The Employee Retirement Income Security Act (ERISA), the federal legislation governing private retirement, group life, and health care programs, requires program participants to obtain a document called a summary plan description (" SPD "). Although the SPD must be prepared following two Labor Department regulations, it should not be called a "Summary Plan Description." You can learn more about Simplified Healthcare Claims Exchange at CXC Solutions.
What does the summary plan description cover?
SPD is a comprehensive document that educates program participants on how the program works and is managed. Among other elements, the SPD must clearly identify the following elements in easily understandable language:
A description or summary of the benefits.
- Title of program sponsors and administrators
- Financing Mechanism
- Participation and eligibility guidelines
- The process of finding solutions and benefits.
- Benefits award schedule
- Save time and payment processes
- The procedure for submitting claims
A statement of the ERISA rights of participants along with other specialist notices. Questions that participants might have strategies for after studying the SPD could be answered by calling the program administrator.
When should the summary plan description be given?
The welfare and child care of this program is provided by the employer for its administration and highly paid employees who are exempt from the requirements of the SPD. There is no exemption from the SPD requirements for smaller plans that include fewer than 100 participants.