What Is It?

The Employee Retirement Income Security Act of 1974 (ERISA) requires that plans develop and maintain a document called a summary plan description (SPD). The intent of Congress and the DOL was that the SPD would serve as a plain-language summary of the larger and more technical plan document. Provided it can satisfy the plain-language requirements of ERISA, though, the SPD and plan document can be the same document.

What Employers and Plans Must Provide It?

ERISA's SPD disclosure requirement applies to nearly all employer-sponsored benefits except dependent care assistance accounts, HSA contribution accounts, adoption assistance and properly structured voluntary long-term care insurance.

Who Must Receive the SPD?

DOL regulations require that the SPD be given to "participants covered under the plan." "Participants" for this purpose means enrolled employees, former employees who elected COBRA continuation coverage and spouses and dependents who do not share the same address as the employee or former employee.

When Must the SPD Be Distributed?

ERISA requires that SPDs be distributed to an individual employee within 90 days after that employee first becomes covered. ERISA also requires that SPDs be distributed to all participant-employees once every five years. Some employers, particularly those that do not often change their plans, choose to restate their plans every five years and distribute the SPD at that time. Other employers, particularly those that make frequent changes to their plans, choose not to keep track of an every-fifth-year requirement and distribute SPDs annually, such as at some point during or after open enrollment. 

How May the SPD Be Furnished?

SPDs must be provided in a manner reasonably calculated to ensure delivery to employees entitled to receive it, which is DOL-speak for US Mail, courier, hand delivery or electronic delivery under the DOL's electronic delivery safe harbor rules.

DOL Electronic Delivery Safe Harbor Explained

General Rule

The DOL electronic delivery safe harbor rule splits recipients into two categories: those whose integral job duties include work-related computer access and those whose integral job duties do not include work-related computer access. For employees with work-related computer access as an integral part of their job duties, an employer may distribute documents and notices electronically without obtaining employee consent. For individuals whose integral job duties do not include work-related computer access, an employer must obtain affirmative consent meeting DOL's standards; otherwise, the employer must provide paper copies of documents and notices.

Employees Whose Integral Job Duties Include Work-Related Computer Access

An employer may distribute documents and notices electronically without obtaining employee consent if the employer (or plan administrator, to the extent the employer is not the ERISA plan administrator) complies with the following requirements: 
  • The employee can access documents at any location where he/she is reasonably expected to perform employment duties.
  • The employee's access to the employer's electronic information system is an integral part of his/her employment duties.
  • The employer/plan administrator uses appropriate and necessary means to ensure that the electronic distribution method results in actual receipt of the information.
  • The electronically-delivered documents meet all requirements that are otherwise applicable (such as requirements on content, format and timing).
  • The employer notifies each recipient, at the time the information is distributed electronically, of the availability and significance of the document and of the recipient’s right to request a paper version of the document, and whether an additional charge will apply. (Some welfare benefit notice regulations allow the employer to charge for paper copes, but most prohibit it.)

Employees Whose Integral Job Duties Do Not Include Work-Related Computer Access

An employer may distribute documents and notices electronically to employees whose integral job duties do not include work-related computer access only if the employer/plan administrator complies with the following requirements:
  • The employee affirmatively consents to electronic disclosure before the disclosure is made.
  • The employee consents in a manner that reasonably demonstrates the individual’s ability to access information in the electronic format that will be used, such as by requiring that the employee click on an email link to confirm the employee's consent to electronic notices.
  • The employee provides an email address at which he/she can receive notices or the employee is provided instructions on how to access notices electronically.
  • The employee is provided a statement before electronic delivery of notices begins that describes: the types of documents the employer/plan administrator will provide electronically; that the individual can subsequently withdraw consent at any time; the procedures for withdrawing consent and updating information (for example, changing the email address at which electronic disclosure will be received); that the individual has the right to request a paper version at no charge; and the particular electronic delivery system the employer will use and what hardware and software will be needed to use it.
  • The employer/plan administrator uses appropriate and necessary means to ensure that the electronic distribution method results in actual receipt of the information.
  • The electronically-delivered documents meet all requirements that are otherwise applicable (such as requirements on content, format and timing).
  • The employer notifies each recipient, at the time the information is distributed electronically, of the availability and significance of the document and of the recipient’s right to request a paper version of the document, and whether an additional charge will apply. (Some welfare benefit notice regulations allow the employer to charge for paper copes, but most prohibit it.)
For employees whose integral job duties do not include work-related computer access and who do not affirmatively consent to electronic disclosure as outlined above, the employer/plan administrator must provide paper copies of the documents or notices and generally cannot charge an additional amount to do so. 

