Generally, the same content is required for fully-insured and self-funded ERISA Plans and an SPD’s. Fully insured plans are issued benefit booklets or certificates of coverage. These booklets describe the coverage being purchased from the carrier and outlines the deductible, coinsurance, exclusions, coverage limitations and more. Eligibility requirements are typically not listed; instead the reader is directed to the employer for more information.
Complete ERISA required language may also not be included in most self-funded arrangements. In most self-funded arrangements, the Sponsor/Employer are the insurance carrier. In fully-insured plans, the named fiduciary and plan administrator are the insurance carriers. The SPD that ERISA Documents Inc. provides, addresses the items that are generally not included in the carrier booklets. Self-funded SPD’s will include all of the necessary and required information including the details of coverage, definitions, limitations, and more.