Summary Plan Descriptions: What to Look for in Your Benefits

When dealing with employer-provided benefits, it is easy to get confused about the exact benefits to which you are entitled or for which you are eligible. Employers have an obligation to disclose the various types of benefits they provide and are required by law to make summary plan descriptions. They are also required to provide copies of summary plans to employees on request. The following highlights what to look for in these documents. 

Employer Obligations and Employee Rights in Summary Plans

Summary plan descriptions give employees a clear idea of the benefits offered through their employers. They also provide guidance in determining eligibility requirements and can help you hold your employer accountable in situations where benefits are either denied, delayed, or mismanaged.  The Employee Retirement Income Security Act of 1974 (ERISA) requires a summary plan description for all benefits offered. These include: 

• Employer health and wellness or educational programs;
• Medical, dental, and vision insurance policies;
• Supplemental accident insurance policies;
• Short- and long-term disability;
• Retirement and pension benefits;
• Stock option plans;
• Life insurance policies;
• Severance packages. 

ERISA requires employers to provide copies of summary plans and other important documents free of charge at the employee’s request. Request these documents if you are unsure of your coverage and to protect your rights when filing a claim. 

What is Included in a Summary Plan Description?

The Internal Revenue Service (IRS) advises that a summary plan description, or SPD, must convey in clear language about your benefits, rights, and responsibilities. In addition to the employer’s IRS-assigned number, the employee’s name and address, and the plan administrator’s contact information, it must also include: 

• The name and type of benefit plan;
• Plan eligibility requirements;
• A complete description of benefits offered;
• Who is entitled to be covered by the plan;
• Sources of contributions to the plan and how benefits are managed;
• Provisions regarding the termination of the plan;
• Whether pension benefits are covered by the Pension Benefit Guaranty Corporation;
• Whether the plan is maintained through a collective bargaining agreement;
• Statement of Health Insurance Portability and Accountability Act rights;
• ERISA disclosures and guidance on how employees can file a grievance or an appeal. 

In the event that you file a claim for benefits, and it is denied, your first step in the appeals process should be obtaining a copy of the summary plan description. 

Our Chicago ERISA Attorneys are Here to Help

ERISA helps to protect your rights to employer-provided benefits and in filing appeals. At Bartolic Law, we can guide you through these laws and how they apply in your particular case. To schedule a consultation, call or contact our Chicago ERISA attorneys online today.