What Must the SPD Contain?

All SPDs must contain the following content:
  • Name of the plan (and, if different, the name by which the plan is commonly known by its participants and beneficiaries) 
  • Name and address of the plan sponsor (usually the employer whose employees are covered by the plan)
  • The plan sponsor's EIN assigned by the IRS
  • The plan's ERISA plan number
  • Type of welfare benefit(s) provided (e.g., group health plan, dental, vision, disability plan, prepaid legal service plan, etc.)
  • Type of administration of the plan (e.g., contract third-party administrator, insurer administration, plan sponsor self-administration) 
  • Name, business address, and business telephone number of the “plan administrator” (usually, but not always, the employer-plan sponsor or a benefits committee of the employer)
  • If there is a trust, the name, title, and address of the principal place of business of each trustee of the plan
  • Agent for service of legal process (name and address at which process may be served on such person)
  • Statement that service of legal process may be made on a plan trustee (if any) or the plan administrator
  • If collectively bargained, a statement referring to the collective bargaining agreement and information on how to obtain a copy of that agreement
  • Date of the end of the plan year 
  • Statement of whether the records of the plan are kept on a calendar, policy or fiscal year basis 
  • Description of COBRA continuation coverage, including COBRA-qualifying events (for medical, dental and vision benefits)
  • HIPAA privacy provisions (for medical, dental and vision benefits)
  • Eligibility provisions (employee eligibility such as full-time employee definition, waiting periods and/or actively-at-work provisions, enrollment and open enrollment requirements, special enrollment, and eligibility for spouses, domestic partners, and children) 
  • Description of plan benefits
  • Circumstances causing loss or denial of plan benefits 
  • Procedure for amending the plan 
  • Subrogation (if self-insured)
  • Reimbursement provisions, if any (including recovery of over-paid or accidentally paid benefits)
  • Plan contributions (employer vs. employee), method for allocation plan contributions and funding (insured and unfunded, premiums paid out of general assets, etc.)
  • DOL statement of ERISA rights
  • Claims procedures 
  • Appeal procedures 
  • If applicable, offer of assistance in non-English language(s) (applicable plans covering 100 or more participants, which have the lesser of 10% or 500 or more covered participants literate only in the same language; and plans covering fewer than 100 participants, if 25% or more of the participants are literate only in the same non-English language)
  • If SPD is also the plan document, a statement to that effect

SPDs for non-excepted group health plans (i.e., major medical benefits) must also include the following content:
  • USERRA notice
  • Qualified Medical Child Support Order (QMCSO) provisions, including procedures for determining if a court order is, in fact, a QMCSO 
  • Women's Health and Cancer Rights Act (WHCRA) notice
  • Mothers' and Newborns' Health Protection Act notice
  • HIPAA special enrollment description
  • Cost-sharing provisions (coinsurance, deductibles copayments, etc.)
  • Caps or limits on any benefits
  • Coverage of preventive services
  • Drug coverage provisions, if applicable
  • Network versus non-network provisions
  • Conditions limiting primary care provider or specialty care
  • Preauthorization and/or utilization review provisions
  • If insured, the name and address of the insurer, a description of whether and to what extent benefits are guaranteed under a policy of insurance and the nature of administrative services provided by insurer
  • Mental Health Parity and Addiction Equity Act provisions
  • ACA claims and appeals process enhancements
  • Notice of grandfathered status, if applicable