Although they are not commonly ERISA Plans, it is possible for a severance policy to be an ERISA plan. These plans fall under Pension or Health & Welfare. If that is the case, then an SPD is required. Considering the rarity of the situation, we do not include the necessary language to support this; but … Continue reading ARE SEVERANCE PLANS ALSO ERISA PLANS?
Yes, and there are a few ways to do this. This question emphasizes why it is convenient for groups of employers to offer the same benefits to all employees transferring among the different employers. Reason being, it would be a complicated situation if an employer would have to take away a benefit from an employee … Continue reading IS IT POSSIBLE TO USE ONE DOCUMENT FOR A CONTROLLED GROUP OF DIFFERENT EMPLOYERS THAT PROVIDE DIFFERENT BENEFITS?
No, it is not necessary for the dates to coincide. Your plan can be set up to begin any month; the 12 month period will not be affected by the 15 month renewal by the insurer. If a Form 5500 is filed, the insurer will proved Schedule A premium information for the plan year being … Continue reading IS IT NECESSARY FOR MY PLAN YEAR TO BE CONSISTENT WITH THE CARRIER’S POLICY YEAR?
No, if no contributions are required, Section 125 language will not appear in your document.
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 … Continue reading WHAT ARE SOME OF THE MAJOR DIFFERENCES BETWEEN SELF INSURED SPD DOCUMENTS AND A FULLY INSURED SPD DOCUMENT?
There is an option for exceptions in the eligibility section, you can include a sentence for STD that explains who is not eligible (example: New York and New Jersey are not eligible for Short Term Disability described here). If a reason exists for the non-eligible status it would help to include it. When you request … Continue reading CAN WE EXCLUDE CERTAIN GROUPS/CLASSES OF EMPLOYEES FROM SPECIFIC COVERAGE?
The Department of Labor requires SPD’s in order to disclose the source of contributions to the plan. However, it is not required to include the contributions or the specific rates. This would often require annual updates when contributions change. Included in our documents is the source of contributions, we also reference the plans enrollment materials … Continue reading IS IT REQUIRED TO HAVE CONTRIBUTION RATES BE PART OF THE SPD?
You can create an SPD for that benefit only and distribute solely to the eligible/covered employees. If your objective is to have one ERISA Plan, you can include the separate SPD by reference in your Combined SPD/Plan Document. Alternatively, you could create a separate SPD/Plan Document for the separate benefit offered to the specific group … Continue reading IN A SITUATION WHERE WE OFFER A SEPARATE BENEFIT TO A SUBSET OF EMPLOYEES, WHAT HAPPENS?
Here the dental plan is an employee reimbursement program which reimburses a specific amount yearly. This could easily be included as an appendix to the fully insured plan SPD. Since the claims are reimbursed, all claims are considered a post service claim. The appendix could be a 1 or 2 page addition to the fully … Continue reading IF A GROUP EXCEEDS 100 EMPLOYEES FOR THE FIRST TIME AND HAS A FULLY INSURED PLAN, BUT DOES NOT INCLUDE DENTAL; IS A SEPARATE DENTAL SPD REQUIRED?
In 2008, the Department of Labor issued “Field Assistance Bulletin 2008-04” (FAB), which provides the statutory and regulatory requirements for ERISA bonding. FAB defined who is exempt from the bonding requirement: The bonding requirement does not apply to plans that are not subject to Title I of ERISA, for example, governmental plans, church plans, worker’s … Continue reading ARE THERE ANY EXCEPTIONS TO THE BONDING REQUIREMENT?