Nearly every employer, regardless of their size, is subject to ERISA if they offer an employer-provided group benefit including health, dental, vision, accidental death & dismemberment, disability, or group term life insurance; medical flexible spending account or health reimbursement account; wellness and employee assistance program; or any other benefit for which the employer contributes to the cost. The only exempt employers are churches and government entities.
A requirement under ERISA is for companies to distribute a written plan document and Summary Plan Description (SPD) to all plan participants – including spouses and COBRA enrollees.
With the Affordable Care Act (ACA), all sponsored health plans will be changing in order to meet certain legal requirements such as providing essential health benefits and following established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts). This means that at the time of your customer’s health plan renewal, they will need an updated SPD.
Many small employers mistakenly think the insurance company or their insurance agent is responsible for providing the Summary Plan Description. However, the employer (plan sponsor) is the one held accountable when the plan is subject to a DOL audit. Your customers will turn to you, their health insurance agent, for an affordable and trustworthy solution.
SBAM takes care of it for you! Every customer you enroll in an SBAM-sponsored BCBSM and BCN plan receives a FREE customized SPD. Please contact Kara Wise at kara.wise@sbam.org for details.