Does everyone have SPD's for their group health plans? Is this not just a letter form of the insurance booklets that we already give our employees with a few names and address' of contact people? Needless to say, we do not have a SPD. If it is truly necessary and from what I have been reading it is, does anyone have a template that I could go by to write one? To my recollection, I have never been given one by any employer nor have I given one to anyone. I guess the insurance booklet itself can not take the place of the SPD? We do give out new ins. booklets every year. Thanks for any input.


  • 8 Comments sorted by Votes Date Added
  • For some reason, this question comes up regularly. You might do a search. At any rate, what you refer to as your insurance booklet is probably the SPD. The Summary Plan Description must be given to employees along with any amendments that you make during the plan year. Ask your carrier or TPA if the insurance booklet meets the applicable requirements for the SPD.
  • Thanks. From what I have read it would be a case of duplicating the insurance booklet and that didn't make a lot of sense to me. I will check with our TPA and it may be that I can provide a letter giving any infomation not provided in the booklet. Thanks again.
  • Not sure if I should include the following info since it's about a seminar available through a different organization, but thought it might be helpful for KD13. There are strict legal requirements as to what must be included in SPD's and who should receive them. It definitely goes beyond a booklet that has a few names and addresses of contact people. It must describe the plan benefits, identify plan sponsor and administrator, and include specific ERISA info.

    At any rate, if you're interested, EBIA will be holding a seminar that describes all you'll need to know:

    Are You in Compliance? What Employers Need to Know and Do

    An EBIA tele-web seminar
    April 21, 2005
    1:00-2:30 p.m. EDT (12:00 p.m. CDT; 11:00 a.m. MDT; 10:00 a.m. PDT)

    Almost every employee benefits plan is required to have a summary plan
    description (SPD)--a document that tells plan participants their rights
    and obligations in a manner calculated to be understood by the average
    plan participant. The DOL regulations on SPDs fill several pages, and
    many lawsuits have been decided by what was, or was not, in an SPD. But
    many plans, employers, and advisors have difficulty understanding or
    complying with the law's requirements. This 90-minute
    intermediate-level tele-web seminar is designed to translate the legal
    requirements into plain English and to provide practical, hands-on
    advice for anyone who is responsible for drafting, reviewing, or
    revising SPDs.

    Here's some of what we'll cover: How should you go about revising an
    SPD or drafting one from scratch? What, exactly, do the regulations
    require to be in an SPD? How can an SPD be detailed enough to reflect
    plan terms accurately and still be understood by the average plan
    participant? Who's responsible for the SPD? Can an employer rely on a
    TPA to do the job? Does a fully insured plan need an SPD? Is the
    insurer responsible for it? What are the distribution requirements for
    SPDs? Is electronic distribution a realistic option? What happens if a
    plan doesn't have an SPD that meets the law's requirements?

    MORE INFORMATION AND TO REGISTER: For one registration fee ($195), you
    and your co-workers can gather in one office or conference room to
    attend the seminar. A registration form with more information can be
    downloaded at [url]http://www.ebia.com/static/misc/050421teleweb.pdf[/url] .

  • That sounds like information I need very much. I have put a call in to our TPA to see if our booklets, which are pretty thorough, cover enough information to be considered a SPD but have not received a call back today. The booklet does not give the plan number nor names the plan administrator but does tell how to use the plan, what is and is not covered, how to appeal decisions, ERISA rights of the employee and much more. I would at the least have to supply the missing information. Your seminar at $195 is a lot cheaper than a fine for not having a legal SPD would be? Thanks for the info.
  • Our insurance broker prepares our Summary Plan Descriptions. This is a part of the job we contracted for.
  • SPD's from what I have been told are indeed complicated and just the basic letter from the insurance carrier doesn't cut it. I called our insurance carriers and were advised to contact our legal counsel for advice. When I contacted them, they stated that it is a complicated issue that would be outside of what they do for us pro bono. So that tells me it's a biggie! We have yet to pursue it further so if anyone knows any different info I'd be happy to hear of it.
  • It is definitely more than just a summary letter. It has all types of legal stuff that you are required to provide employees... sometimes even once a year.
    Your TPA will provide this for you. I feel sure that the booklet that you reference is your SPD. You must provide that to each employee at least at the time they are eligible and any updates/changes/amendments throughout the year. Yes, you have to copy it or print it.
    Our SPD is actually our Plan Document. So what employees get is the exact same thing that our TPA uses to pay our claims. It is only about 70 pages (and fairly large print.) We also give them a summary sheet for future reference as well. It is really no big thing. (You have the SPD for Life, LTD, and STD policies as well, if you provide these.)
    E Wart
  • So you merely copy your plan document for each insurance? I was told that was not enough!
Sign In or Register to comment.