ERISA requires the plan administrator—usually the employer—to provide covered participants and certain beneficiaries with an annual statement summarizing the latest annual report (i.e., Form 5500) for the plan. This statement, known as the summary annual report (SAR), is a narrative summary (as the name says) of the information contained in the plan's Form 5500.

If a plan is not required to file a Form 5500, such as if the small plan exception applies, then there is nothing to summarize. Obvious? Perhaps, but regulatory agencies are not above creating absurd requirements, so sometimes we need to state things that are common sense.
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The DOL regulations for SARs contain an exception for self-insured, unfunded plans—that is, plans for which all benefits are self-insured, funded from employer general assets and haven't put plan funds in the hands of a third party or a trust. This exception applies even if a Form 5500 is required for the plan. Plans with insured benefits are still subject to the requirement to distribute SARs.
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Plans subject to the SAR requirements must distribute SARs annually within nine (9) months of the end of the plan year, or if an extension was obtained for the plan's Form 5500, within two (2) months after the extended due date for the Form 5500.

SARs must be distributed to plan participants, but not beneficiaries. In DOL-speak this means employees but not spouses or children covered under the plan. In addition, SARs must be distributed to COBRA beneficiaries and QMCSO alternate recipients. SARs should be given to spouses or children of deceased employees, if they are still receiving benefits.

Generally, less is more. The more an employer says, the more can be used against it. That said, a little explanation can help reduce employee questions. We recommend just posting the SAR with your other benefits-related notices and sending copies to recipients who would not have access to such posted notices (e.g., COBRA beneficiaries and QMCSO alternate recipients), assuming that can be done in a way that meets the SAR distribution rules. If you feel you need to explain the SAR, you could include something like this in front or before the SAR:

Below [or “Attached,” as the case may be] is a copy of the Summary Annual Report (SAR) for the [PLAN NAME] (the Plan). The report, required by the Employee Retirement Income Security Act of 1974 (ERISA), is a text summary of an annual filing the Plan makes with the US Department of Labor (DOL) called Form 5500. The report includes certain financial and/or insurance information taken from the annual Form 5500 filing, not all of which may be applicable to you. In reviewing the SAR, you will learn about some basic financial information about the Plan and where you can obtain a copy of the plan’s full annual Form 5500, if you desire one.

To make sense of the DOL's SAR content requirements, the first thing to understand is that they are not the employee benefit plan equivalent of annual reports of the sort given to shareholders. They are summaries of the Form 5500. As the regulation states, " The information used to complete the [SAR] shall be based upon information contained in the most recent [Form 5500]."
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For insured benefits, the SAR must state the types of insurance for which the plan has contracts (medical, dental, vision, life, disability, etc.), the name of each insurer, and the total premiums paid for the plan year. Stop-loss insurance would only be a plan benefit if the stop-loss policy is held by the plan itself (which is extremely rare) or the proceeds of the stop-loss policy are payable to the plan rather than the employer (again, very rare). If the insurance contracts are “experience rated,” additional information must be disclosed about premiums and claims under the contract, all of which information comes from the insurer's Schedule A.
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For self-insured benefits, the SAR must simply state the types of benefits plan sponsor is committed to pay (medical, dental, vision, life, disability, etc.).
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If the plan is considered funded for ERISA purposes (such as if premiums or claims are paid from a trust or plan assets that are held separate and apart from the employer), then the SAR must include the value of the plan assets as of the beginning and the end of the plan year; the amount of increase or decrease in net assets; the total income during the plan year, including a breakdown of employer contributions, employee contributions, realized gains or losses from the sale of assets, and earnings from investments; and plan expenses, including a breakdown of administrative expenses, benefits, and other expenses.
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If the plan is unfunded, meaning insurance premiums (in the case of insured benefits) or claims (in the case of self-insured benefits) are paid from general assets of the employer and employee contributions are made through a cafeteria plan, then the SAR need not include this funded plan information.
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The SAR must contain a statement that the recipient has the right to request a copy of the full Form 5500 or any schedule thereto. The SAR must then list any of the items (such as schedules and attachments) in the annual report that are applicable to the plan, such as the accountant's report, financial information and information on payments to service providers, and insurance information including sales commissions paid by insurance carriers. Again, this list is tied to the Form 5500; if the Form 5500 is not required to include the attachment or schedule, then it is not listed in the SAR. The SAR must also include information about how to obtain a copy of the SAR from the US Department of Labor.
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For funded plans, the SAR must also include a statement that the recipient has a right to receive a statement of plan assets and liabilities or a statement of plan income and expenses (or both statements), and that the recipient has a right to examine the annual report at, among other places, the main office of the plan.
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If the plan is subject to the SPD requirement to offer assistance in other languages, then a similar statement in the non-English language must be included.