Summary Plan Description


Integrated Benefit Solutions provides up to date ERISA compliance documents backed by our partner attorneys to give employers protection against Department of Labor violations as they pertain to the Employee Retirement Income Security Act of 1974. All employer sponsored health plans must provide Summary Plan Descriptions to their eligible employees or face penalties that can be far more costly than putting a plan document in place.

Overview

The summary plan description or SPD is an important written document that a plan administrator must provide automatically and free of charge to participants of an ERISA-covered health benefit plan. The SPD provides information on when an employee can begin to participate in the plan, how service and benefits are calculated, when and in what form benefits are paid, and how to file a claim for benefits.

SPDs for Health Plans

The SPD explains what coverage the plan offers, how the plan operates, and the rights and responsibilities of participants and beneficiaries. Among other information, the SPD must describe:

  • Cost-sharing provisions, including premiums, deductibles, coinsurance and copayment amounts for which the participant or beneficiary will be responsible
  • The extent to which preventive services are covered under the plan
  • Whether, and under what circumstances, existing and new drugs are covered under the plan
  • Whether, and under what circumstances, coverage is provided for medical tests, devices and procedures
  • Provisions governing the use of network providers, the composition of provider networks and whether, and under what circumstances, coverage is provided for out-of-network services
  • Provisions requiring per-authorizations or utilization review as a condition to obtaining a benefit or service under the plan

ERISA also requires that SPDs be updated periodically. In addition, ERISA requires disclosure of any material reduction in covered services or benefits to participants and beneficiaries generally within 60 days of the adoption of the change through either a revised SPD or a summary of material modification (SMM). Material changes that do not result in a reduction in covered services or benefits must be disclosed through an SMM or revised SPD not later than 210 days after the end of the plan year in which the change was adopted.

What’s included in our SPD package from Integrated Benefit Solutions

You will receive:

  • Our industry low price; we urge you to shop around and if you find a better price, we will match it
  • 5 years of SMM updates – your document will stay current if your company changes plans
  • Electronic PDF copies of all SPD and SMM related documents
  • A bound hard copy of the Master Wrap Plan document

We have the lowest price for creating summary plan descriptions verses that of our competitors. Please review the sidebar document “Does my business need an SPD” and then use the form on our contact page to order today.