SAR).  

Here is a simple example of a wrap doc SMM:

"Effective [INSERT EFFECTIVE DATE OF WRAP SPD] the Company adopted a new form of plan document for the [INSERT PLAN NAME], including a new form of summary plan description. The new plan document includes new and different terms that may affect the rights and obligations of employees and their dependents including, but not limited to, powers and duties of the Plan Administrator, subrogation, plan funding, assignment of benefits (including assignments to healthcare providers), tax consequences of participation in the plan and other general terms and conditions. For questions concerning these new terms and conditions, or to obtain a copy of the new plan document or summary plan description, contact [INSERT COMPANY HR CONTACT INFORMATION]."

Happy to Help

If you'd like assistance complying with ERISA's notice and disclosure requirements, we're happy to do so. Just drop us a note or ping us on the in-app messenger.

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